Posts Tagged ‘White House’

U.S. Supreme Court Is Likely to Decide On the ACA This Term

Tuesday, October 11th, 2011

As of the first Monday of October, the United States Supreme Court is back in session and likely to make what could be a momentous decision on the Patient Protection and Affordable Care Act (ACA).  The nation’s highest court will consider President Barack Obama’s landmark healthcare overhaul, which impacts almost everyone in the country.  The Obama administration’s request last week that the justices resolve whether or not the healthcare law is constitutional makes it more likely than not that they will deliver their verdict by next June, shortly before the president and his Republican opponent move into the fall general election campaign.

Already, the GOP presidential candidates are taking advantage of virtually every debate and speech to attack Obama’s major domestic accomplishment, which extends health insurance to more than 30 million people who now lack coverage.  If, as expected, the justices agree to review the law’s constitutionality, those deliberations would define the court’s coming term.  Their decision could rank as the court’s most momentous since the December, 2000, ruling that sent George W. Bush to the White House.

According to the Med Page Today website, “The Obama administration petitioned the Supreme Court to decide on the constitutionality of the ACA, making it very likely that the high court will hear at least one of the cases challenging the landmark healthcare reform law before next year’s presidential election.  The U.S. Appeals Court for the 11th Circuit ruled in August that the individual mandate provision of the ACA is unconstitutional.  The Justice Department had until November to ask the Supreme Court to hear the case, but filing its petition sets the stage for oral arguments in the spring, and a final decision in June — at the height of Obama’s re-election campaign.  The 11th Circuit case was filed by 26 states that object to the ACA on a number of fronts, but opposition to the individual mandate is the main thrust of their argument.  The individual mandate, considered the linchpin of the law, requires everyone to have health insurance by 2014.  In its petition, lawyers for the Obama administration said the appeals court decision is ‘fundamentally flawed.’”

Supreme Court analysts say it is difficult to predict how the court would rule on the conservative challenge to the health care law.  Miguel Estrada argued several cases before the Supreme Court as an official with the Justice Department in the 1990s.  “The issues are really hard. Every time you ask the Supreme Court to overturn an act of Congress, it is a very difficult thing for the court to do. And Congress comes to the Supreme Court with a presumption of deference (to Congress) and constitutionality,” said Estrada.

Writing on the Big Think website, Robert de Neufville writes that “The administration’s decision strongly suggests that it will ask the Supreme Court to hear the case, since it doesn’t want the 11th Circuit’s decision to stand.  That puts the Supreme Court in the difficult position of having to rule on a politically charged piece of legislation during an election year.  Rick Hasen (of the Election Law Blog) that a Supreme Court decision is win-win for Obama: either the court affirms the constitutionality of the law or it seems to overreach by overturning it.  By the same token, ruling on the law may be a lose-lose proposition from the perspective of the court.  Whatever the court decides it will seem to be taking sides in a political struggle.  As Slate’s Dahlia Lithwick says,  there may not be five justices who want to want to make the court itself an election-year issue.  Lithwick says that “I don’t think Chief Justice John Roberts wants to borrow that kind of partisan trouble again so soon after Citizens United, the campaign-finance case that turned into an Obama talking point.  And I am not certain that the short-term gain of striking down some or part of the ACA (embarrassing President Obama even to the point of affecting the election) is the kind of judicial end-game this court really cares about.  Certainly there are one or two justices who might see striking down the ACA as a historic blow for freedom.  But the long game at the court is measured in decades of slow doctrinal progress — as witnessed in the fight over handguns and the Second Amendment — and not in reviving the stalled federalism revolution just to score a point.” 

The editors of Bloomberg Business Week fear the collateral damage that overturning the ACA might cause.  They note that “Should the Supreme Court take up healthcare reform this year?  So far, only one appeals court has ruled that the ‘individual mandate’ in ObamaCare — the requirement that virtually everybody must buy insurance, with government assistance if needed — overreaches the federal government’s powers under the commerce clause of the Constitution.  It’s not a trivial argument.  But an affirmative ruling would be a huge departure from our understanding of the commerce clause going back to the New Deal.  If the healthcare law’s individual mandate is unconstitutional, so is much of what the government has been doing for 80 years or so, and it will be the duty of the Supreme Court to sort through the ruins of the federal government as we know it and find a few shards to start building again.  We can’t help but suspect that the court will choose to avoid this opportunity, by not taking the case, by finding some other grounds for ruling, or by upholding ObamaCare.

“Ever since it passed in 2010, ObamaCare has been attacked as a costly and possibly unconstitutional intrusion of the federal government into people’s lives.  Almost the central issue in the campaign for the Republican presidential nomination has been the resemblance between ObamaCare and the state healthcare plan enacted in Massachusetts under then-Governor Mitt Romney.  Today, most Democrats feel the less said the better.  But if the new law loses in the Supreme Court, the political ramifications may look very different.  If the Supreme Court kills healthcare reform, it will stay dead a long time.  It took 17 years before anybody felt like scaling that mountain again after Hillary Clinton’s failure two administrations ago.”

Senate Republicans Refusing to Confirm Dr. Donald Berwick

Monday, March 14th, 2011

Senate Republicans are trying to block the nomination of Harvard-educated pediatrician Dr. Donald Berwick to serve a full term as the administrator of the Centers for Medicare and Medicaid Services.  Led by Senators Orrin Hatch (R-UT), the ranking member of the Senate Finance Committee, and Mike Enzi (R-WY), the ranking member of the Senate Health, Education, Labor and Pensions Committee, the senators contend that President Barack Obama’s recess appointment last year was completed before a hearing was held.  The senators contend that this hindered the 111th Congress’ ability to fully consider Berwick’s nomination.

“This abrupt and unilateral action meant that no senator — Democrat or Republican — was given the opportunity to ask Dr. Berwick a single question before he was placed in charge of an agency with a budget larger than the Department of Defense; which controls four percent of our nation’s gross domestic product; and, most importantly, directly impacts more than 100 million American lives every single day,” according to the Senators’ letter.  The senators say that Berwick’s “past record of controversial statements, and general lack of experience managing an organization as large as complex as CMS should disqualify him” from the post.  “Once you have withdrawn his nomination, we are confident we can all work together to find a nominee for administrator we can support and confirm after appropriate hearings are held,” the letter stated.

Even some Congressional Democrats are urging the Obama administration to find another Medicare chief after concluding that the Senate is unlikely to confirm Dr. Berwick. The most-favored nominee is Dr. Berwick’s principal deputy, Marilyn B. Tavenner, a nurse and former Virginia secretary of health and human resources who has extensive management experience and would likely be confirmed.  President Obama bypassed Congress and named Dr. Berwick to his post while the Senate was in recess last summer.  The current appointment allows him to serve to the end of 2011.

Despite the vocal opposition to Dr. Berwick, President Obama is refusing to withdraw his nomination. “The president nominated Don Berwick because he’s far and away the best person for the job, and he’s already doing stellar work at CMS: saving taxpayer dollars by cracking down on fraud, and implementing delivery system reforms that will save billions in excess costs and save millions of lives,” White House spokesman Reid Cherlin said.  Unfortunately for the president, even some Senate Democrats believe that Berwick cannot be confirmed.  Senate Finance Committee Chairman Max Baucus (D-MT) has said that he would not commit to a confirmation hearing, and other Democrats have acknowledged that the nomination is in trouble.  “I think it would be very tough in this environment.  If we can get some bipartisan products moving forward, then the answer is yes. If you can’t get some bipartisan products moving forward, it’s going to be difficult,” said Senator Ben Cardin, (D-MD).

The Medicare administrator’s job involved significant responsibilities under the healthcare law, such as establishing new insurance markets, expanding Medicaid, and overhauling the way Medicare pays providers to reward quality instead of volume. Republicans need 41 votes to block Berwick’s confirmation in the full Senate; their letter indicates they have more than enough.  The loss of Berwick, a respected medical innovator and patient advocate, would be a blow to the administration as it moves ahead in its implementation of the healthcare reform law.

Five Republican senators did not sign Hatch’s letter.  They are Scott Brown (R-MA), Susan Collins (R-ME),  Olympia Snowe (R-ME), Lisa Murkowski (R-AK), and Rob Portman (R-OH).

Republicans “A Pledge to America” Vows to Repeal the Affordable Care Act

Sunday, October 3rd, 2010

House Republicans want to repeal the Affordable Care Act.Republicans are threatening to repeal the Patient Protection and Affordable Care Act as part of their “A Pledge to America” proposal.  On the six-month anniversary of healthcare reform’s enactment, House Republicans issued their “Pledge” , which proposes overturning the law and replacing it with “real reforms” focusing on medical liability reforms to control “junk lawsuits” and defensive medicine.  Other elements of the “Pledge” would expand health saving accounts; ban taxpayer funding of abortion; allow people to buy insurance across state lines; assure access for patients with pre-existing conditions by expanding state high-risk pools and reinsurance programs; as well as cutting the cost of coverage.

According to Stephanie Cutter, assistant to the president for special projects, “The (Republicans’) agenda claims to protect people with pre-existing conditions, but it repeals the new law’s ban on discriminating against uninsured Americans, including children who have a pre-existing condition.  It will mean that seniors will pay more for their prescription drugs, and their new free preventive Medicare benefits will be cut.”

Ron Pollack, executive director of Families USA, noted that the GOP proposal “will raise taxes by more than $40 billion on up to four million small businesses that provide health benefits to their employees…and will result in premium increases by eliminating the billions of dollars in cost-saving measures.”

Democratic lawmakers assailed the “Pledge” as recycled ideas that will only intensify the nation’s problems.  “Republicans want to return to the same failed economic policies that hurt millions of Americans and threatened our economy,” said Nadeam Elshami, a spokesman for Speaker of the House Nancy Pelosi (D-CA).  Even if Republicans vote to repeal the Affordable Care Act, President Barack Obama still has the power to veto their legislation.  It’s likely that he would use his veto power to protect one of his major legislative achievements.

New White House Initiative Boosts Patient Security in Cyberspace

Thursday, July 22nd, 2010

The National Strategy for Trusted Entities in Cyberspace will protect patient’s electronic medical records.  The White House – in partnership with public- and private-sector organizations – has created a new program intended to enhance security and halt identity theft in cyberspace, especially physician-patient relationships.  The plan, called the National Strategy for Trusted Entities in Cyberspace, is designed to address issues such as personal health information safety. It relies primarily on creating an identity ecosystem, an online environment that would eliminate the need for multiple passwords and logins.  Rather, it would give people the opportunity to access a secure, interoperable credential for authentication.

As medical records increasingly are stored online, the initiative lets people and organizations “complete online transactions with confidence, trusting the identities of each other,” according to Howard Schmidt, national cybersecurity coordinator.  In a demonstration, a woman requested a smart identity card which she used to authenticate obtaining her electronic health records.  Although participation is voluntary, the government plans to adopt the identity ecosystem as soon as possible.  At that point, the government will identify and facilitate a pilot program in the healthcare sector.

Got Healthcare Reform Questions? Click These Links for Answers

Monday, April 26th, 2010

Click these links to learn more about healthcare reform.  Confused about what healthcare reform means to you?  Following is a handy guide to links that clarify the new rules and have timelines detailing when the various elements will kick in.

The Kaiser Family Foundation summarizes what healthcare reform means under Its “New & Noteworthy” section.  Click on the “summary of the law” for an outline and on the “timeline”.

Families USA, a non-profit advocate for healthcare consumers has a “Health Reform Central” that provides a full rundown of the changes.

This website has a “Health Care Reform” button that links to an easy-to-read timeline.  Be aware that the site belongs to an insurance broker.

This is the Obama administration’s explanation of how healthcare reform will work.

Consumer Reports presents useful information at the “Health-care reform” button towards the bottom of the home page.

Although this website is used primarily by house buyers looking for low mortgage rates, it presents a good summary of healthcare costs.  Type “reform” into the search box, then click on the “What’s in it for you” button.

The March’s website summarizes important new provisions impacting women and children.  Access it by clicking on “In the news.”

The Medicare Rights Center reviews important new provisions impacting senior citizens.  Click on the box that says “learn more about health reform and Medicare.”

The Department of Health and Human services is planning to launch a website on healthcare reform that will include links to insurance options that it considers to be affordable on a state-by-state basis.

Healthcare Industry Offers Cost Savings

Thursday, July 16th, 2009

Healthcare providers will slash up to $1.7 trillion in costs over the next 10 years by enhancing the care of chronic diseases, reorganizing administrative procedures and eliminating unnecessary treatments.medical_bill

This is a sneak peak at how healthcare systems, physicians, pharmaceutical companies, insurers, medical device manufacturers and other stakeholders plan to respond to President Barack Obama’s request that the industry find ways to control patient costs.  Among the American Medical Association’s (AMA) suggestions are cutting overused – and often unnecessary — procedures, such as Caesarean sections.  The savings are crucial to funding the Obama administration’s proposed health system overhaul.

A new White House study states that reforming healthcare will increase the nation’s GDP by two percent in 2020 and eight percent in 2030, cut unemployment and save families an average of $2,600 a year by 2020.  Without healthcare reform, the number of uninsured Americans will rise to 72 million by 2040, compared with 46 million today.

Christina Romer, chair of the president’s Council of Economic Advisers, said “The one thing that’s happened relative to the 1990s is the nightmare scenario is getting closer.”  Other recommendations include reducing medical errors, using common insurance forms, improving physician performance standards, readmitting fewer patients to hospitals, improving drug development efficiency and expanding in-home care for patients with long-term illnesses.

Healthcare Industry Plan Mandates Welcome Cost Reductions

Monday, May 18th, 2009

Barack Obama may get his way on healthcare reform with the full cooperation of those who vocally lobbied against it during the 1990s.  The timing couldn’t be better — healthcare costs total $2.4 trillion annually (an average of $7,868 per person) and are projected to rise to $4 trillion by 2016.health-care-reform-more-critical-than-ever_large

In a reversal, hospitals, pharmaceutical companies, physicians and other industry leaders presented a plan to the White House proposing to save $2 trillion in healthcare delivery costs over the next 10 years.  Participants included the American Medical Association, the American Hospital Association, the Advanced Medical Technology Association, America’s Health Insurance Plans and the Service Employees International Union — which master-minded the bold move.  Although healthcare costs will continue to rise, this plan will slow the pace.

“We cannot continue down the same dangerous road we’ve been traveling for so many years, with costs that are out of control, because reform is not a luxury that can be postponed, but a necessity that cannot wait,” Obama said.

Obama’s proposed plan is based on the existing system, where employers, the government and individuals share responsibility for paying for privately delivered healthcare.  The government will subsidize coverage for additional people and mandate stricter consumer protection.

It’s evident that the healthcare industry has seen the writing on the wall.  Their willingness to work with the Obama Administration and Congress – compared with the fierce opposition to Bill Clinton’s healthcare reform efforts 15 years ago – is a turnaround that should translate to real change.

Democrats May Use “Nuclear Option” to Pass Healthcare Reform

Tuesday, May 12th, 2009

The Obama administration is playing hardball to force Congress to pass healthcare reform legislation before the end of the year – preferably without the customary Republican-led filibuster delaying the final vote. obamahealthcare President Obama’s aggressive approach to protect healthcare legislation from Republican filibusters demonstrates the magnitude this ambitious reform package and has come to be called in some circles the nuclear option.

The agreement between the White House and Congressional Democrats lets healthcare legislation that meets budget targets win approval by a simple Senate majority — a process called reconciliation.  Not surprisingly, Republican leaders are up in arms about the no-filibuster deal, claiming that healthcare is too important to be exempt from the Senate’s usual rules.

Republicans have threatened to use their own procedural weapons to bog down the Senate if the Democrats try to restrict filibusters.  Options include forcing multiple votes on routine bills, inaction on administration nominations, or requiring lengthy legislation to be read in full.  Even some Democrats – notably Kent Conrad of North Dakota and Max Baucus of Montana – are uncomfortable with reconciliation.  Other Democrats point out that Senate Republicans successfully used reconciliation to enact President George W. Bush’s tax cuts in 2001 and 2003.

The president is relying on his significant political capital to push his agenda through, relying on unwavering support from his sizable Senate Democratic majority.  This is likely to total 60 Senators once the Minnesota courts finally certify Al Franken’s victory, and as a result of Arlen Specter’s surprise exit from the Republican Party. That could give President Obama the filibuster-proof majority he wants.