“The Patient Protection and Affordable Care Act (PPACA) creates federal ‘accountable care organizations’ (ACOs). In theory, ACOs provide financial incentives to health care organizations to reduce costs and improve quality. In reality, given the complexity of the existing system, ACOs will not only fail; they will most likely exacerbate the very problems they set out to fix. ACOs will concentrate more and more power in fewer and fewer organizations, allowing them to become ‘too large to fail.’ Such a system undermines competition and entrepreneurship—the bedrock of innovation and job growth in this country.”
“Mr. Obama wants to expand the power of the 15-member panel, which was created by the new health care law, to rein in Medicare costs.
But not only do Republicans and some Democrats oppose increasing the power of the board, they also want to eliminate it altogether. Opponents fear that the panel, known as the Independent Payment Advisory Board, would usurp Congressional spending power over one of the government’s most important and expensive social programs.”
“Messrs. Ryan and Obama agree that Medicare spending must decline, and significantly. The difference is that Mr. Ryan would let seniors decide which private Medicare-financed insurance policies to buy based on their own needs, while Mr. Obama wants Americans to accept the commands of 15 political appointees who will never stand for election.”
“The ACA presents New York policymakers with a unique opportunity to reform its individual and small-group insurance markets. However, creating an effective market-based exchange requires policymakers to recognize that simply imposing its current high-cost insurance arrangements on the exchange may lead to the collapse of the exchange over time. Instead, reforms should build on the lessons learned from state exchanges in Utah and Massachusetts, federal programs such as Medicare Part D, and private exchanges such as New York’s HealthPass.”
“It’s not often that states turn their back on money from Washington, but at least two states may say no thanks to federal grants to implement the new federal health-care law.
In February the federal Department of Health and Human Services selected seven states to get $240 million in demonstration grants this year to kick start the health-care plan. But Oklahoma Governor Mary Fallin announced last week that the Sooner State will decline $54.6 million from the feds to establish new insurance exchanges.”
“The fact of the matter is that IPAB won’t make the notoriously inefficient Medicare program any more efficient. Through arbitrary reductions on payments to providers, it will simply reduce the supply of care. Even before the advent of a new, more powerful IPAB and a new, tougher limit on spending, Medicare’s chief actuary warned that ObamaCare will drive providers out of the program. If you love Medicaid, you’ll adore the new IPAB version of Medicare.”
“President Barack Obama signed a bill repealing a tax-compliance mandate in last year’s health- care law, giving a victory to business groups that led a campaign against the requirement.
The repealed provision, under which companies would have had to report more transactions to the Internal Revenue Service, was included in the law as a revenue-raising measure. It was to have taken effect in 2012.”
“It’s rare for the Supreme Court to expedite cases because justices generally prefer to have the benefit of looking at the decisions of the appeals’ courts as well as letting the arguments mature as they move up the judicial ladder. But in this case, the uncertainty regarding the constitutionality of the health care law is causing problems for governors who have to decide whether to start implementing aspects of the law. If they proceed with implementation and it’s ruled unconstitutional, all that money will be wasted.”
“The House on Wednesday voted to terminate another piece of last year’s healthcare law — the Prevention and Public Health Fund, which is currently scheduled to receive nearly $18 billion over the next few years.”
“The Department of Health and Human Services has released draft rule that governs Accountable Care Organizations. ACOs are groupings of health care providers who join together under specific rules in order to create shared savings. The idea is to bundle a single payment for a patient so that providers do not have incentives to prescribe additional services that generate additional fees. This sounds like a relatively simple concept, and it is worth exploring different ideas for needed payment reform. But the truth is, changing payment systems is far from simple. The devil is in the details about the ‘specific rules’ that define an ACO’s structure.”