Topics This Week:
- Bills proposed in the House and Senate to Increase the Number of Residency Slots
- Public Misunderstandings Concerning the Affordable Care Act (ACA).
- States Being Urged to Expand Medicaid Through Private Insurance Subsidies
- Impacts on Health Care in Proposed House and Senate Budgets
- Health Policy 101: How Is a Federal Budget Created and Passed?
1. Bills proposed in the House and Senate to Increase the Number of Residency Slots
On March 14 (the day before Match Day), bills were proposed in the House and Senate to increase the number of residency positions in the U.S. The “Training Tommorow’s Doctors Today Act” (H.R. 1201) and the “Resident Physician Shortage Act of 2013” (S. 577) would increase the number of Medicare-supported residency positions by 15,000 over the next five years. The bills would prioritize the distribution of these positions to:
- Community/outpatient settings
- States with new medical schools/campuses
- Eligibility of hospitals/programs for electronic health record incentive payments.
AAMC President and CEO Darrel G. Kirch, M.D. commended the sponsors of these bills for “the leadership and long-term vision these lawmakers have shown in reintroducing this measure.” The sponsors of these bills are Reps. Aaron Schock (R-Ill.) and Allyson Schwartz (D-Pa.) and Sens. Bill Nelson (D-Fla.), Charles Schumer (D-N.Y.), and Majority Leader Harry Reid.
Source:
https://www.aamc.org/advocacy/washhigh/highlights2013/331020/031513aamcapplaudsthereintroductionofhouseandsenategmebills.html
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2. Public Misunderstandings Concerning the Affordable Care Act (ACA)
A nationwide poll conducted this month found that widespread confusion exists about the provisions in the ACA. For example, two-thirds of the uninsured, as well as two-thirds of people with incomes less than $40,000 (two of the key groups that the ACA seeks to assist) indicate that they do not understand how the ACA will impact them. Additionally, public awareness of the key elements of the law is declining. For example, almost half of those surveyed were unaware that the law would extend health insurance subsidy assistance to individuals, that the law would extend Medicaid coverage, and that health insurance exchanges will be established. A majority of Americans surveyed mistakenly believe that the ACA will cut benefits for Medicare recipients, establish end-of-care “death panels,” allow undocumented immigrants to receive subsidies to purchase insurance, and allow for a public option (none of these provisions are included in the ACA).
Source:
http://www.kff.org/kaiserpolls/upload/8425-F.pdf
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3. States Being Urged to Expand Medicaid Through Private Insurance Subsidies
The original ACA, passed in 2010, required states to expand Medicaid to 138 percent of the federal poverty level. Then, last June, the Supreme Court ruled that the Medicaid expansion was optional. Since the Supreme Court ruling, there has been vigorous debate among the states as to whether or not they will choose to participate in the Medicaid expansion. The federal government will pay for 100% of the expansion from 2014 to 2016, and then their participation will decrease gradually to 90% in 2020. The Obama administration had begun to encourage states who are on the fence to consider using the federal dollars to offset/cover the cost of private insurance for new Medicaid beneficiaries. This option is likely to be more expensive, but may be better received by states and providers who may favor the general increased reimbursement of private payers compared to public payers.
Sources:
http://www.nytimes.com/2013/03/22/us/politics/states-urged-to-expand-medicaid-with-private-insurance.html?pagewanted=1&ref=health
To where your state stands in medicaid expansion under the ACA, go to the link below:
http://dl.ebmcdn.net/~advisoryboard/infographics/Where-the-States-Stand63/story.html
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4. Impacts on Health Care in Proposed House and Senate Budgets
The House and Senate have both passed budget proposals this month. Here is a brief overview of how each of them would impact health care dollars:
House:
- Retains the ACAs $700 billion cut to Medicare spending to offset the cost associated with health insurance coverage expansion for Americans under the age of 65.
- Converts Medicaid program into block grants to states, with $756 billion in cuts from Medicaid and other health programs over the next 10 years.
- Eliminates the $129 billion proposed under the ACA to close the Medicare Part D “donut hole.”
- Total cuts to health care equal to $2.6 trillion over the next 10 years (compared to outlays provided for under the ACA).
Senate:
- Proposed $275 billion dollar cut to Medicare and Medicaid over the next 10 years, part of which ($138 billion) would be used to maintain the reimbursement fees for physicians. This avoids the 26.5% cut which would be imposed
under the Sustainable Growth Rate formula.
- Maintains all other provisions provided in the ACA.
For further discussion on how the ideology behind these plans as well as the economic theory from which they stem, see the link below:
http://healthaffairs.org/blog/2013/03/21/reflections-on-the-federal-budget-resolutions
----------
5. Health Policy 101: How Is a Federal Budget Created and Passed?
The Budget and Accounting Act of 1921 requires that the President submit a budget to Congress each year. This is typically done between the first Monday in January and the first Monday in February (however, the President has not submitted his budget yet this year). After the budget is submitted, the Congressional Budget Office publishes an analysis of the budget, which typically comes out about a month later. The House and Senate then undergo consideration of the President’s budget proposals. Typically, the House and Senate each pass a budget proposal by April 1, and a final budget, with amendments, is passed (typically) by April 15. The appropriations process (how to hand out the money within specific departments/programs) begins after May 15, and both the House and Senate eventually pass an appropriations bill. After these are passed, a committee meets to work out the differences between the two bills, and when that is completed, a final bill is sent to the President for final approval. The budget goes into effect from October 1 of that year until September 30 of the following year (this is the fiscal year). If the budget isn’t finalized by October 1, Congress will often pass a continuing resolution to fund the government for a short period of time, during which, it is hoped that the budget will be finalized. If a continuing resolution is not passed, then the government is not funded, and all non-essential departments close until a budget is passed.
Sources:
http://www.budget.senate.gov
http://www.cbo.gov/about/overview
http://nationalpriorities.org/budget-basics/federal-budget-101/federal-budget-process/
http://en.wikipedia.org/wiki/United_States_budget_process
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
Alexandra Printz – National Delegate
----------------------------------------------------------------------------
To access previous updates see our blog at:
https://www.aamc.org/members/osr/communications/legislative_affairs/
For more Health Care Policy news go to:
https://www.aamc.org/members/osr/communications/legislative_affairs/49198/legislative_affairs_resources.html
On March 14 (the day before Match Day), bills were proposed in the House and Senate to increase the number of residency positions in the U.S. The “Training Tommorow’s Doctors Today Act” (H.R. 1201) and the “Resident Physician Shortage Act of 2013” (S. 577) would increase the number of Medicare-supported residency positions by 15,000 over the next five years. The bills would prioritize the distribution of these positions to:
- Community/outpatient settings
- States with new medical schools/campuses
- Eligibility of hospitals/programs for electronic health record incentive payments.
AAMC President and CEO Darrel G. Kirch, M.D. commended the sponsors of these bills for “the leadership and long-term vision these lawmakers have shown in reintroducing this measure.” The sponsors of these bills are Reps. Aaron Schock (R-Ill.) and Allyson Schwartz (D-Pa.) and Sens. Bill Nelson (D-Fla.), Charles Schumer (D-N.Y.), and Majority Leader Harry Reid.
Source:
https://www.aamc.org/advocacy/washhigh/highlights2013/331020/031513aamcapplaudsthereintroductionofhouseandsenategmebills.html
----------
2. Public Misunderstandings Concerning the Affordable Care Act (ACA)
A nationwide poll conducted this month found that widespread confusion exists about the provisions in the ACA. For example, two-thirds of the uninsured, as well as two-thirds of people with incomes less than $40,000 (two of the key groups that the ACA seeks to assist) indicate that they do not understand how the ACA will impact them. Additionally, public awareness of the key elements of the law is declining. For example, almost half of those surveyed were unaware that the law would extend health insurance subsidy assistance to individuals, that the law would extend Medicaid coverage, and that health insurance exchanges will be established. A majority of Americans surveyed mistakenly believe that the ACA will cut benefits for Medicare recipients, establish end-of-care “death panels,” allow undocumented immigrants to receive subsidies to purchase insurance, and allow for a public option (none of these provisions are included in the ACA).
Source:
http://www.kff.org/kaiserpolls/upload/8425-F.pdf
----------
3. States Being Urged to Expand Medicaid Through Private Insurance Subsidies
The original ACA, passed in 2010, required states to expand Medicaid to 138 percent of the federal poverty level. Then, last June, the Supreme Court ruled that the Medicaid expansion was optional. Since the Supreme Court ruling, there has been vigorous debate among the states as to whether or not they will choose to participate in the Medicaid expansion. The federal government will pay for 100% of the expansion from 2014 to 2016, and then their participation will decrease gradually to 90% in 2020. The Obama administration had begun to encourage states who are on the fence to consider using the federal dollars to offset/cover the cost of private insurance for new Medicaid beneficiaries. This option is likely to be more expensive, but may be better received by states and providers who may favor the general increased reimbursement of private payers compared to public payers.
Sources:
http://www.nytimes.com/2013/03/22/us/politics/states-urged-to-expand-medicaid-with-private-insurance.html?pagewanted=1&ref=health
To where your state stands in medicaid expansion under the ACA, go to the link below:
http://dl.ebmcdn.net/~advisoryboard/infographics/Where-the-States-Stand63/story.html
----------
4. Impacts on Health Care in Proposed House and Senate Budgets
The House and Senate have both passed budget proposals this month. Here is a brief overview of how each of them would impact health care dollars:
House:
- Retains the ACAs $700 billion cut to Medicare spending to offset the cost associated with health insurance coverage expansion for Americans under the age of 65.
- Converts Medicaid program into block grants to states, with $756 billion in cuts from Medicaid and other health programs over the next 10 years.
- Eliminates the $129 billion proposed under the ACA to close the Medicare Part D “donut hole.”
- Total cuts to health care equal to $2.6 trillion over the next 10 years (compared to outlays provided for under the ACA).
Senate:
- Proposed $275 billion dollar cut to Medicare and Medicaid over the next 10 years, part of which ($138 billion) would be used to maintain the reimbursement fees for physicians. This avoids the 26.5% cut which would be imposed
under the Sustainable Growth Rate formula.
- Maintains all other provisions provided in the ACA.
For further discussion on how the ideology behind these plans as well as the economic theory from which they stem, see the link below:
http://healthaffairs.org/blog/2013/03/21/reflections-on-the-federal-budget-resolutions
----------
5. Health Policy 101: How Is a Federal Budget Created and Passed?
The Budget and Accounting Act of 1921 requires that the President submit a budget to Congress each year. This is typically done between the first Monday in January and the first Monday in February (however, the President has not submitted his budget yet this year). After the budget is submitted, the Congressional Budget Office publishes an analysis of the budget, which typically comes out about a month later. The House and Senate then undergo consideration of the President’s budget proposals. Typically, the House and Senate each pass a budget proposal by April 1, and a final budget, with amendments, is passed (typically) by April 15. The appropriations process (how to hand out the money within specific departments/programs) begins after May 15, and both the House and Senate eventually pass an appropriations bill. After these are passed, a committee meets to work out the differences between the two bills, and when that is completed, a final bill is sent to the President for final approval. The budget goes into effect from October 1 of that year until September 30 of the following year (this is the fiscal year). If the budget isn’t finalized by October 1, Congress will often pass a continuing resolution to fund the government for a short period of time, during which, it is hoped that the budget will be finalized. If a continuing resolution is not passed, then the government is not funded, and all non-essential departments close until a budget is passed.
Sources:
http://www.budget.senate.gov
http://www.cbo.gov/about/overview
http://nationalpriorities.org/budget-basics/federal-budget-101/federal-budget-process/
http://en.wikipedia.org/wiki/United_States_budget_process
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
Alexandra Printz – National Delegate
----------------------------------------------------------------------------
To access previous updates see our blog at:
https://www.aamc.org/members/osr/communications/legislative_affairs/
For more Health Care Policy news go to:
https://www.aamc.org/members/osr/communications/legislative_affairs/49198/legislative_affairs_resources.html