Customized Briefing for Kimberly Barry-Curley
February 1, 2011
From NAHU
Public Health and Private Healthcare Systems
Leading the News
Also in the News
Legislation and Policy
Leading the News
Federal Judge Declares Healthcare Law Unconstitutional.
Media reports are casting the latest court ruling on the 2010 healthcare reform law as a setback for the
Administration, although analysts agree the matter will ultimately be settled by the Supreme Court.
Meanwhile, only two of the network news broadcasts ran very brief reports on the ruling last night.
NBC Nightly News (1/31, story 8, 0:20, Williams) reported, "A Federal judge in Florida ruled today
that President Obama's health care reform law is unconstitutional. The judge sided with 26 states which
had sued to overturn the law, arguing the Federal government cannot force people to buy health
insurance." The CBS Evening News (1/31, story 7, 0:30, Smith) said that "on the legal battle
over...Obama's health care reform law, the score is now 2-2. ... A judge in Virginia issued a similar
ruling in December, but two other courts have upheld the insurance mandate. It seems quite certain this
issue will have to be resolved by the Supreme Court."
The AP (2/1, Nelson, Alonso-Zaldivar) refers to a "major legal setback" for the Administration, and
reports that DOJ "quickly announced it would appeal." Meanwhile, "administration officials declared that
for now the federal government and the states would proceed without interruption to carry out the law. It
seemed evident that only the US Supreme Court could deliver a final verdict."
US District Judge Roger Vinson, the Los Angeles Times (2/1, Levey, Savage) reports, is "an
appointee of President Reagan," and he "signaled for months that he would back the challenge to the
law filed by Florida's Republican attorney general and joined by 25 other states." The Times notes that
"other federal judges in Michigan and Florida -- both appointed by President Clinton -- have concluded
that Congress had the authority to require Americans to get health insurance." Politico (2/1, Haberkorn)
notes that "underscoring the political subtext of the legal debate," all judges have so far "ruled along
partisan lines."
At the Supreme Court, writes William McGurn of the Wall Street Journal (2/1, A17, subscription
required), the law's fate may be decided by the decision of Justice Anthony Kennedy, a key swing vote.
USA Today (2/1, Kennedy, Biskupic) notes that while Vinson "ruled the entire law
unconstitutional...he declined to block the law while administration officials appeal the decision." USA
adds that "Vinson went further than the earlier decision against the law -- in December from Richmondbased US District Court Judge Henry Hudson -- by declaring that the invalidated individual-mandate
provision could not be separated from the rest of the health-care overhaul and doomed it entirely."
The Christian Science Monitor (2/1, Richey) notes that Vinson ruled that "under the [Constitution's]
commerce clause, as interpreted by the Supreme Court, Congress is empowered to regulate economic
activity, but not inactivity." Vinson wrote, "If [Congress] has the power to compel an otherwise passive
individual into a commercial transaction with a third party...it is not hyperbolizing to suggest that
Congress could do almost anything it wanted." The Hill (2/1, Millman) "Healthwatch" blog reports that
Vinson also ruled that "the whole law cannot stand because the law depends on the mandate to work,"
declaring, "I must conclude that the individual mandate and the remaining provisions are all inextricably
bound together in purpose and must stand or fall as a single unit."
Politico (2/1, Haberkorn) reports, "In his ruling, Vinson quoted James Madison and put his
judgment in a broader context." Said Vinson, "I emphasized once before, but it bears repeating again:
this case is not about whether the Act is wise or unwise legislation, or whether it will solve or exacerbate
the myriad problems in our health care system. ... In fact, it is not really about our health care system at
all. It is principally about our federalist system, and it raises very important issues regarding the
Constitutional role of the federal government."
The New York Times (2/1, A1, Sack) reports on its front page, "On Capitol Hill, Republicans sent
out a stream of e-mails praising the ruling, while Senator Richard J. Durbin, Democrat of Illinois, said he
would convene a Judiciary Committee hearing on Wednesday to examine the constitutionality of the
law." The Times goes on to note that "in a silver lining for the Obama administration...Vinson rejected a
second claim that the new law violated state sovereignty by requiring states to pay for a fractional share
of the planned Medicaid expansion." Nonetheless, reports the Washington Post (2/1, A1, Aizenman,
Goldstein) on its front page, "the decision bolsters Republican efforts to overturn the law through the
courts. All but one of the state officials who brought the suit are Republican."
White House, Dems Say Law's Implementation To Proceed "Without Interruption."
CQ HealthBeat (2/1, Norman, subscription required) reports that Vinson's ruling "prompted immediate,
difficult questions about what might happen to the law's implementation -- suggesting to some of the
law's critics a scenario in which 26 states could decide to sit back and wait and see what happens as
the case is appealed up to the Supreme Court." CQ adds, "The issue of the impact on implementation
came up for the first time in this suit because in an earlier decision in Virginia, US District Court Judge
Henry E. Hudson severed the individual mandate and separately ruled it unconstitutional, allowing the
rest of the law to stand." But, "despite Vinson's ruling, White House officials and Democrats insisted that
implementation of the law...would continue without interruption, both on the federal level and in the
states."
From NAHU
Tip of the Hat: Thank to you our Capitol Conference Gold Sponsor Assurant Health, Silver
Sponsor MARSH, Young Agents Sponsor Colonial Life, Bronze Sponsors Gen 4 Systems and
eflexgroup. For information on sponsoring or exhibiting at the 2011 Capitol Conference, please
contact Dianne Sautkulis at dsautkulis@nahu.org.
Visit the Capitol Conference website here.
Legislation and Policy
GOP Bill Would Allow States To Opt Out Of Health Reform
Provisions.
McClatchy (2/1, Rosen) reports, "Two Senate Republicans," Sens. Lindsey Graham and John Barrosso,
"Tuesday aim to introduce a measure that would allow states to opt out of the federal health care law, a
day after a federal judge declared President Barack Obama's signature legislative achievement
unconstitutional."
CQ Today (2/1, Ethridge, subscription required) reports that the measure "would allow states to get
exemptions from the law's expansion of Medicaid, its requirement that most individuals have health
insurance or pay a penalty, and the requirement that businesses of a certain size offer coverage to their
employees." CQ adds that it seems that "their bill was targeted at giving states greater leeway in
deciding how to proceed with implementing the law."
All 47 GOP Senators Sign On To Healthcare Law's Repeal Measure.
Politico (2/1) reports in a blog entry that "Sen. Jim DeMint (R-S.C.) announced this afternoon that all 47
Republican senators have signed on to his bill to repeal the sweeping health law passed last year."
Politico notes that the last four to offer their support were "Sens. Lamar Alexander (R-Tenn.), Susan
Collins (R-Maine), Thad Cochran (R-Mississippi), and Charles Grassley (R-Iowa)."
Establishing Insurance Exchanges No Easy Task For States.
The Sacramento Bee (1/31, Vestal) reported that nearly every state in the nation is implementing
insurance exchanges, a massive undertaking that essentially reorganizes the entire health insurance
industry. According to the Bee, states "must have simplified insurance offerings and a standardized
application...ready to pass muster with federal regulators by Dec. 31, 2012. If they don't, the federal
government will step in and run the exchanges for them." Anne Gauthier, senior analyst with the
National Academy for State Health Policy, called the task "herculean," while Linda Blumberg, a
healthcare policy analyst at the Urban Institute, said, "The art of the exchange is striking a balance
between getting carriers to participate and providing consumers with the best competitive choices."
Utah Lawmakers Consider Requiring College Students To Purchase
Maternity Coverage.
The Salt Lake Tribune (2/1, Stewart) reports that although "bitterly opposed" to the health reform law's
individual mandate, Utah's "Republican legislative leaders are considering imposing their own insurance
mandate." In weighing "millions of dollars in cuts to Medicaid on Monday, ranking members of the
Social Services Appropriates subcommittee debated the merits of requiring college students to
purchase health plans that cover maternity." The policy fix would "target the purported problem of
affluent college students using Medicaid to pay for their prenatal care and deliveries -- one that
legislative fiscal analysts estimate could save $1 million in state and $2.5 million in federal funds." Still,
the Tribune points out that "Utahns marry young, at an average age of 26 for first marriages." Also, the
state "boasts the nation's highest birth rate," with Medicaid paying "for nearly a third" of deliveries.
Public Health and Private Healthcare Systems
New York Governor Considering School Aid, Medicaid Cuts.
According to the AP (1/31), New York Gov. Andrew Cuomo (D) is weighing budget cuts between two
and three percent in school aid and Medicaid, "and may propose as many as 10,000 state employee
layoffs." An anonymous official said Cuomo was considering the cuts as "true reductions in about $21
billion in annual school aid and in Medicaid...which costs more than $50 billion." That would reduce
current funding levels, "not higher projected levels for the coming fiscal year."
Texas Budget Proposal Would Cut Benefits For Some Disabled
Children.
The AP (2/1, Ingram) reports, "The state will cut assistance to half the autistic children currently
receiving help and a third of blind children from state programs under the Texas Senate's current
budget proposal, officials said Monday." The AP adds that "state senators on the finance committee
heard from those responsible for carrying out proposed cuts for the first time on Monday morning.
Legislative Budget Board analyst Shaniqua Johnson told the committee that the number of blind
children helped by the Department of Assistive Rehabilitative Services would be cut from 3,600 to 2,491
per fiscal year." Notably, "the number of autistic children who currently receive services would be
reduced from 180 children now to 90 children under Senate Bill 1."
Texas Needs $6 Billion To Fund Medicaid Gap. The Austin (TX) American Statesman (2/1)
reports, "The chief of the state's Health and Human Services Commission, Tom Suehs, will tell
members of the Senate Finance Committee today that the Medicaid estimates they've been looking at
are a little bit off by several billion dollars." The senators have been "looking at a base budget that does
not take into account the cost of adding 250,000 people who are expected to join the rolls of Medicaid."
The additions to the program come from "typical growth in the number of eligible people and are not the
result of federal healthcare reform." The higher price tag is due to "medical costs rising through inflation,
more people using the program and more services being provided," explained HHSC spokesperson
Stephanie Goodman. Suehs "is expected to say" that $6 billion is needed "to pay for the expected
increases in costs."
Texas Medicaid Costs To Increase To $9 Billion. According to the AP (2/1, Ingram), the
Legislative Budget Board Director John O'Brien said that "regardless of whether state legislators fund it
or not," the cost of Medicaid "will rise to more than $9 billion in additional state funding to accommodate
the growing number of caseloads in Texas." The AP also reports that "the draft of the budget bill before
the Senate includes a 10 percent reduction in reimbursements to providers, a figure that some say
could lead doctors to leave the program."
West Virginia Could Add Up To 182,000 More People To Medicaid
Rolls.
The Charleston Daily Mail (2/1, Rivard) reports, "Three years before national health care reform's most
expensive provisions take effect, West Virginia officials are struggling to guess how many residents will
suddenly be insured by the government-run Medicaid program and how much the state will owe
because of it." The paper points out that "as many as 182,000 new people could enroll in the state
Medicaid program, costing the state as much as $175 million a year starting in 2017, officials from the
West Virginia Department of Health and Human Resources said Monday."
Chicago Tribune Lauds Illinois Medicaid Reform Law.
The Chicago Tribune (2/1) editorializes that after "years of foot-dragging and excuse-mongering," the
Illinois General Assembly passed a "Medicaid reform bill earlier this month." The bill "zipped through
both chambers with hardly any opposition in a matter of hours"; and Gov. Pat Quinn "signed the bill on
Tuesday." But one of the new law's "most significant changes: moving Medicaid patients into managed
care" remains controversial; and Illinois "hasn't settled on which protocol it will follow." Meanwhile,
Department of Healthcare and Family Services Director Julie Hamos should "expect plenty of blowback
from hospitals, healthcare providers, patient advocates and unions that defend the status quo." Some
will "complain about having to accept reduced reimbursements"; others will "warn that Medicaid patients
may face restricted access to care." Still, other states "have found smart ways to deal with those
hurdles. ... It can be done."
Also in the News
Healthcare Law Provides Funding To Train Residents In Outpatient
Facilities.
CQ HealthBeat (2/1, Reichard, subscription required) reports, "The healthcare overhaul law includes a
variety of funding streams to build up the nation's primary care work force -- the latest example of which
are grants to train budding doctors to practice in healthcare settings outside of the hospital." Notably,
the "Health Resources and Services Administration (HRSA) is required under the health law...to award
up to $230 million to community health centers in fiscal years 2011-15 to train residents in outpatient
settings. It has issued its initial round of grants totaling $1.9 million to 11 centers for a three-month
period," and the "centers are expected to receive word of full-year funding in the coming months."
HRSA spokesman Martin Kramer said, "We do expect that there will be an increased number of
applications, and we anticipate adding more residents every year."
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