NAHU Government Affairs - There is a movement underway led by the lieutenant governor, Speaker of the House and Republican legislators to delay state exchange legislation this session. The group would like for Tennessee to wait for the Supreme Court ruling and November election before moving forward. If this plan holds, Tennessee will likely call the legislature into special session to pass a state exchange bill if necessary.

The New York Times (1/17, A1, Pear, Subscription Publication) reports on its front page, "To head off medical conflicts of interest, the Obama administration is poised to require drug companies to disclose the payments they make to doctors for research, consulting, speaking, travel and entertainment." According to "the new standards, if a company has just one product covered by Medicare or Medicaid, it will have to disclose all its payments to doctors other than its own employees." The Times noted that "the new requirements, or something very similar, will take effect soon; in fact, they are overdue."

Who woulda thunk it? Did you know the state health insurance exchanges will be excluded from the new Federal MLR requirements? (Beginning not later than January 1, 2011, and subject to the definitions established through NAIC/HHS regulation, large‐group plans (101 employees or more) that spend less than 85% of premium revenue and small‐group (one to 100 employees) and individual plans that spend less than 80% of premium revenue on clinical services and activities to improve health care quality must provide a rebate to enrollees.)

NEW YORK, Dec. 2, 2011 /PRNewswire/ -- Even in an environment of uncertainty about the future of health care reform, a majority of employers surveyed (56 percent) say that they are likely to continue to offer employer-sponsored health insurance after health care reform is enacted, according to a new survey of benefit decision-makers conducted by GfK Custom Research North America. Only 12 percent of benefits decision-makers say they would be very or somewhat likely to drop coverage, and another 32 percent of the 502 private-sector companies surveyed are unsure what they will do.

The Wall Street Journal (12/3, Radnofsky, Subscription Publication) reports HHS altered a component of the new healthcare law that requires insurance companies to spend a certain percentage of income from premiums on medical care. Providers not doing so must issue refunds to consumers. On Friday, HHS revised the rule to state that such refunds would be tax-free.

WASHINGTON--(BUSINESS WIRE)--The Stop The HIT Coalition applauded Senators John Barrasso (R-WY), Orin Hatch (R-UT) and Olympia Snowe (R-ME) today, for introducing The Jobs and Premium Protection Act, legislation to repeal the Health Insurance Tax (HIT). The bill brings relief to millions of small businesses nationwide, by preventing the recently passed HIT from collecting billions of dollars from their operations beginning in 2014.

“For our nation to maintain any hope of recovering from these difficult economic times, we must repeal the HIT. Senators Barrasso and Hatch along with a bipartisan group of House members recognize this reality and should be applauded for introducing this much needed legislation.”

“This legislation comes at a crucial time for our nation’s small businesses and we commend Senators Barrasso and Hatch for recognizing that Washington must take action to repeal the HIT,” said Neil Trautwein, Vice President and Employee Benefits Counsel at the National Retail Federation. “As the nation’s number one creator of private sector jobs, small businesses have the potential to reinvigorate our economy if provided with a more certain economic environment. Passage of the The Jobs and Premium Protection Act would be a reassuring sign from Washington to small businesses that it is ok to invest in their futures and create jobs.”

The HIT was passed as part of the Patient Protection and Affordable Care Act (PPACA) last year. Although guised as a tax on insurance companies, it is a clear pass-through tax as it only applies to the fully-insured market where nearly all small businesses and the self-employed purchase their policies. The HIT, projected to cost small businesses, the self-employed, and their employees $87 billion by the end of this decade, will also reduce the take-home pay by $500 a year, or $5,000 in the first decade, for an employee with a family plan.

In the House of Representatives, Representative Charles Boustany (R-LA) has proposed HR 1370 “To Repeal the Annual Fee on Health Insurance Providers Enacted by the Patient Protection and Affordable Care Act.” The bill has 78 bipartisan co-sponsors.

Last week, a number of significant events occurred in the ongoing legal battle over the constitutionality of PPACA, which has now seen three circuit courts rule in three different ways on the issue. Last week’s legal development primarily concerned the case being brought by 26 states and the National Federation of Independent Businesses (NFIB), the largest and highest profile challenge to the health reform law. The 11th Circuit Court of Appeals last ruled on this case this past summer, upholding a lower court’s finding that PPACA’s individual mandate provisions are unconstitutional. -NAHU Washington Update October 3, 2011

The CLASS Act faces more public scrutiny this week after an e-mail from HHS official Bob Yee was publicly circulated last Thursday morning which announced to colleagues he was leaving his position because the CLASS Act office was closing effective last Friday. Yee served as the HHS actuary overseeing the Community Living Assistance Services and Supports (CLASS) Act program established by PPACA to be an optional, government-backed, long-term care insurance program. The e-mail left the Obama administration fiercely denying reports of the program's demise, and a statement was released saying the CLASS office is cutting back on staff but not shutting down. –NAHU Washington Update

On Aug. 12, 2011, the 11th Circuit Court of Appeals ruled that the health care reform law’s individual mandate is unconstitutional, upholding the Florida district court decision. However, the Court of Appeals overturned Florida’s decision to invalidate the entire law, preferring to strike only the individual mandate. The Court of Appeals stated that Congress violated the U.S. Constitution by passing legislation that would force all Americans to buy a product or pay a penalty. The opinion said Congress has broad power to deal with the problems of the uninsured, "but what Congress cannot do...is mandate that individuals enter into contracts with private insurance companies for the purchase of an expensive product from the time they are born until the time they die."

This will ultimately be decided by the U.S. Supreme Court…

 

ATLANTA (AP) — A federal appeals court has struck down the requirement in President Obama's health care overhaul package that virtually all Americans must carry health insurance or face penalties.