Health Care Reform Update - July 16, 2012

Implementation of the Affordable Care Act (ACA)

In the wake of the Supreme Court's ruling regarding the ACA, officials from several states have made statements on whether their states will participate in the ACA's Exchanges or its Medicaid expansion. A summary of each state's current position, compiled by USA Today, can be seen here.

On July 9th the Department of Health and Human Services (HHS) announced that 89 new Accountable Care Organizations (ACOs) had begun operating as of July 1, 2012. The ACOs are expected to serve more than 2.4 million Medicare beneficiaries. An HHS press release can be found here.

On July 10th HHS announced that more than 16 million people with Medicare have received free preventative services in 2012. An HHS news release can be seen here.

On July 10th Virginia Governor Bob McDonnell (R), on behalf of the Republican Governors Association, sent a seven-page letter to President Obama sharply criticizing several provisions of the ACA and asking several questions about the administration's plans for implementing federal Exchanges and the Medicaid expansion under the ACA. On July 13th Marilyn Tavenner – Acting Administrator for the Centers for Medicare and Medicaid Services (CMS) – sent a response answering some of the questions and emphasizing that CMS is open to working with individual states. The response clarified that there is no deadline for states to inform CMS of a decision to expand Medicaid and that states that ultimately decide not to implement the Medicaid expansion would not be required to repay federal grants they had received to implement the expansion. Governor McDonnell's letter can be seen here. Ms. Tavenner's response can be seen here.

Only July 11th the House voted to repeal the Affordable Care Act. The vote was 244-185, with five Democrats voting in favor of repeal. A record of the vote can be seen here. A floor statement by House Speaker John Boehner urging colleagues to vote for the repeal can be seen here. A statement by Democratic Leader Nancy Pelosi opposing the repeal can be seen here. Just two days before, the White House pledged to veto the bill if it were to pass the Senate as well.

On July 11th twelve states—California, Colorado, Connecticut, Hawaii, Massachusetts, Maryland, Minnesota, New York, Oregon, Rhode Island, Vermont and Washington—sent letters to HHS indicating their intention to set up state-based exchanges through the ACA. The letters can be seen here.

On July 13th CMS...