After more than a year of often contentious political debate, historic health insurance reform legislation was passed and signed into law last week. But the ink was not yet dry on the bill before 14 states filed a lawsuit challenging the new law, and everyone else began poring over provisions to determine exactly what it would mean for them. Time magazine concluded that health insurance premiums will continue to rise under the new law, and with more predictability. In a BusinessWeek magazine interview last week, Aetna Chairman and CEO Ron Williams agreed that premiums will continue to rise because health care costs were not adequately addressed. He added, however, that the nation still can get back to meaningfully taking on the drivers of rising health care costs in the next several years during the new law’s implementation period. As stated in an Aetna news release issued last week, Aetna stands ready to help if that happens.
The President’s signature on health care reform legislation March 23 and his signing on March 30 of the Reconciliation measure to “fix” the March 23 version starts the clock ticking for implementation of the biggest change to American health care in 45 years. Irrespective of policy position or political persuasion, two truths emerge from its passage: 1) Health care reform is now President Obama’s health care reform, and he and the Democratic Party will have to defend it going forward for many years to come; and 2) The entire country (starting with health plans and insurers) needs to fasten its seat belt tightly and get ready for the most massive regulatory and implementation process since Medicare.
For the past three months, the House and Senate have been unable to agree on either a long-term “doc fix” (to permanently eliminate the 21 percent cut to Medicare doctors in 2010) or a COBRA fix (to provide a full 2010 calendar year extension of the right for certain COBRA recipients to receive a 65 percent government subsidy). The impasse has resulted in month-to-month extensions as neither Chamber has been able to get the other to agree to its version of a permanent extension. Just before the two-week recess (March 25 to April 12) the House once again did its part and passed an extension through April for each item. The Senate refused to play ping-pong this time and went home for recess without agreeing to the same month-long extension. This could prove both costly and administratively messy. CMS has already ordered a temporary halt on processing claims for the first days in April hoping to stave off the problems associated with letting a 21 percent cut go into place early in April only to retroactively unwind the cut within weeks. Whether Congress can figure out what to do and then do the right thing is at best a 50-50 proposition