Weekend update

The principal legislative focus this week from the FEHBlog’s standpoint is H.R. 4213, the American Jobs and Closing Tax Loopholes Act of 2010. Last Thursday, the Chairmen of the Senate Finance and House Ways and Means Committees released a set of mutually acceptable changes to this bill.  The House Rules Committee takes up the bill tomorrow.

The revised bill will extend the COBRA / TCC subsidy program through the end of 2010. Absent this amendment, the program will sunset on May 31. The current Labor Department model COBRA notices are available here.

The revised bill also would address the 21% cut in Medicare Part B reimbursement to physicians that will occur on June 1, 2010, under the statutory sustainable growth rate (SGR) formula absent Congressional action. The bill would provide a fix through the end of 2013. The Politico reports that

Under the [SGR] changes, physicians would get a 1.3 percent raise this year and an additional 1 percent raise in 2011. In 2012 and 2013, primary care and preventive services doctors would get an additional raise equal to the gross domestic product at the time plus 2 percent. Other doctors would get a raise of GDP plus 1 percent.

Politico points out that this would be the first time that the SGR formula would distinguish between primary care providers and specialists. Modern Healthcare adds “But the formula backtracks to current law in 2014, setting physicians up with a possible 27% cut, according to one healthcare lobbyist.”  Federal budget issues, e.g., the eye popping impact of repealing the SGR formula, complicate the creation of a permanent fix.

Not all is well with the healthcare provider community. According to Modern Healthcare, the American Hospital Association is objecting to a provision in the bill that would modify “a Medicare policy known as the ’72-hour rule’, amounting to about a $4.5 billion hit to the hospital sector.”
A colleague called my attention to the fact that a May 11, Congressional Budget Office letter to Congress discussing the costs of implementing PPACA/the Affordable Care Act notes that 

Costs to HHS, especially the Centers for Medicare and Medicaid Services, and the Office of Personnel Management for implementing the changes in Medicare, Medicaid, and the Children’s Health Insurance Program, as well as certain reforms to the private insurance market. CBO expects that those costs will probably total at least $5 billion to $10 billion over 10 years.

The private insurance market reforms referenced in this quote certainly include the multistate plans contracts that OPM will negotiate for insertion into PPACA’s state based heath insurance exchanges under PPACA Section 1334.

On Wednesday, the House Armed Services Committee approved the Fiscal Year 2011 Defense Authorization bill HR 5136). According to Govexec.com, one of the bill’s provisions would increase the TRICARE maximum dependent child eligibility age from 24 to 26. The Committee summary of the bill states

Earlier this year, the President signed into law a bill to overhaul America’s health care system. Because TRICARE is already such a good program, it already would have met all of the minimum requirements of health care reform. However, Congressional leadership made and kept a promise to ensure that TRICARE was not impacted in any way by the health reform bill. Unfortunately, this means that TRICARE beneficiaries are not currently able to extend health coverage to their adult dependent children up to age 26 like the rest of the country. To make sure that TRICARE beneficiaries can enjoy this same opportunity, this year’s NDAA includes language from legislation introduced by Congressman Martin Heinrich (D‐N.M.) to allow TRICARE beneficiaries to extend coverage to their dependent children until age 26, the same benefit that was afforded to individuals with private insurance policies under the new health care law.