Affordable Care Act faces Antitrust challenges

by Dan Diamond, California Healthline Contributing Editor

Wednesday, September 07, 2011

FTC Emerges as Another Obstacle to Health Reform Law
by Dan Diamond, California Healthline Contributing Editor

Many assessments of the Affordable Care Act's long-term viability have focused on Congress' ability to weaken or repeal the law, especially if Democrats lose both chambers in 2012. Others are looking ahead to the Supreme Court's potential impact on the individual mandate's constitutionality.

But another Washington, D.C. player -- the Federal Trade Commission -- is already creating problems for the Obama administration.

True to its name, the Affordable Care Act tries out a number of new ideas to make health care less expensive. As one tactic, the law provides incentives for the creation of accountable care organizations to care for dedicated populations of Medicare beneficiaries.

However, the White House and FTC don't see eye to eye on ACOs' antitrust implications. The White House -- and by extension, the Department of Justice -- has viewed ACOs through the lens of consumer benefit. Meanwhile, the FTC spots a risk that ACOs could help already strong health care providers further fix prices.



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Pre-Existing Condition Insurance Program (PCIP) to pay Brokers

June 1, 2011



The U.S. Department of Health and Human Services is making several changes to the Pre-Existing Condition Insurance Plan (PCIP), and making it easier to qualify.

Beth Uselton is a patient advocate with the Tennessee Health Care Campaign and she said, "For many decades people with pre-existing conditions were often locked out of insurance or small group insurance market."

Uselton said these are important steps to get insurance to the people who need it the most. "The irony is that so many people who have high health needs, or already have a medical condition, are some of the people least likely to be covered by the private insurance market." Broker will be able to direct insureds to this program and earn a commission beginning in the fall More

Big changes in Medicare appear to be inevitable

Obama calls for slowing growth of Medicaid, Medicare to reduce deficit Apr 13
By Jack Torry, Washington Bureau
12:53 AM Sunday, April 24, 2011
WASHINGTON — No matter which sides prevails in the intensely ideological and partisan debate in Washington over the mushrooming costs of Medicare, one thing is certain: The program as we know it is in for big changes.
“Everybody admits doing nothing is not an option,’’ said Michael Tanner, an analyst at the CATO Institute in Washington.

In particular, they contend that health costs continue to rise because of the increase of such diseases as diabetes, caused in large part by preventable conditions such as obesity. They say that until hospitals and physicians become more efficient in preventing and treating the chronically ill, U.S. health care costs will continue to soar. read more

Ryan, Obama both fail Medicare test

Updated: April 16, 2011 - 9:01 PM
They offer contrasting approaches, but there are flaws in each.

Wisconsin Congressman Paul Ryan deserves credit for putting Medicare's soaring costs front-and-center in the raging debate over the nation's runaway spending.

But his prescription for fixing the federal health program for the elderly -- Ryan's plan would provide subsidies to buy private health insurance -- is too harsh and would shift unaffordable care costs onto seniors

The reality is that Medicare's current costs are an existential threat to the program. The total Medicare bill in 1999 was $212 billion: Ten years later, it had increased to $502 billion as the baby boomers prepared to retire.

Obama's speech offered reassuring but vague rhetoric about Medicare's future. He's right that there are alternatives to Ryan's plan, which paints in stark detail what it means to rein in entitlement programs without a tax increase.

But the president needs to provide details..

Now the president and his party need to do the same. The nation can't afford to wait until after the 2012 election..

ANOTHER CONCERN
"When Roosevelt invented Social Security, it was not designed to lift the old out of poverty. It was designed because the cost of caring for the old was crushing middle-aged families. One of the questions that needs to be asked here about the [Ryan] plan is not how does this affect the old, but rather what are the Gen-Xers and -Yers going to do when Grandpa's medical bills come due? Because they're going to come due.''read more

DR. STEVEN MILES, Minneapolis physician and bioethicist
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Agents Likely to be Part of Exchange System

By ARTHUR D. POSTAL
Published 2/16/2011 Subscribe to Life & Health

WASHINGTON BUREAU -- The role that insurance agents play in the health insurance marketplace in 2014 and beyond will likely be left up to the states, according to Joel Ario, head of the insurance exchange bureau at the U.S. Department of Health and Human Services (HHS). more

And now the real work begins

Some parts of the Affordable Care Act simply don’t work for small employers, a New Jersey business owner testified today at a House Ways and Means Committee hearing.
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House republicans Start spin to take credit for HealthCare Reform

By ALLISON BELL
Published 1/19/2011

"House leaders scheduled a vote on H.R. 2, the Repealing the Job-Killing Health Care Law Act bill, to take place just as many civic-minded citizens were coming home from work and flipping on C-SPAN.

House members voted 245-189 to pass the bill at 5:53 p.m. today. All Republicans in the House voted for the bill; 189 of the 193 Democrats voted against it. "read more