A bumpy road for health reform
The United States approves the first comprehensive healthcare reform in its history after a legislative rollercoaster ride in the first weeks of 2010. The debate spills over from 2009 into the new year after the House and Senate approve different reform bills. Prospects for reform legislation dim in January as Republican Scott Brown unexpectedly wins a special election in Massachusetts to fill the Senate seat long held by Democrat Edward Kennedy, who died in August 2009. The victory sends shock waves through the ranks of Democratic lawmakers and deprives them of the 60th vote needed to break Senate filibusters. By March, House Democrats decide to circumvent Republican filibuster attempts by dropping their own bill and backing a Senate reform bill passed on Christmas Eve. A rancorous debate ensues in March, but the bill passes the House on a partyline vote. The Senate then approves a package of alterations to the original bill sought by House Democrats. President Barack Obama signs the measure into law on March 23 during a White House ceremony.
Anthem Blue Cross, a unit of WellPoint, tells subscribers on Feb. 13 that it intends to raise premiums for individual insurance plans by an average of 25%. The Obama administration seizes on the announcement as proof that insurance reform is needed, and it launches a series of attacks on the insurance industry.
Republicans vow to repeal the health reform law. Officials in about 20 states, mostly Republicans, file legal challenges or take other steps to block enforcement of the law, particularly the mandate that requires all Americans to have insurance coverage. GOP candidates denounce the reform measure during congressional campaigns and win control of the House in the new Congress, although they fall short of control of the Senate.
State and federal officials battle in federal courts over the law. The contests appear des- tined to be resolved by the U.S. Supreme Court. As the year closes, a federal judge in Virginia declares the insurance mandate portion of the healthcare law unconstitutional, siding with Virginia’s attorney general in that dispute. In Pensacola, Fla., U.S. District Judge Roger Vinson rules in October that the suit’s arguments are strong enough to warrant proceeding to trial. A federal judge in Akron, Ohio, also rules that a reform challenge suit filed by a conservative legal group can move forward. Meanwhile, two other federal judges—one in Virginia and one in Michigan—uphold the law. Another federal court in New Jersey dismisses a challenge to the law filed by a physicians group.
Several provisions of the law go into effect before the end of 2010. These include a ban on insurance discrimination against children with pre-existing conditions, coverage of dependents up to age 26, a prohibition on lifetime benefits, an end to insurance rescissions and temporary high-risk insurance pools for people without coverage because of pre-existing conditions.
Consultants enjoy a field day as providers attempt to set up the “accountable care organizations” called for under the reform law.