More to Washington in 2012 than high court rul­ing,elec­tion re­sults

Fu­ture of re­form and di­rec­tion of health­care pol­icy will hinge on rul­ings from Supreme Court, na­tion’s vot­ers

Modern Healthcare - - FRONT PAGE -

The na­tion’s health­care sys­tem faces an­other ma­jor pol­icy fork in 2012 as a U.S. Supreme Court case and a national elec­tion will de­cide whether the 2010 fed­eral health­care over­haul con­tin­ues, ma­jor por­tions are elim­i­nated, or the en­tire law is scrapped.

The po­ten­tial for sig­nif­i­cant upheaval from ei­ther a Supreme Court re­jec­tion of the law or re­peal by a newly elected Repub­li­can Congress and pres­i­dent has left many health­care pol­icy lead­ers ner­vous. But sev­eral in­sist a ma­jor re­jec­tion in 2012 is un­likely.

What is cer­tain is that this year will bring a slate of ma­jor new reg­u­la­tions im­ple­ment­ing the health­care law, in­clud­ing re­quire­ments states must meet to cre­ate health in­sur­ance ex­changes. State ex­changes—or a fed­eral ver­sion in states that fail to act—are a cen­tral linch­pin of the law and their sta­tus re­mains un­cer­tain.

The lead­ing 2012 health­care pol­icy dis­cus­sions that have noth­ing to do with the 2010 law re­volve around con­gres­sional plans to ad­dress the Medi­care physi­cian pay­ment for­mula, for­mally known as the sus­tain­able growth-rate for­mula, and au­to­matic deficit-re­duc­tion cuts slated to be­gin in 2013 as a re­sult of in­ac­tion last year by the con­gres­sional su­per­com­mit­tee.

On the first item, Congress de­layed a 27.4% Medi­care pay cut for the first two months of the year, but leg­is­la­tors will need to ad­dress that and sev­eral other ex­pir­ing pay­ment pro­vi­sions. On the sec­ond is­sue, providers hope to per­suade law­mak­ers to find off­sets that avert the need for provider cuts of up to 2% un­der a deficit-re­duc­tion scheme Congress ap­proved in 2011.

Chip Kahn, pres­i­dent and CEO of the Fed­er­a­tion of Amer­i­can Hos­pi­tals, says the im­me­di­ate chal­lenge for hos­pi­tals in this year will be the con­tentious SGR for­mula for physi­cians that law­mak­ers will re­visit.

“We are against ar­bi­trary pol­icy rob­bing Peter to pay Paul,” Kahn says, re­fer­ring to a de­ci­sion to pay for the physi­cian pay­ment fix by cut­ting re­im­burse­ments to hos­pi­tals. “It

U.S. Supreme Court jus­tices have given an un­prece­dented amount of time—more than five hours— for oral ar­gu­ments in chal­lenges to

the Af­ford­able Care Act.

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