Opinion

White House Delays Employer Insurance Mandate

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Today’s Washington Read:

Health Law Penalties Delayed

from Wall Street Journal by Louise Radnofsky

The Obama administration said Tuesday it would delay enforcing a provision of the new health-care law that requires large employers to provide coverage for workers or pay a penalty in 2014, the biggest revision so far to the federal health-care overhaul. The law, passed in 2010, requires companies with the equivalent of 50 or more full-time workers to offer health benefits starting on Jan. 1-or pay a penalty of at least $2,000 per employee. The delay, announced by the Treasury Department in a blog post Tuesday, means that penalty won’t kick in until 2015. The decision reflects pressure from companies in such lower-wage industries as restaurants, retail and agriculture, which had cited a host of practical difficulties posed by the law’s requirements. Most large companies in the U.S. already provide health coverage to their employees.

Today’s Business Strategy Read:

European Drug Group to Require Disclosing Payments to Doctors

from Bloomberg by Makiko Kita Mura

Drugmakers operating in Europe must disclose payments made to doctors starting in 2016 in an effort to boost transparency and make patients aware of possible conflicts of interest. The new ethical code requires all members of the European Federation of Pharmaceutical Industries and Associations to disclose payments made in 2015 by 2016, the trade group said in a statement yesterday.

Today’s Chart Review:

Insurance Eligibility and Full-Time Employee Participation at Larger Firms

from the 2013 Healthcare Benchmarks & Trends for Large Companies by ADP

ADP_Eligibility and Participation

 


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NEWS ARTICLES
1: General
2-4: Payers
5-7: Providers
8-10: Pharma/Biotech/Device

OPINIONS, EDITORIALS, PERSPECTIVES
11-12: Washington Post
13-14: Health Affairs
15-16: Bloomberg
17: New York Times

 

NEWS ARTICLES
General

1) U.S. Stock Futures Retreat as ADP Jobs Data Tops Estimate

from Bloomberg by Michael P. Regan

U.S. stock-index futures remained lower after a private report showed companies added more jobs than economists forecast last month, fueling concern the Federal Reserve will begin to reduce monetary stimulus. Futures on the Standard & Poor’s 500 Index (SPX) expiring in September slipped 0.6 percent to 1,598.3 at 8:17 a.m. in New York.

Payers

2) Crucial Rule is Delayed a Year for Obama’s Health Law

from New York Times by Jackie Calmes and Robert Pear

In a significant setback for President Obama’s signature domestic initiative, the administration on Tuesday abruptly announced a one-year delay, until 2015, in his health care law’s mandate that larger employers provide coverage for their workers or pay penalties. The decision postpones the effective date beyond next year’s midterm elections. Employer groups welcomed the news of the concession, which followed complaints from businesses and was posted late in the day on the White House and Treasury Web sites while the president was flying home from Africa. Republicans’ gleeful reactions made clear that they would not cease to make repeal of Obamacare a campaign issue for the third straight election cycle. While the postponement technically does not affect other central provisions of the law – in particular those establishing health insurance marketplaces in the states, known as exchanges, where uninsured Americans can shop for policies – it threatens to throw into disarray the administration’s effort to put those provisions into effect by Jan. 1.

3) Health Law Penalties Delayed

from Wall Street Journal by Louise Radnofsky

The Obama administration said Tuesday it would delay enforcing a provision of the new health-care law that requires large employers to provide coverage for workers or pay a penalty in 2014, the biggest revision so far to the federal health-care overhaul. The law, passed in 2010, requires companies with the equivalent of 50 or more full-time workers to offer health benefits starting on Jan. 1-or pay a penalty of at least $2,000 per employee. The delay, announced by the Treasury Department in a blog post Tuesday, means that penalty won’t kick in until 2015. The decision reflects pressure from companies in such lower-wage industries as restaurants, retail and agriculture, which had cited a host of practical difficulties posed by the law’s requirements. Most large companies in the U.S. already provide health coverage to their employees.

4) Business Groups, Consumer Advocacates, Politicians, Policymakers React to Mandate Decision

from Kaiser Health News by Phil Galewitz

Opponents of the federal health law, especially business groups and conservatives, were quick to praise the decision by the Obama administration to delay enforcing the employer mandate provision by one year, until 2015. Some supporters of the law said the decision would not create major problems. Here is a roundup of some of the statements and edited quotes from interviews within the first few hours of the announcement.

 

Providers5) Justice Department, 55 Hospitals Reach $34 MIllion Settlement Over Medicare Fraud Claims

from Washington Post by Associated Press

Fifty-five hospitals in 21 states have agreed to pay $34 million to the U.S. government to settle allegations that they used more expensive inpatient procedures rather than outpatient spinal surgeries to get bigger payments from Medicare, the U.S. Justice Department said Tuesday. The settlement involves kyphoplasty procedures used to treat spinal fractures usually caused by osteoporosis. It can be done as an outpatient procedure, but the Justice Department said the hospitals performed the surgeries as inpatient procedures to increase Medicare billings.

6) To Avoid Root Canals, Teeth That Replace Themselves

from Wall Street Journal by Shirley S. Wang

Scientists have made advances in treating tooth decay that they hope will let them restore tooth tissue-and avoid the painful dental procedure. Several recent studies have demonstrated in animals that procedures involving tooth stem cells appear to regrow the critical, living tooth tissue known as pulp. Treatments that prompt the body to regrow its own tissues and organs are known broadly as regenerative medicine. There is significant interest in figuring out how to implement this knowledge to help the many people with cavities and disease that lead to tooth loss.

 

7) Stem Cell Transplants Clear HIV in Two Patients in Study

from Bloomberg by Simeon Bennett

The two patients, treated at Brigham and Women’s Hospital, stopped HIV treatment after the transplants, which in other patients has opened the door for the virus to come roaring back. In one patient there was no sign of the virus 15 weeks after stopping treatment, while the other has gone seven weeks without HIV rebounding, according to results presented today at the International AIDS Society’s meeting in Kuala Lumpur.

Pharma/Biotech/Device

8) European Drug Group to Require Disclosing Payments to Doctors

from Bloomberg by Makiko Kita Mura

Drugmakers operating in Europe must disclose payments made to doctors starting in 2016 in an effort to boost transparency and make patients aware of possible conflicts of interest. The new ethical code requires all members of the European Federation of Pharmaceutical Industries and Associations to disclose payments made in 2015 by 2016, the trade group said in a statement yesterday.

 

9) Glaxo J&J Combination May Control HIV With Monthly Injections

from Bloomberg by Simeon Bennett

Monthly injections with HIV therapies from GlaxoSmithKline Plc (GSK) and Johnson & Johnson (JNJ) sustained levels of the drugs in blood that should control the virus, according to a study that suggests the shots may one day provide a safer, more convenient treatment option to daily pills.

10) Adcock Receives $1.3 Billion Bid from Chile Drugmaker CFR

from Bloomberg by Janice Kew and Kamlesh Bhuckory

Adcock Ingram Holdings Ltd. (AIP) said it received a non-binding bid from Chilean drugmaker CFR (CFR) Pharmaceuticals SA that values South Africa’s largest supplier of hospital products at 12.9 billion rand ($1.3 billion). A combination with CFR, Chile’s largest drugmaker, would create a company with annual revenue of about $1.3 billion and an asset base of approximately $2.1 billion, Adcock said. It would have a presence in more than 23 countries and employ more than 10,000 people.

 

OPINIONS, EDITORIALS, PERSPECTIVESWashington Post

11) The Politics of Delaying Obamacare

from Washington Post by Sarah Kliff

By delaying a requirement that all large employers provide health insurance, the Obama administration heads off the unseemly spectacle of companies vowing to cut jobs or workers’ hours to avoid the costly mandate. But the late Tuesday action is not a free pass: It contributes to critics’ claims that the White House does not have the ability to launch its biggest legislative accomplishment on schedule.

12) Obamacare’s Employer Mandate Shouldn’t Be Delayed. It Should Be Repealed.

from Washington Post by Ezra Klein

Delaying Obamacare’s employer mandate is the right thing to do. Frankly, eliminating it – or at least utterly overhauling it – is probably the right thing to do. But the administration executing a regulatory end-run around Congress is not the right way to do it. It’s a bad bit of policy.This is a regulatory end-run of the legislative process. The law says the mandate goes into effect in 2014, but the administration has decided to give it until 2015 by simply refusing to enforce the penalties. The regulatory solution reflects the fact that the legislative process around the health-care law is completely broken. Republicans won’t pass any legislation that makes the law work better. Improving the law, they fear, will weaken the arguments for repeal. But Democrats, of course, won’t permit repeal. So Congress is at a standstill, with no viable process for reforming or repairing the Affordable Care Act as problems arise. And so the White House is acting on its own.

Health Affairs

13) Implementing Health Reform: A One-Year Employer Mandate Delay

from Health Affairs by Timothy Jost

One has to hope, however, that the Administration has thought through the ramifications of this delay for the other provisions of the ACA. The statements say that implementation of the rest of the ACA, including the availability of premium tax credits, is going forward on schedule. From all appearances this is true. But tax credits are only available to employed individuals who are either not offered health coverage by their employers or are only offered employer coverage that costs more than 9.5 percent of household income or that fails to offer “minimum value”- covering 60 percent of health care costs. Also, taxpayers are subject to the individual mandate penalty if they fail to accept coverage from their employer that meets the minimum value requirement and costs 8 percent or less of household income.

If employers have no obligation to report coverage, how will the exchanges or the IRS verify claims that coverage is unaffordable or inadequate? Currently proposed rules allow the exchanges to rely on the attestation of the applicant as to these claims if verification is not needed or cannot be obtained. Will the lack of an employer mandate mean that many more individuals will become eligible for premium tax credits, either because their employers drop or do not expand coverage, or fail to respond to requests to verify coverage? If employers fail to expand coverage to employee’s children, as they would have had to under the mandate, more children may end up on CHIP or Medicaid, or become eligible for premium tax credits.

14) Competitive Bidding in Medicare: A Response to the Bipartisan Policy Center’s Proposals

from Health Affairs by Robert Coulam, Roger Feldman, and Bryan Dowd

Competitive bidding thus is a proven method for bringing efficient prices to Medicare. Unfortunately, the BPC’s proposals for competitive bidding are critically flawed. Most important, the BPC proposal proposes a limited form of competitive bidding, restricted to Medicare Advantage plans only – the traditional Medicare fee-for-service (FFS) plan is not one of the bidders. For reasons detailed below, that is a serious flaw. There are other important flaws as well in the BPC proposal. We propose a bidding arrangement for all Medicare plans, MA plans and the traditional FFS Plan. In this post, we explain why. We first review the BPC proposals and then describe the problems that would result from the particular form of competitive bidding BPC has proposed, and why a more comprehensive bidding arrangement would be a far more important reform for Medicare.

Bloomberg

15) Fix Doctors’ Pay and Improve Health, Too

from Bloomberg by Lanhee Chen

Aside from the instability created by the SGR overrides, the formula also cuts pay indiscriminately, failing to distinguish between specialties or physicians. Worse, the regular reprieves set up even steeper future cuts in physician reimbursements — and potentially in access to health care — under the Medicare program. The SGR is set to impose a 24.4 percent cut in physician payments in 2014. The formula also fails to tie payment to quality. Outside of Medicare, private insurers have started using physician compensation to encourage providers to employ resources more effectively and efficiently. Fixing the SGR is an opportunity to embrace some of those changes in Medicare.

16) Retirees’ Medical Bills are Brining Down Detroit

from Bloomberg by Stephen Eide

The emergency manager in charge of keeping Detroit afloat says the city’s $20 billion debt load can’t be reduced to manageable levels without “shared sacrifice” from all stakeholders, including retirees. Pension and retiree-health-care obligations make up the bulk of the city’s unsecured debt, and their costs are rising rapidly. The emergency manager, Kevyn Orr, is right that Detroit must reduce its retirement-related debt to secure its future, but he has to be more specific about his target. Cutting retiree health care — also referred to as “other post-employment benefits,” or OPEBs — should take priority over pensions.

New York Times

17) A Chance for Pro Sports to Help on Health Care

from New York Times by Editorial Board

It would be nice to imagine that sports officials would ignore this entirely self-serving pressure tactic. Given its struggle with on-field injuries, for example, the N.F.L. would do well to help 25 million people receive the health insurance to which they are now legally entitled. So far, though, it seems the intimidation is working. The N.F.L. said last week it has no plans to help out, and the other leagues have yet to sign on. Apparently, when confronted with bullying and misinformation, a bunch of professional tough guys are nothing but pushovers.

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