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Mitt Romney's selection of Rep. Paul Ryan, R-Wis., as his running mate has brought his Medicare reform proposal to the front of the presidential campaign. Polling in February suggested that while Americans strongly prefer the Medicare status quo, they also know little about the details of what premium support means or how it would work. Does the Ryan selection mean either of those things will change by election day?
The International Aids Conference is back in the United States for the first time in more than 20 years, with a star-studded cast that includes top U.S. health officials, former presidents, philanthropists, and public health officials from around the world. Recent years have seen major strides in the prevention and treatment of AIDS around the world, but challenges remain, including declining financial support, according to a recent UNAIDS report.
What do you see as the key successes of the global fight against AIDS? What future challenges most concern you?
So the Court has spoken. We can now end all the speculating and vague worrying about what the Supreme Court might or might not do to the health reform law. A majority of the Court said that the controversial individual mandate can stand but that the law's expansion of Medicaid must now be optional for the states. So now that the legal fight is through, what do you see as the biggest challenges and opportunities for health reform forward? Will there be successful efforts to repeal or reform the Affordable Care Act? Will the Health and Human Services department release all the necessary regulations in time? What will happen if states opt out of the Medicaid expansion? Will the president turn the corner on selling the law to the public?
The countdown to the Supreme Court's decision in the health care case is on. Chief Justice John Roberts said Monday that the justices would be issuing rulings in the remaining cases on Thursday, which means, barring some extraordinary circumstance, that we will know then whether the Affordable Care Act will stand, fall, or move forward in some partial form.
The health care law would usher in a large reorganization of how many Americans get health insurance and of how Medicare pays providers for the care they offer seniors. In many important ways, the future of health care in this country will depend on what the Court decides. But in the two years since the law passed, insurers, providers and state governments have already begun making big changes. Which of those changes do you think will live on, regardless of the future of the health care law?
On Monday, the health insurer UnitedHealthCare announced that it will be preserving several consumer protections now required by the Affordable Care Act, regardless of what the Supreme Court opts to do about the health reform law. Even if the law is overturned, United will keep covering young adults on their parents' plans, offer preventive benefits with no copayment, and write all policies without lifetime limits, among other provisions. The company did not embrace every consumer protection imposed in the law, but did include many popular reforms that have already been enacted.
Do you think other insurers will follow United's lead? Do you think that these changes are here to stay, regardless of what the Courts or Congress do?
A rumor that the Supreme Court might rule on the health care case last week turned out to be just that. But, with the Court's decision drawing near, members of Congress have begun thinking about how they will react should the Court overturn the sprawling health care law. In the House, which has repeatedly voted to repeal the law, leadership says it remains committed to complete eradication, but some members have begun talking about the possibility of restoring some popular provisions.
If the Court overturns the law, what, if anything, should the Congress do next? What do you think they will do?
Unlike so much else in the 112th Congress, the package of legislation to authorize Food and Drug Administration user fee agreements is humming along. At a House markup last week, Rep. Henry Waxman, D-Calif., was one of many members who commended his colleagues for their ability to collaborate and compromise: "Consideration of this bill should be a model for legislative action," he said. The "UFA" legislation, as it's known, is nearly identical on the House and Senate sides, has passed through markups with nary a complaint, and looks set to pass months before the programs it reauthorizes are set to expire at the end of September.
In a session marked by so much partisan rancor, why are the UFA bills different? What can Congress learn from this process?
What role should employer-sponsored health insurance plans play in U.S. health care?
House Republicans have bashed the health reform law as the beginning of the end of the employer-sponsored health insurance market, since it would be less expensive for some employers to drop their plans and pay a fine to the federal government. The House Ways and Means committee released a report last week finding 71 of Fortune 100 companies could save $422 billion by simply paying fines for their employees, instead of the insurance plans they offer now.
But Republicans haven't been huge fans of employers dictating health insurance coverage for individuals in the past. Sen. John McCain, R-Ariz., proposed getting rid of the employer-sponsored health insurance tax exclusion in his failed 2008 presidential campaign, which could incentivize people to buy their own plans. Gov. Mitt Romney, the presumptive Republican presidential nominee for 2012, hasn't gone that far yet. But he does want to "equalize" the tax treatment of health insurance, giving individual buyers the same tax breaks that employees get on their employer health insurance.
Should people get their health insurance through their employers? What considerations should lawmakers take into account when writing policies that shape insurance coverage?
Last week the federal government announced it had signed up 27 hospital and doctor groups to participate as accountable care organizations, one of the health reform law's great cost-saving hopes.
The number is well under federal projections from October, which predicted up to 270 groups would sign up to become Medicare accountable care organizations, or ACOs. The ACO program pays bonuses to doctor and hospital groups if they successfully coordinate care and improve health outcomes for certain Medicare patients. The groups can eventually lose money from the federal government if they don't meet those standards.
Does the low turnout mean ACOs are over? Or is the program just off to a slow start? Why?
After tougher-than-expected questioning for the Obama administration at last week's historic Supreme Court arguments on the health reform law, figuring out how to make the law work if the court strikes down the insurance coverage requirement has become a fulltime hobby.
Several options have been floated-- like auto-enrolling people in health insurance plans or restricting enrollment to certain times of the year--but so far no formal strategy has emerged.
Are there any ways to salvage the health care law that have been missed? What programs do you see surviving if the Supreme Court decides the insurance requirement is unconstitutional?