March 2012 Archives

Friday marks the second anniversary of the health reform law. Just three days later, what Republicans like to deride as "Obamacare" will face the biggest challenge it has ever seen: oral arguments at the Supreme Court on whether the law is constitutional. Democrats are spending the week telling voters just how they've benefited from the law, and what they'd lose if it is overturned. Republicans are keeping on their message that the law is an unprecedented government intrusion into Americans' health care. In the meantime, states are scrambling to get insurance exchanges up and running while every facet of the health industry--from insurance companies to doctors to hospitals--are making significant changes to their businesses to adhere to the law's new rules.

If you were implementing the law, what would you have done differently? What would you keep the same? In the battle for public opinion, who is winning: Democrats or Republicans?

2 responses: Doug Peddicord, Gene Steuerle

House Budget Committee Chairman Paul Ryan is getting ready to release his second budget blueprint, and he isn't expected to pull any punches on Medicare.

Ryan told National Journal's Nancy Cook that the budget plan is more important than Republicans winning the White House in November.

"The moral obligation to do something about the debt crisis trumps everything," Ryan said.

For health policy that means one thing: Medicare and Medicaid are once again in for a significant overhaul from Ryan, despite the upcoming presidential election and political challenges of tweaking popular health programs. Medicare and Medicaid make up a huge chunk of the deficit, especially in the long run.

Has Ryan succeeded in changing the dialogue of Washington policymakers when it comes to Medicare and Medicaid? Is a Medicare voucher system or block grants for Medicaid becoming an inevitable solution to the country's fiscal woes?

Two House committees meet this week to mark up a bill repealing the Independent Payment Advisory Board, an executive-branch board with control over Medicare prices that even Democrats don't like. A bill from Rep. Phil Roe, R-Tenn., to repeal IPAB has 19 Democratic cosponsors.

The 15-member IPAB garners ire on Capitol Hill because it can cut Medicare payment rates to doctors and hospitals without congressional approval. To override the board, Congress must pass its own equivalent cut with a supermajority.

Congress doesn't have a great track record when it comes to Medicare prices. One easy example: the sustainable growth rate that controls Medicare physician payments. Democrats and Republicans want to get rid of it, but can't agree how to do it. Should the executive branch get to control Medicare pricing? The executive branch controls the money supply through the Federal Reserve - is IPAB really that different?

3 responses: Ethan Rome, Grace-Marie Turner, Joseph Antos