Much of the talk from Republican lawmakers on health care reform has focused on efforts to repeal the 2010 health care reform law. But this year, they are talking about what could replace it if they accomplished that goal. Last week Rep. Joe Pitts, the chairman of the health subcommittee of the Energy and Commerce Committee, described a package of policy initiatives that he hoped his committee would tackle later this year.

The planks of the package included medical liability reform, rules to make health insurance purchases possible across state lines, and efforts to ensure that employees could take their insurance with them if they left a job.

Would such policies be a good replacement for the current health care reform package? Would they expand access to health insurance? Would they bring down costs?

In order to survive 2012, the health care law will have to overcome two major hurdles: a Supreme Court hearing on its constitutionality, and an election that could tilt Congress, the White House or both in favor of repeal.

Which pathway do you think will be more likely to bring down the legislation: the Supreme Court's June decision, or the November election?

Or despite these challenges, do you think the health reform law will survive to see 2013?

Believe it or not, we are just one week away from President Obama's fourth State of the Union address, scheduled for January 24. We want to know what you want to hear from the president when it comes to health policy.

Do you think the president should defend his landmark health reform law, especially in front of the Supreme Court justices who are set to rule on its constitutionality this year?

Should the president offer up ways to save money in Medicare and Medicaid, like raising eligibility age for Medicare or changing how the federal government matches state Medicaid contributions?

Should President Obama address Republican efforts to convert Medicare into a program that gives seniors a subsidy to purchase private health insurance?

Or do you think the president should steer clear of health policy altogether?

The Obama Administration kicked off the Supreme Court case on health care reform Friday with its brief defending the 2010 law's most controversial feature -- its requirement that individuals buy health insurance. The government offered several legal arguments in support of the provision, contending that it is a valid exercise under Congress's powers to regulate interstate commerce and to collect taxes. The legal analysis was no surprise--the government has been making similar arguments for nearly two years in the lower courts, with mixed results.

Will these arguments be persuasive to the justices? Will the Supreme Court uphold the health reform law?

After a year-long reprieve from having to fix the Medicare "sustainable growth rate" formula, Congress is once again scrambling to avoid a 27 percent cut to Medicare physicians pay in January 2012.

Hopes for a permanent fix this year dimmed with the failure of the super committee. That means any "doc fix" Congress passes will last no longer than a year, at most maybe two years.

How many more years will it take before a permanent solution is found? Is a bill from Rep. Alyson Schwartz, D-Pa., a first step to permanently addressing the Medicare SGR? Or is a Medicare Payment Advisory Commission plan, which cuts most doctors pay, a more realistic solution?

If the super committee fails to reach a deal, how badly do you think Medicare and Medicaid will be cut in 2013 and beyond?

The federal health programs, along with Social Security, are projected to grow from 10 to 15 percent of GDP in the next 25 years. Democrats are already looking at ways to hem that in - last week Democrats floated a super committee proposal to cut $400 billion from federal health programs, in part by asking Medicare beneficiaries to pay an extra $100 billion to cover the cost of their care.

Republicans have been pushing for more drastic, structural changes to Medicare, like transforming the entitlement program into a voucher system where seniors would get government subsidies for private insurance coverage. Short of that change, Republicans in the super committee have regularly pushed for significant entitlement spending cuts.

Are the federal health programs destined for the chopping block once the 2012 presidential election is over?

Last week the federal government did its best to reignite enthusiasm around the so-called accountable care organizations, making significant changes that are meant to coax doctors and hospitals to come on board.

Accountable care organizations, or ACOs, are a centerpiece of the 2010 health reform law that aim to get doctors and hospitals to work together to keep patients healthier. The interim rule released in March was panned by doctors and hospitals expected to volunteer for the program.

The revisions include allowing ACOs to operate without financial risk and will let ACOs collect a full bonus once they hit a savings target; the interim rule would have kept the first 2 percent of savings for the federal government.

They also eliminate a confusing and unpopular provision that would have kept patients and doctors in the dark about who was actually included in an ACO, and they slash the number of quality measures doctors and hospitals will have to report from 65 to 33.

Are these changes enough to attract wary doctors and hospitals back to the ACO drawing board

The Food and Drug Administration has been the target of criticism from Republicans and the medical device industry alike, arguing that increased medical device approval times are pushing innovation abroad.

After holding several hearings examining the FDA's approval process, House Energy and Commerce Chairman Fred Upton, R-Mich., last Friday unveiled a package of legislation that Republicans say will "improve the predictability, consistency, and transparency of FDA's medical device review and approval process."

The legislation would require FDA reviewers to provide "scientific or regulatory rationale for major decisions," and reaffirms that FDA should follow "least burdensome" practices to approve devices. You can read more about the bills here.

Do you think these proposals will be useful to getting new treatments to market? Or will these changes put patients in danger with unchecked devices?

This response comes from Rep. Cathy McMorris Rodgers, R-Wash.

Last month, I hosted the first “Jobs and Innovation Forum” on Capitol Hill with a special focus on medical device innovators, how the regulatory process impedes innovators, which ultimately hurts patients, and how to improve that process. The job creators who participated in our forum had a simple yet powerful message: While America has led the medical technology industry for decades, our leadership is being threatened by the Food and Drug Administration’s unpredictable, inconsistent and inefficient regulation of medical devices. To maintain our leadership, they want Congress to charge the FDA with improving the regulatory climate. Should the FDA do that, it would spur innovation in a high-tech, high-paying field, expedite approval of life-saving and life-improving treatments, bolster America’s competitiveness, and create much-needed jobs.

This response comes from Janet Trunzo, executive vice president of regulatory affairs at AdvaMed:

America’s medical device and diagnostics companies are engines of innovation -- developing life-changing, life-enhancing technologies and, in the process, creating nearly 2 million U.S. jobs. In order to improve patient access to these technologies and address some of the critical issues impeding our industry’s global competitiveness, the Energy and Commerce committee, under Chairman Upton’s leadership, has put forth the Saving American Jobs and Saving American Patients legislative package.

The package reflects the committee’s extensive work in examining the need for reform through hearings and debate. We believe the effort is an excellent starting point in a legislative discussion to address several important issues critical to maintaining our global leadership and competitiveness.

In addition, we are continuing to work collaboratively with the FDA to make improvements in the device review process, which are

The controversial long-term disability insurance program, known as the Community Living Assistance Services and Supports program or CLASS, had a rough month in September. But the Obama administration hopes a report, expected out this week, might clear some of the bad air.

The insurance program, established under the 2010 health reform law, is on an indefinite hiatus. Staff at the CLASS office within HHS were reassigned last month. Senate Democrats removed all funding for CLASS in the Labor-Health and Human Services 2012 spending bill because program "implementation has been delayed." The program was originally intended to start collecting premiums in October 2012.

Assistant Secretary on Aging Kathy Greenlee said the report would include "recommendations about how to proceed."

Do you think the CLASS program can be saved? Is it possible to tweak the voluntary program so the premiums collected can cover the cost of benefits?

If not, what is needed for the estimated 10 million Americans that need long-term support services not covered in traditional health insura

(These comments were submitted by Kathryn Nix, a policy analyst in the Center for Health Policy Studies at The Heritage Foundation.)

Health and Human Services will not be able to fix CLASS. The program’s poor design makes it unsustainable, and only significant changes by Congress can address this. Broad eligibility requirements allow almost anyone to enroll, with students and those below the poverty line paying just $5 in premiums. Combined with the policy of guaranteed issue and the program’s voluntary nature, CLASS will experience severe adverse selection.

One solution put forth by Secretary Sebelius is to index premiums to inflation. But the premiums required to cover CLASS’ high costs are likely to be unaffordable for most Americans. Increasing premiums even further would exacerbate adverse se

The Institute of Medicine is expected to release a report Friday detailing exactly how the federal government should go about selecting what health benefits need to be covered by insurance plans in order to get on state exchanges.

The highly anticipated report has insurance companies concerned that HHS will add too many benefits, while consumer groups want as many covered benefits as possible.

Between both of those positions is the difficult balance of giving consumers affordable care that has enough benefits to help keep people healthy. Is it possible to give consumers affordable coverage with generous benefits? If you were at HHS, how would you balance affordable insurance coverage with adequate benefits?

This week's question comes from one of our newest experts, Cindy Gillespie. Gillespie served as an adviser to former Massachusetts Gov. Mitt Romney during the state's health reform efforts, and now leads the health care policy team at McKenna Long & Aldridge.

"In addition to the individual and small business exchanges mandated under PPACA, private exchanges are emerging as potential vehicles for innovation in the way employers offer coverage to their workforce.

For example, WellPoint recently announced the acquisition of Bloom Health, through which 20,000 employees at 50 companies purchase coverage using pre-tax dollars and a defined contribution from their employers.

What impact do you think that exchanges, public and private, will have on the employer-sponsored insurance

President Obama's latest plan to reduce federal health costs kept true to his call for "modest" adjustments to Medicare. Obama didn't go for any big reforms--like increasing the Medicare eligibility age to 67--but his proposal does go after a few Democratic sacred cows, namely by asking seniors to pay more for their care.

The plan is full of policy proposals that have been around for months, wringing $248 billion in savings from Medicare and $73 billion in savings from Medicaid and other health programs.

They are also items that every lobby can love to hate. The savings come from hits to pharmaceutical companies, hospitals, doctors, insurance companies, and beneficiaries -- a combination that will be a tough vote for politicians in either party. Democrats loathe asking seniors to pay more for their care, and cuts to hometown hospitals are hard for any member of Congress to support, regardless of party. Republicans will especially oppose charging pharmaceutical companies more.

What do you think of the president's plan for Medicare? Does it stand a chance of passing,