NEJM article compares and contrasts Paul Ryan’s “Roadmap for America’s Future” with the ACA

Posted on May 13, 2011 | No Comments
Filed under Health Care Quality and Delivery System Reform, Health Insurance, Library, Long Term Care, Medicaid and CHIP, Medicare, Third Party Resources

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Editor's Comment

The New England Journal of Medicine’s perspective piece “Consensus and Conflict in Health System Reform–The Republican Budget Plan and the ACA” by Timothy Stoltzfus Jost, J.D., compares and contrasts Representative Paul Ryan’s (R-WI) “Roadmap for America’s Future” with the Affordable Care Act (ACA). In terms of their similarities, both plans would create a health care system in which many Americans purchase private health insurance using partially means-tested public subsidies through an exchange-based, information-rich competitive market, which is (more or less) open to all regardless of health status. Those who choose to remain uninsured would incur a penalty (or forgo a benefit), and those who purchased insurance would be responsible for significant costs. Jost also details five key differences between Roadmap and the ACA in the piece.

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CRS issues report regarding presidential power over the ACA

November 15, 2011

On November 14, 2011, the Congressional Research Service issued a memorandum regarding the extent to which a President, through use of an executive order or other administrative actions, could impact provisions under the Affordable Care Act (ACA). The report confirms that while the President would be able to alter certain regulations, a "President would not appear to be able to issue an executive order halting an agency from promulgating a rule that is statutorily required by PPACA, as such an action would conflict with an explicit congressional mandate..." CRS examined the issue for Republican Senator Tom Coburn of Oklahoma, finding that federal courts would frown upon any attempt to undo White House legislation.

Republican Governors Public Policy Committee releases proposal to develop a more efficient Medicaid system

August 31, 2011

The Republican Governors Public Policy Committee, a branch of the Republican Governors Association (RGA), released the proposal, "A New Medicaid: A Flexible, Innovative and Accountable Future," which refers the super committee to 31 ideas for saving and reforming Medicaid. Specifically, the governors support block grants and capped allotments outside of a waiver and the reform of multiple federal programs including workforce training programs. The RGA report opposes cost shifting and tax increases. Key areas of agreement between the GOP report and the Democratic governors include the support of "dual-eligible" health care reform and an opposition to cost shifting proposals such as "blended rates."

NEJM article discusses how to rein in Medicare/Medicaid spending

May 19, 2011

In her New England Journal of Medicine article, "Hard Choices--Alternatives for Reining in Medicare and Medicaid Spending," Dr. Meredith B. Rosenthal of the Harvard School of Public Health compares and contrasts the two most prominent proposals to reform health care: Paul Ryan's "Roadmap for America's Future" and the White House's Affordable Care Act (ACA). She summarizes the main arguments supporting and opposing the two plans. The beauty of Ryan's plan is that by fixing the federal government's contribution to Medicare and Medicaid to a formula unrelated to the growth of overall health care costs, it would guarantee controlled federal spending growth. However, this would also shift financial risk to beneficiaries and state governments. The ACA alters the landscape for control federal health care spending by creating new institutions intended to facilitate progress toward reform and by directly altering payment formulas for Medicare and Medicaid. The downside of this cost savings portion of the ACA is that implementation of payment and delivery reforms is complex.

House Budget Committee's FY2012 Budget Resolution proposes repeal of ACA

April 10, 2011

"The Path to Prosperity: Restoring America's Promise" is the House Budget Committee's Fiscal Year (FY) 2012 budget resolution. The sections "Strengthening the Social Safety Net," and "Fulfilling the Mission of Health and Retirement Security for All Americans," encourage government to repeal and defund the Affordable Care Act (ACA), offering instead a reform proposal that builds upon the Rivlin-Ryan Medicare reform plan advanced in the President's Fiscal Commission in 2010. The FY2012 budget resolution proposes to 1) convert state Medicaid funding into a block grant, 2) offers Medicare beneficiaries the same health care options as members of Congress, 3) calls for the advance of social security solutions.

New Health Affairs article warns of potential breaks in coverage under health reform

February 4, 2011

A new article released in the February 2011 issue of Health Affairs, co-authored by Professor Benjamin Sommers, MD, PhD, of the Harvard School of Public Health, and Professor Sara Rosenbaum, JD, Chair of the Department of Health Policy at the George Washington University School of Public Health and Health Services, examines the potential for gaps in health coverage for some Americans under the Affordable Care Act (ACA).

Update: Legal Challenges to the Affordable Care Act

September 23, 2011

Since the enactment of the Affordable Care Act (ACA), at least 27 lawsuits have been filed challenging the constitutionality of various provisions of the law. While nearly half of the lawsuits have been dismissed on procedural grounds, three district courts have found provisions challenged to be constitutional, and three have found them to be unconstitutional. Previous HealthReform GPS Implementation briefs/updates have discussed these lower court decisions. Following appeals of each of these rulings, the United States Courts of Appeals in the Fourth, Sixth, and Eleventh Circuits have now issued decisions as well. Most importantly, the appellate decisions continue to reflect a split in judicial opinion regarding the constitutionality of the Affordable Care Act’s individual mandate. Other important issues addressed by the appellate rulings concerned the constitutionality of the ACA Medicaid expansion and the question of whether the trial court in the Virginia cases (Liberty University v. Geithner and Commonwealth of Virginia v. Sebelius) had the authority to hear the cases at all.

Editor's Comment: GOP Promises to Repeal and Replace Affordable Care Act in “Pledge to America”

October 8, 2010

On September 23, 2010, Congressional Republicans released a document entitled “A Pledge to America” to help voters in November better understand their position on a broad set of policy issues. Featured in the document, is a pledge to repeal the Patient Protection and Affordable Care Act (ACA), and replace it with “common-sense solutions focused on lowering costs and protecting American jobs.”