Politics and Policy

The Office of Health Reform, in fact, is working overtime to meet deadlines for 2010 policies.

The effect of new Medicaid expansion under the Patient Protection and Affordable Care Act will depend largely on federal and state actions to roll out the provisions and encourage enrollment.

Comparative effectiveness research is suddenly flush with fundings. Tucked in last year's American Recovery and Reinvestment Act was $1.1 billion to accelerate CER.

The Patient Protection and Care Act will allow health insurance coverage through state-based health insurance exchanges, expand Medicaid eligibility, and subsidize insurance premiums, all of which involve state implementation.

It's likely that most major health insurers will participate in the insurance exchanges that must be up and running in each state by 2014, according to experts.

Although the most revolutionary health reform provisions do not go into effect until 2014, insurers and payers are scurrying to implement a number of big changes required this year.

The impact of the tax change generated speculation about whether employers would continue to fund retiree drug plans or overall health benefits.

Medicaid rolls will be expanded to include those earning up to 133% of the federal poverty level and adults without children.

The challenge of implementing various components of health reform was immediately apparent as one of the first new programs went into effect: establishing state high-risk pools for individuals with pre-existing condtions.

First on the reform agenda is an overhaul of the formula for calculating Medicare Advantage payments.

PPACA promises to eventually close the coverage gap for seniors.

Under pressure from the Obama administration, insurers say they will not deny health coverage for sick children pending new regulations, and would follow the intent of the law, not the exact language of it.

The reform law provides for and expansion of Medicaid recipients and dependent children as well as an expansion of the Children's Health Insurance Program.

The new Medicare Advisory Board will have broad responsibility to make recommendations to reduce spending in the Medicare program.

Industry executives were grilled at congressional hearings and summoned to a White House meeting called by Health and Human Services (HHS) Secretary Kathleen Sebelius to discuss rising premiums

One of the main revenue-raising provisions in health reform legislation is to revise methods for calculating payments to Medicare Advantage (MA) plans.

Timely access to treatment for HMO patients in California has been a long time in coming as HMOs, physicians, hospitals, and consumer groups battled it out.

Anthem Blue Cross says that rising healthcare costs in a challenging economy necessitate higher premiums.

The inability of the nation's fragmented health IT systems to communicate with one another has made the task of leveraging data extremely difficult, as have concerns about patient privacy and protecting personal health information.

Insurance exchanges will not exist in a vacuum; they will touch every part of the healthcare system and require substantial changes to the way payers do business.

Medicare cuts, quality measures and operational scrutiny is high on the list of insurers' other concerns in 2010

Two senators investigating medical loss ratios and pricing rationale for small-business policies

Coverage percentages in the high 90s needed to reach critical mass and spread risk

More modest legislative package would stand to gain bipartisan approval in light of Baucus plan reaction

CMS wants to reduce low-value plans and improve information systems to help seniors shop for the best coverage options

State of the Industry survey results

State of the Industry survey results

As the healthcare debate wages on, tea parties are top of mind.

Exchanges could channel subsidies, specify plan design and provide an efficient way to enroll members

The Senate Finance Committee is hammering out a bipartisan bill while other leaders will drive ultimate implementation