Federal Officials Face Challenges in Reform Law Implementation
As implementation of the new health reform law begins, federal officials face a host of challenges, including pressure from dozens of special-interest groups who are working to influence provisions of the law not yet finalized, USA Today reports.
The new reform law calls for several federal agencies to define many of the law's components.
The effort to fully write the law and clarify specific regulations could take years, largely take place "behind the scenes" and be subject to intense lobbying from interested parties, according to USA Today.
For example, the U.S. Chamber of Commerce will work to influence the Treasury Department's definition of "full-time" employee, because one component of the overhaul requires employers with more than 50 full-time employees to offer insurance coverage to their workers.
In another instance, the National Partnership for Women and Families wants HHS officials to consider quality of care when evaluating various pilot programs established by the reform law (Fritze, USA Today, 4/27).
Meanwhile, there are other challenges standing in the way of fully implementing the overhaul. Expansion of Medicaid -- which could cover as many as 20 million of the 32 million U.S. residents expected to gain insurance under the law -- poses several hurdles.
Many physicians currently refuse to accept Medicaid patients because the program's reimbursement rates are below that of private insurers and Medicare.
Although the new reform law raises payments to Medicare levels without requiring states to pay a portion of the higher costs, the increases are only temporary and might not encourage specialists to accept more Medicaid patients, observers note. Providers who do accept Medicaid likely will face a greater strain as more U.S. residents join the program.
Medicaid could also face new administrative burdens because of outdated computers, which need to be upgraded for the program to share data with new insurance exchanges and handle large amounts of paperwork (Rabin, New York Times, 4/26).
Extending Insurance to Young Adults
Further, one component of the new reform law that Democrats recently touted as an immediate benefit -- allowing roughly 485,000 young adults to remain on their parents' insurance plans until age 26 -- has run into troubles, the AP/Miami Herald reports.
A number of insurers announced recently that they would begin extending coverage to such young adults before the overhaul requires them to do so in 2011. However, the change only applies to policies sold directly to the customer, without an intermediary.
Because large employers generally use intermediaries to purchase coverage for workers, some young adults may experience a gap in coverage and may not gain insurance until 2011.
Although some businesses are considering immediately offering coverage to workers' children up to age 26, many of those companies are struggling to determine how to price such coverage and what the tax implications will be (Alonso-Zaldivar, AP/Miami Herald, 4/27).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.