Health Law and Policy Update
Headlines of the week
Florida judge allows health reform case to move forward
A federal judge in Florida issued a ruling Thursday permitting a constitutional challenge to the individual mandate in national health reform to proceed. The ruling did not address the merits of the case, but it said with regard to some of the plaintiffs' challenges, the plaintiffs have standing to pursue their claims and have stated plausible claims for relief.
The plaintiffs include 16 state attorneys general, including John Suthers of Colorado, four governors, the National Federation of Independent Business and two individual plaintiffs. They sued federal agencies, seeking a ruling that the Affordable Care Act's requirement for most people to have insurance violates the U.S. Constitution.
The judge dismissed count 2 (challenging the individual mandate as violating substantive due process under the Fifth Amendment), count 3 (challenging the individual mandate as an unconstitutional capitation or direct tax), count 5 (challenging the states' option to create health insurance exchanges as improper coercion and commandeering violating the Ninth and Tenth Amendments), and count 6 (challenging the requirement that states offer and enroll their employees in health benefits as interfering with state sovereignty). The judge allowed count 1 (challenging the individual mandate based on the Commerce Clause), and count 4 (challenging to the expansion of Medicaid as being coercive and violating Congress's Article I powers, Commerce Clause, and Ninth and Tenth Amendments) to go forward. Motions for Summary Judgment are due to the court by Jan. 4, 2011.
Recently, another federal judge held the individual mandate constitutional. The various federal district court decisions are very likely to be appealed to the circuit courts of appeal, and from there, possibly to the U.S. Supreme Court, which is likely to take the case if different courts of appeal reach opposite conclusions. A final decision is 18 months to two years away.
NAIC approves model regulations on medical loss ratio
The National Association of Insurance Commissioners (NAIC) Health Insurance and Managed Care Committee on Thursday approved the model regulation containing the definitions and methodologies for calculating medical loss ratios. Medical loss ratios for health insurance companies are the portion of each premium dollar the companies spend on medical care for their customers.
The model regulation now goes to a vote of NAIC's Executive/Plenary Committee next week and once approved, the NAIC will forward the model regulation to the Department of Health and Human Services for certification.
Advancing the debate
Amendment 63 could disrupt student health
Colorado's Amendment 63 on the November ballot could prohibit state colleges and universities from requiring students to have health insurance, and it could undermine the student health system by prohibiting a state college or university from assessing mandatory health fees. Such a prohibition might shut down student health care and mental health services on state college campuses. Those are among the conclusions of an analysis of the amendment by the Colorado Center on Law and Policy.
Amendment 63 cannot do what it purports to accomplish. It is a reckless addition to the Colorado constitution, is broad and ill-defined, and it will lead to costly litigation.
For more information, see a comprehensive analysis and shorter issue brief. To endorse the No on 63 campaign, go to www.coloradodeservesbetter.com.
The Boulder Daily Camera and The Durango Herald editorial boards this week advised readers to vote "no" on Amendment 63.
What's new
Affordable Care Act money helps community health centers
Community health centers in Englewood, Alamosa and Lafayette will receive grants from the federal government enabling them to serve 15,200 more people, the Department of Health and Human Services announced Oct. 8.
The grants to Colorado-based agencies total $18.6 million. They're part of $727 million to 143 community health centers across the country. Colorado's grant recipients include Valley-Wide Health Systems in Alamosa ($4.6 million), Metro Community Provider Network in Englewood, $10.2 million) and Clinica Campesina Family Health Services in Lafayette ($3.8 million).
"These funds from the Affordable Care Act will help get more people care in some communities where there have not been many options in the past," Secretary of Health and Human Services Kathleen Sebelius said in a prepared statement. "The newly constructed or expanded community health centers will provide care to an additional 745,000 patients and much needed employment opportunities in both rural and urban underserved communities."
Grant will help Colorado fight Medicare fraud
A $100,000 federal grant to the Colorado Department of Regulatory Agencies will boost the state's efforts to combat Medicare fraud. The Centers for Medicare & Medicaid Services announced the grant Oct. 1 along with 50 other recipients nationwide.
The $9 million in grants nationwide represents a doubling of funding for Senior Medicare Patrol programs, which use volunteers to educate seniors about potential fraud.
Colorado doctor will serve on health workforce commission
A top official at the University of Colorado School of Medicine has been named to the National Health Care Workforce Commission, the Government Accountability Office (GAO) announced Sept. 30.
The official, Dr. Richard Krugman, is vice chancellor for health affairs at the University of Colorado at Denver and dean of the University of Colorado School of Medicine. He helped start rural health education and physician assistant training programs in Colorado, the GAO said in an announcement of the appointment. Fourteen other officials were also appointed to the commission.
The Affordable Care Act created the National Health Care Workforce Commission to " serve as a national resource for Congress, the President, and states and localities; to communicate and coordinate with federal departments; to develop and commission evaluations of education and training activities; to identify barriers to improved coordination at the federal, state, and local levels and recommend ways to address them; and to encourage innovations that address population needs, changing technology, and other environmental factors," the GAO said.
Health insurance consumers will pay more next year
Open enrollment season for health insurance this fall will bring higher premiums, higher deductibles and other changes to boost insurance companies' revenues, according to a Tuesday report by Kaiser Health News.
The report cites a study released last month by the Kaiser Family Foundation and the Health Research & Educational Trust. Among the findings, insurance companies are complying with the Affordable Care Act's requirement to allow coverage of adult children up to age 26 on a parent's policy. Now, though, "plans are charging for every dependent on a plan rather than including an unlimited number in a single family premium."
What's next
Latina Health Summit set for Saturday
The 5th Annual Latina Health Summit, set for Saturday, Oct. 16, in Denver, will provide opportunities to learn about reproductive justice, political involvement, self-care and artistic expression. It's sponsored by the Colorado Organization for Latina Opportunity and Reproductive Justice (COLOR). The summit will also offer community resource booths with wellness information, speakers, live entertainment and more.
"By creating a safe space for young Latinas and their families to talk about reproductive rights and health issues, these Latinas will leave the health summit with great information about their health, resources within their community and the opportunity to build a reproductive justice movement with other Latinas," the organization said in a news release.
The cost to attend is $5. Breakfast, lunch and appetizers will be served; free childcare is provided. For more information or to register, contact Mimi at 303-393-0382 or miriam@colorlatina.org or visit www.colorlatina.org.
Opportunities to learn about health reform
People along Colorado's western Interstate 70 corridor will have several opportunities to learn about health reform later this month at meetings put on by Senior Link and the Colorado Center on Law and Policy. The meetings will include presentations by Health Care Director Elisabeth Arenales.
- 1:30 to 3:30 p.m. Oct. 26 at the Eagle County Community Center, Mount Sopris Room, 0020 Eagle County Drive, El Jebel.
- 6 to 8 p.m. Oct. 26 at Colorado Mountain College, Rifle Campus, auditorium, 3695 Airport Road, Rifle.
- 2 to 4 p.m. Oct. 27 at Colorado Mountain College, Glenwood Center, Lucy Huntley Room, 1402 Blake Ave., Glenwood Springs.
- 5:30 to 7:30 p.m. Oct. 27 at Mesa Vista Assisted Living, 0072 E. Sipprelle Drive, Battlement Mesa.
- 8:30 to 10:30 a.m. Oct. 28 at Golden Eagle Center, 800 Broadway St., Eagle.
- 5:30 to 7:30 p.m. Oct. 28 at the Summit County Community-Senior Center, Fremont Room, 0083 Nancy's Place, Frisco.
What you can do
Schedule a presentation on health reform
Health reform can be confusing. The health staff at the Colorado Center on Law and Policy is ready to help community groups, medical professionals, lawmakers and others understand the complexities of health reform and how it will roll out during the next few years. Please contact us to schedule a presentation.
Health Law and Policy Update is issued weekly by the health staff of the Colorado Center on Law and Policy. Subscribe by e-mail or read previous editions.
Health Care Director
Elisabeth Arenales
Health Care Attorney
Adela Flores-Brennan
Special Counsel
Ed Kahn
Communications Director
Perry Swanson
Released Oct. 15, 2010