Consumer Power Report: The Good, Bad, and Ugly on Cancer

The lead-up to the March 26 hearing has begun.

The Obama administration on Friday told the Supreme Court that the requirement to buy insurance in its health reform law is well within Congress’s constitutional boundaries – and insisted that legally, the law doesn’t break any new ground. The 130-page brief is the first the Justice Department has filed since the court agreed to review the law. … In the brief, the Justice Department argues that the mandate is needed to break a “cycle” of cost-shifting that ultimately makes health insurance more expensive for everyone.

A letter from Sens. Coburn and Brown to CMS demands a response on Reuters’ December Mediscam report, on two main questions:

(1) what GAO and OIG recommendations CMS is considering/working on implementing, and

(2) how many staff/contractors use the free service, Google Earth, to verify addresses before bills are paid.

An interesting report:

Brownback’s administration plans to have three private companies administer Medicaid statewide, with recipients choosing among the firms’ plans. The state already has two private contractors administering health coverage for poor and working-class families with children, but Brownback’s overhaul would pull in coverage of the disabled and elderly.

Bids from prospective contractors are due Jan. 31. The administration said three-year contracts, which start in 2013, will include goals, such as moving mentally ill and disabled Kansans into jobs, providing comprehensive care for diabetes and integrating physical and mental health care. The plan also is designed to ensure that Medicaid clients have a medical “home” and coordination among different providers.

The plan also includes reorganizations of the state’s health, aging, juvenile justice and social and rehabilitation services departments.

Brownback’s administration projects that the changes will reduce overall Medicaid costs by $29 million during the current fiscal year, which ends with June. By 2017, the total annual savings will be $277 million, the administration projects.

Exempt from Obamacare, Christian cost-sharing programs thrive:

The radio spots advertise the fact that Medi-Share members are exempt from the Patient Protection and Affordable Care Act, the new health-care law that requires most Americans who can afford it to purchase insurance by Jan. 1, 2014, or pay fees.

Meggs stressed that while Medi-Share can help Christians manage the costs of health care, it is not insurance. Resources are shared directly between members, and there is no pooling of funds, he said.

Whether Medi-Share qualifies as insurance is controversial in at least one state.

In Kentucky, a circuit court judge issued an injunction in March to keep Medi-Share from operating in the state. The decision followed a 2010 ruling from the state Supreme Court that Medi-Share does, in fact, qualify as insurance.

In November, the Kentucky Department of Insurance filed a motion requesting Medi-Share be held in contempt for violating the injunction, as Medi-Share continues to operate with several hundred members across Kentucky.

According to Meggs, Medi-Share doesn’t legally compel its members to help one another with their bills. Each member is ultimately responsible for his or her own bill.

“You have to be willing to rely on the moral collective will of members to share in your medical bills,” Meggs said.

For Christians who are self-employed or working with a missions agency, the service is invaluable, Armstrong said.

Sebelius had to know this was coming – Oregon balks at new essential benefit challenge.

Even before a new public corporation sets up an electronic marketplace enabling individuals and small businesses to shop for health insurance coverage, its executive director says it’s been tossed “a grenade.”

But Howard “Rocky” King told lawmakers last week that the Oregon Health Insurance Exchange will proceed to submit a business plan for them to consider when they convene their 2012 session Feb. 1. The exchange is scheduled to offer coverage, starting in January 2014, for an estimated 300,000 Oregonians who do not have coverage now.

The “grenade” King referred to was a Dec. 16 announcement by the Obama administration that it intends to give states broad leeway to pick the benefits offered under the 2010 federal health-care overhaul, rather than establish a national standard for “essential benefits.” A national standard would wait until 2016.

At a joint meeting of the House and Senate health care committees a few days after the announcement, King said the federal decision will affect benefits offered in all health insurance coverage for individuals and small businesses, not just those to be offered under the exchange.

A useful report from The Heritage Foundation:

In 2012, Congress will take up the fifth reauthorization of the Prescription Drug User Fee Act (PDUFA), which was first enacted in 1992. This bill will affect millions of American consumers and patients. Although the Food and Drug Administration (FDA) used to be a model for drug approval around the world, today its policies and organizational structure lack predictability, certainty, and efficiency. PDUFA reauthorization should be a priority for 2012 not only for reasons relating to its original establishment, but also as a vehicle to bring the FDA into the 21st century and reversing the slowdown of drug development through transparency and partnership.

The Administration and Members of Congress need to realize the impact that overarching and unnecessary regulations have on biopharmaceutical research and development, which in turn affect the U.S. economy and its competitiveness in the global economy. An ambiguous and inconsistent approval process prevents Americans from accessing new therapies and drugs that save lives. The medical product development path in the U.S. has become more challenging, costly, and unpredictable as the previous reauthorizations have piled on regulations that detract from the FDA’s primary task of providing innovative medical products to the American public as quickly and safely as possible.