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Events of Interest:
Finding Your Way: A Navigation Guide for Wisconsin Families Who Have Children and Youth with Special Health Care Needs and Disabilities has been published. Download a pdf version of the booklet here.
April 11, 5:30 - 8:30 pm, Rhinelander. Family Voices Spring Training: “Did You Know? Now You Know” is a training that provides a comprehensive overview of health care, community supports and services and resources for children and youth with disabilities and special health care needs from birth through young adulthood. Contact the Northern Regional Center at 1-866-640-4106 or e-mail Julia.Stavran@co.marathon.wi.us.
April 16. Parent to Parent of Wisconsin's Support Parent Trainings are held periodically throughout the State. Trainings are held in small group settings (8-15 participants). Registration is required for all trainings. The next training will be held on Saturday, April 16, 2012 from 9:00 am to 3:30 pm at the Children’s Hospital of Wisconsin Corporate Center (999 North 92nd, Milwaukee, WI). Call or email to register: 715-361-2934.
April 17, 5:00 - 8:30 pm, Door County (Brussels) - Family Voices Spring Training: “What’s After High School - Training on Transition” is training on transition to adult life for youth with disabilities and/or special health care needs. Topics include: envisioning a youth’s future in the community; the role of schools; long term supports; vocational resources; transitioning to adult health care; guardianship and other legal options; advocacy; and the fundamentals of self-determination. Contact the Northeast Regional Center at 877-568-5205 or email Kara at KVanVooren@chw.org.
WI Youth Leadership Forum is accepting applications for its 2012 Leadership Forum event. The YLF is a FREE program for high school students with disabilities who would like to take part in a unique and fun week long leadership development program. Participants will sharpen their leadership and self-advocacy skills, develop their career awareness, experience college life, meet successful speakers from across the state with similar disabilities as theirs and develop their own Personal Leadership Plan that they will implement when they return home. The YLF will be held June 17 – 22, 2012 on the Edgewood College campus in Madison, WI. The APPLICATION DEADLINE is April 16, 2012. The YLF is a competitive process. Applicants must complete the application, submit a brief response to 2 essay questions and obtain 3 letters of recommendation.
April 19. CYSHCN Collaborator's Meeting, Wisconsin Dells.
April 20-21. Youth in Partnership with Parents for Empowerment. 5 p.m. Fridays ending by 3 p.m. on Saturdays at the Tundra Lodge Resort & Conference Center, Green Bay, WI. Youth, parents and guardians must attend all five sessions. For more information, contact Martha DeYoung at 800-862-3725.
April 26-27. Circles of Life Conference 2012: a statewide conference for the families of children and youth with disabilities and the professionals who support them. This year's conference will be at the Madison Marriott Hotel. Fore more information, click here.
Is there an event missing from our list? Let us know! Email us with events, directions and details other collaborators may like to attend.
May 2, 5:00 - 8:30 pm, Eau Claire - Family Voices Spring Training: “What’s After High School - Training on Transition” is training on transition to adult life for youth with disabilities and/or special health care needs. Topics include: envisioning a youth’s future in the community; the role of schools; long term supports; vocational resources; transitioning to adult health care; guardianship and other legal options; advocacy; and the fundamentals of self-determination. Contact the Western Regional Center at 800-400-3678 or email Rose at rmarsh@co.chippewa.wi.us.
May 3, 10:00am - 1:00pm, Black River Falls. Family Voices Spring Training: “Did You Know? Now You Know” is a training that provides a comprehensive overview of health care, community supports and services and resources for children and youth with disabilities and special health care needs from birth through young adulthood. Contact the Jackson County Birth to 3 Program/Family Support Program at 715-284-4301 x 301 (Anita) or x 359 (Erin) or email Anita.Leis@co.jackson.wi.us.
JOB ANNOUNCEMENT
Wisconsin Family Ties is seeking a compassionate, motivated individual to work as a Parent Peer Specialist in Grant County. Use your own life experience as a caregiver of a child with a mental health or autism spectrum disorder to assist other families experiencing challenges related to their child's emotional or behavioral health. This is a great opportunity to get in on the leading edge of the growing peer specialist profession. Send resume and cover letter with salary history to info@wifamilyties.org. Please indicate the position title in the subject line of your email.
A Training Announcement for All CYSHCN Collaborators: CHANGED DATE: Our Next Training is Thursday, April 12!
Training Topic: "So You're Turning 18 and on SSI...What's Next?"
To avoid a conflict with the CYSHCN Collaborator's meeting, ABC for Health will host their next webcast on April 12 at 10:30am. Watch your inbox for login information!
April’s webcast for collaborators will address the pressing topic of “Transitioning to Adulthood.” As children become adults, their medical needs and coverage options may change at the same time. Tune in for this discussion on health care coverage options for individuals approaching the age of 18. When you tune in on April 12, keep in mind the following learning objectives:
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Learn the basics of Adult Disability Programs
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How to help families continually plan, obtain and organize useful information at critical transition times;
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Learn hallmarks of appropriate public and private health care coverage resources and important timelines of when to apply;
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Use resources to facilitate a smooth transition from child- to adult- disability programs;
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Learn strategies for good case management.
ABC for Health hosts these trainings especially for CYSHCN Collaborators. If you missed our live webcast, you can watch the archived version at any time! Need help finding it? Email Adam! Find our last training, "Getting Kids Covered with HealthCheck Other Services" in the archive!
Referrals to ABC: CYSHCN Collaborators, click the "Referral Form" image at right to be directed to the printable version of the CYSHCN Client Referral Form! Use this handy tool in directing a family to ABC for Health for services.
Why should you use this Referral Form? It helps keep YOU in the loop! By using the form, you agree to the language on the form that says you have "Verbal permission from parent/guardian to share information with ABC for Health." This allows us to communicate with YOU!
Analysis & Comment
More on the Affordable Care Act and the Supreme Court
The Supreme Court Hears Health Reform
Not since the New Deal has such a large scale regulatory package appeared before our nation’s highest court. In three days of arguments, lasting over six hours, the Solicitor General Don Verrilli, Jr. represented the interest of the Obama Administration to preserve the Affordable Care Act as law of the land. Former Solicitor General Paul Clement, a well-seasoned litigator, represented the 26 states opposed to the reform law, of which Wisconsin is one. At issue in the Court were the following:
Will the Court strike down the individual mandate? If so, will the Court leave the rest of the law intact? Will the Court alter or strike the Medicaid expansions? Will the Court decide that no one will have standing to challenge the law until someone has to pay a penalty in 2015 for not being insured?
The Supreme Court is charged with looking at whether the law conforms to the specific powers of the federal government authorized by the U.S. Constitution — which include the power to regulate interstate commerce, regulate taxes, and to raise an army. When arguing in front of the Supreme Court, the Solicitor General had to prove that the Affordable Care Act - especially the individual mandate that requires to purchase insurance or face a financial penalty - fits within one of those three enumerated federal powers. Well, we can rule out raising an army. The Obama Administration argued that the Affordable Care Act is an expression of interstate commerce due to the way the law was developed to pass in Congress. The Administration passed the health reform law by sidestepping the tax issue for one logical reason. Politics. That left them to stick to the more difficult constitutional argument that this package of regulatory legislation is “interstate commerce ” And allowed under the constitution.
Politics vs. Ideology
When health reform was being debated in the halls of Congress, legislation that “taxed” the American people would never have passed. To get the “blue dog” Democrats on board, like Ben Nelson and Mary Landrieu, a tax would never have been approved. Instead, to get political buy-in on health reform in 2010, the Obama Administration had to convince the legislature that this health reform legislation was appropriate for all Americans because it fell under their enumerated power to regulate interstate commerce. This was an easier argument in the Congress than in the Courts. The Supreme Court Justices, political appointees but by definition “non partisan,” are not easily swayed by politics. They are, however, driven by ideology. This raises an interesting political consequence to Court opinions. The best example actually was displayed on the first day of argument in front of the Court, as the more conservative, strict constitutionalist members of the Court struggled to “fit” the Affordable Care Act into a category of “interstate commerce,” they hinted that in the case of a single payer health care system, they would not be struggling at all. Politically, single payer is very clearly a liberal, democratic position. Constitutionally, it is obviously an enumerated federal power to tax. Justices Scalia, Alito and Thomas, for example, hinted that they would have had a hard time finding single payer health care unconstitutional, and would most likely uphold such a system of reform. (Now think again about our Congress, complete with blue dog democrats. Good luck getting single payer passed.)
The Commerce Argument
States could very easily implement a health reform system identical to the Affordable Care Act under each state’s “police power.” Consider state laws that require residents to purchase auto insurance or even have a driver’s license. There are some federal parallels to state police power, when jurisdiction becomes a problem. As people move frequently across state line, like a long distance truck driver, such a person can be mandated by the federal government, not the states, to get a special truck license. This simple example delineates the difference between state power and federal powers. The Solicitor General was faced with presenting the very challenging argument that people not buying insurance harms interstate commerce—that is, that an omission, not an act, was at play. Justices struggled to accept the argument that if you’re deciding not to buy health care, that is commerce. Can you “create” commerce in order to regulate it?
Severability
For purposes of argument, if the Court decides the individual mandate is “unconstitutional,” then would other part of health reform disappear? Most experts agree that the Court most likely would not strike down the entire law. They are more likely to strike just those portions that are inextricably intertwined with the individual mandate, such as the “guaranteed issue” and “community ratings” provisions. Maybe, although not entirely likely, exchanges could disappear. The reality is that the Justices have to act fast, with an opinion coming before the session closes in June. Justice Scalia already told us he isn’t reading the full 2,700 pages of the law and doesn’t plan on mapping out every section. The Court doesn’t have the time or resources to do that. So, we can predict that the opinion will be relatively simple: keep it all or strike the mandate with the two pieces the Solicitor General argued were so entwined. (And you can bet that anything that has already been implemented will just stop, that a finding of “unconstitutional” can’t mean it will be retroactive. Look at the benefits of reform already handed out: adding children back to parents’ insurance policies; Medicare Part D rebates; small business tax credits. People can’t repay those benefits.)
The Influence of Political Polarization
Politics mattered to the Court. The consequence of the Court severing the Affordable Care Act, for example, was spoken to by Justice Scalia who understood that if the Court were to find the individual mandate unconstitutional, and leave the rest of the law standing, then “Congressional inertia” would mean nothing would get done. He believed that the Senate would never vote, especially on the heels of an election, to change anything on the books, “you’ll never get 60 votes to change it.” At one point Former Solicitor General Clement argued that all of the Affordable Care Act should be stricken by the Supreme Court. When he clarified that Congress could then act to pass “good parts of the law” such as Indian health coverage or programs to address lung disease, the courtroom erupted in laughter. The political reality is that congress will not compromise and pass the “good parts.” The amazing factor is that the Justices actually were taking the polarization of the Congress into account when determining the constitutionality of the law.
Medicaid Expansion
Health reform includes a Medicaid expansion for all adults under age 65 and below 133% FPL. Effective in 2014, the feds will pick up the full cost of the expansion for the first few years of the expansion. Few argue with this part of the law. Controversy exists once the states are asked to participate in the cost sharing—starting in 2016. If a state does not participate in a Medicaid expansion, they will lose the ability to participate in any other part of the Medicaid program—a “use it or lose it” clause. The states argued that “mandating” states to participate in a federal program is unconstitutional. The Feds argued that this was indeed NOT a mandate. If a state didn’t want to participate, it didn’t have to. I could simply walk away. The implication to finding this “use it or lose it” clause unconstitutional has huge implications inside and out of the health care realm. Consider education, transportation, or environmental functions where the feds provide funding to the states on the condition that states meet specified requirements. The Court will be seriously considering the impact of their decision as potentially powerful precedent. When boiling down Solicitor General’s arguments in favor of expanding Medicaid, at the heart of his comment is the fact that these Medicaid dollars are federal dollars. Congress can (and did) decide that under the “General Welfare and Appropriates Clauses” Congress has the power to decide how the money can be spent. Congress chose to spend money on a Medicaid expansion, making an offer to the states. They would be wise to accept it.
In the Medicaid Debate, Politics Rears its Ugly Head
Former Solicitor General Clement arguing on behalf of the 26 states opposed to health reform said the Medicaid expansion, called the “minimum coverage requirement” forces poor individuals to enroll in Medicaid. He continued that the requirement meant that continued state participation in the existing Medicaid program would be made conditional on participating in the Medicaid expansion. Justice Ginsburg reminded the Court that this has been the case in ALL Medicaid expansions, something Mr. Clement had to admit to be true. He then tried to show how this particular expansion was unique. He started by saying the size and scope was unprecedented. Justice Breyer quickly disagreed. Justice Ginsburg again stated that many states were quite happy with the expansion. (Keep in mind that Wisconsin’s BadgerCare Plus Core Plan—a sample program expansion quite similar to what was proposed in health reform only with much more limited benefits coverage was is very high demand when debuted in 2009, and a total of over 126,000 still sit on the program’s waiting list.) Mr. Clement said he was there to represent the 26 states who didn’t want the program expansion (ironically, Wisconsin is one of those 26 states.) Justice Scalia reminded the Court that those 26 states had Republican governors at the time they joined the suit. Chief Justice Roberts pondered, would a state ever say, “go ahead. . .make my day, take it [Medicaid] away.” Stranger things have happened.
The Problem with a Congressional Boomerang
What would Congress do if parts of health reform were added back to its plate in 2012? Not spoken, but certainly on the minds of the Justices, is the 2012 election. The Feds can’t “fix” health care reform administratively if the Court disagrees with the individual mandate or the balance of reform—they need Congress. The outcome of health reform could be very dependent on the November 2012 election. Keep in mind, the “Bush tax cuts,” the “Medicare Doctor fee issue,” and the budget deficit are all due to be discussed before 2012 rolls to a close. Is there room on the Congressional plate to add a serving of health reform?
Headlines
Small bomb explodes at Appleton Planned Parenthood clinic
Dane101, Apr. 2, 2012
A small explosive device detonated on the windowsill of the Appleton Planned Parenthood facility in Grand Chute on Sunday evening, slightly damaging one of the exam rooms.
Obama's insurance requirement not the only mandate
Associated Press, Apr. 2, 2012
The individual insurance requirement that the Supreme Court is reviewing isn't the first federal mandate involving health care.
5 key questions for the Supreme Court to consider in a healthcare decision
The Hill, Mar. 31, 2012
A handful of specific questions from last week's oral arguments could help shape the Supreme Court's landmark ruling on President Obama’s healthcare law.
Dane County black infant mortality rate remains high
Wisconsin State Journal, Mar. 30, 2012
Dane County's black infant mortality rate remained high last year, further puzzling health officials trying to figure out why the rate dropped from 2002 to 2007 but shot up again beginning in 2008.
Cedarburg native plays key role in care act case
Journal Sentinel, Mar. 29, 2012
For Paul Clement, this was a big week at the U.S. Supreme Court. Clement represented the 26 states challenging the law, and many observers - even those who initially predicted the law would survive - by Wednesday were predicting Clement's argument would prevail.
Building a Consumer-Oriented Health Insurance Exchange: Key issues [Report]
National Academy for State Health Policy, March 2012
This report covers three main areas where consumers intersect with the exchange: ways consumers participate in exchange governance, consumer input into exchange policy and implementation decisions, and early planning for the consumer-serving functions of the exchange, such as navigator programs and the web portal.
Modeling the Impacts of ACA on Health Insurance: A New Tool for States
SHADAC, March 2012
Presentation by SHADAC Deputy Director Julie Sonier at the Minnesota Health Services Research Conference, held March 6, 2012 in St. Paul, MN. This presentation describes a modeling tool of state Affordable Care Act impacts on coverage that allows users to input/change assumptions and allows for detailed analysis by characteristics relevant to health insurance coverage.
Defining Family for Studies of Health Insurance Coverage
SHADAC, March 2012
In this brief SHADAC describes an important decision that should be considered in analyses of health insurance coverage using survey data: Defining the "family unit" for examining insurance coverage, often called the health insurance unit.
The Individual Mandate in Perspective
Urban Institute, March 2012
Researchers find small number of people will be affected by mandate, but large benefit for population and stability of insurance markets.
How Collapse of Health-Care Law Could Help Democrats
NPR, Mar. 29, 2012
There are ways in which the striking down of the law could help the president and his party. First, it would eliminate an issue that Republicans have rallied around since early 2009, a fundamental element of the Tea Party movement and a focal point for GOP candidates in 2012. Second, and conversely, a major hit from the high court could create a bounce-back issue for outraged Democrats in 2012 and beyond.
Judges Question Health Law
Wall Street Journal, Mar. 29, 2012
The court's liberal and conservative wings seemed inclined to split evenly over the question of whether the "individual mandate" requiring Americans to carry health insurance or pay a fine is constitutional.
Court seems split by ideology over health care
Associated Press, Mar. 29, 2012
Questions at the court this week days showed a strong ideological division between the liberal justices who seem inclined to uphold the law in its entirety and the conservative justices whose skepticism about Congress' power to force people to buy insurance suggests deep trouble for the insurance requirement, and possibly the entire law.
Webcast Replay: Deconstructing the Supreme Court's Historic Health Law Arguments
Kaiser Health News, Mar. 29, 2012
After six hours of historic arguments on the health law, the Supreme Court now begins its deliberations. What were the key moments in the debate, and how might they affect the outcome?
Alice Noble and Mary Ann Chirba On Severability: Life Is a Highway
Health Affairs, Mar. 29, 2012
Whether the individual mandate can be severed from the overall Act without causing the Act to implode is not a hard question. The reason? Many provisions are in place and gradually changing the nature of the debate.
Walker signs health care bills at Marshfield Clinic
Wisconsin Rapids Tribune, Mar. 28, 2012
Gov. Scott Walker visited Marshfield Clinic on Wednesday afternoon to sign three bills that he said will make health care delivery more efficient in Wisconsin. The press release can be read here.
Wisconsin Watches Nervously as Court Hears Health Care Case
Rep. Jon Richards, Mar. 28, 2012
Any court decision that effectively rolls back or repeals the Affordable Care Act (ACA) would be a double-whammy for Wisconsin health care consumers. Not only would everyone who is helped by the law lose their hard earned benefits, many would also still be left to rely on a safety net that Gov. Scott Walker is relentlessly tearing down.
States get tough SCOTUS questions on Medicaid
Politico, Mar. 28, 2012
The Supreme Court’s liberal justices hammered the health care reform law’s opponents with tough questions about their objections to the law’s Medicaid expansion.
Medicaid Expansion Caps Supreme Court Arguments
NPR, Mar. 28, 2012
The key issue is whether the health law's expansion of the Medicaid program for the poor unfairly compels the participation of states. Many considered this to be the weakest part of the states' challenge to the health law, and during Wednesday afternoon's arguments, that seemed to be the case.
James Carville: Court loss 'best thing' for Democrats
Politico, Mar. 28, 2012
Overturning President Barack Obama’s healthcare reform law would be a political boost for Democrats, veteran Democratic strategist James Carville said Tuesday.
Obama lawyer asks Supreme Court to save health care law
Reuters, Mar. 28, 2012
The Obama administration's top courtroom lawyer made an impassioned plea on Wednesday for the Supreme Court to save President Barack Obama's healthcare law, capping three days of historic arguments that left it unclear how the nine justices would rule.
Health care: Some justices seem open to saving parts of law
Post Crescent, Mar. 28, 2012
The Supreme Court signaled Wednesday that it could throw out other key parts of President Barack Obama’s health care law if it first finds the individual insurance requirement unconstitutional.
Supreme Court justices signal health care law in deep trouble
Post Crescent, Mar. 28, 2012
The fate of President Barack Obama's health care overhaul was cast into deeper jeopardy Tuesday as the Supreme Court's conservative justices sharply and repeatedly questioned its core requirement that virtually every American carry insurance.
Analysis of Arguments - The Supreme Court Health Care Challenges
The New York Times, Mar. 28, 2012
On March 28, 2012, the Supreme Court concluded the third and final day of arguments challenging the constitutionality of the 2010 health care law. Times reporters offered analysis of the hearings each day, with audio excerpts.
Alice Noble And Mary Ann Chirba On The Individual Mandate Argument: Beyond Uncompensated Care
Health Affairs, Mar. 28, 2012
Uncompensated care is certainly a problem, and a big one. But it is only a portion of a much larger and complicated threat to our national economy, and Congress knew this. Even among the insured, there are people who cannot keep up with their rising premiums, co-payments and deductibles. Therefore, health care cost inflation obviously affects patients, providers and payers; it affects the accessibility, quality and cost of health care and health insurance; and, therefore, it affects the financial viability of all players in the health care sector.
William Sage On The Supreme Court ACA Arguments Day Two: Where No Law Has Gone Before?
Health Affairs, Mar. 28, 2012
The much-anticipated argument over the constitutionality of the Affordable Care Act’s insurance centerpiece, the minimum coverage requirement or “individual mandate,” took place Tuesday morning. It was an entertaining but messy affair, with several individuals often speaking at once and answers to questions frequently getting lost in subsequent comments and inquiries.
Marc Rodwin On The Individual Mandate: Congress Can Constitutionally Build On Private Insurance
Health Affairs, Mar. 28, 2012
The United States differs from most other developed nations in relying largely on private rather than public insurance for health care. It also differs from many nations in making use of the private sector to supply many public services. The private insurance market, however, has been plagued by market failures due to adverse selection, moral hazard, and individual risk-rating. Congress should be allowed to enact legislation that fixes that market failure in order to fulfill a traditional governmental function.
Scott Walker Blames Health Care Reform For Slow Job Growth In Wisconsin
Huffington Post, Mar. 27, 2012
With new employment figures showing sluggish growth, Walker is placing the blame on an unlikely culprit: federal health care reform. Recent federal data show that although the state's unemployment rate has gone down, Wisconsin has lost more jobs than any other state since Walker took office.
Sara Rosenbaum On SCOTUS Day Two: Rashomon On The Potomac
Health Affairs, Mar. 27, 2012
In Rashomon, the classic film exploration of truth, director Akira Kurosawa offers a meditation on the degree to which point of view colors reality. A Rashomon of sorts played out during the second day of Supreme Court oral arguments on the Affordable Care Act. A reflective summation of the day suggests that both sides experienced intense questioning by an extremely engaged Court.
Wendy Mariner On The Supreme Court’s Individual Mandate Oral Argument: The Search For A Limiting Principle
Health Affairs, Mar. 27, 2012
Much of the entire oral argument was devoted to the search for a limiting principle, a standard that would distinguish federal power to require individuals to buy health insurance from the sovereign power of the states to compel individuals to take other types of action.
The Minimum Coverage Requirement Oral Argument: A Comprehensive Discussion By Timothy Jost
Health Affairs, Mar. 27, 2012
It is clear that the four Democratic appointees on the Court will vote to uphold the requirement. It is very likely that Justice Thomas and Justice Scalia will not. Justice Alito also seems like a long shot. But although Justices Kennedy and Roberts pushed General Verrilli hard, they did not seem entirely to side with Mr. Clement and Mr. Carvin.
Reading Between the Lines of Monday's Supreme Court Arguments
NPR, Mar. 26, 2012
The Supreme Court determined that "penalties" for not having health insurance by 2014 are not "taxes" and that the case would move forward without coming into conflict with the Anti-Injunction Act.
Arguing That Health Mandate Is Not a Tax, Except When It Is
New York Times, Mar. 26, 2012
Tax or penalty, the choice of labels mattered in considering whether the Anti-Injunction Act applied to the case but was irrelevant in determining whether Congress could justify the insurance mandate as an exercise of its taxing power.
Marbury v. Medicine
Slate, Mar. 26, 2012
The key to saving Obamacare may be hidden in America's first great constitutional case.
Statement by Secretary Kathleen Sebelius on LGBT Health Awareness Week 2012
HHS, Mar. 26, 2012
"The Department of Health and Human Services continues to address the specific health concerns of LGBT Americans, including by working to incorporate data collection on LGBT populations into national health surveys, releasing rules requiring hospitals to allow same-sex partners the ability to visit each other in the hospital, and setting up an internal working group that ensures we are effectively coordinating policies to best address LGBT health needs across every agency in the Department."
High chourt should uphold health reform law [Opinion]
Journal Sentinel, Mar. 26, 2012
"No matter how the court decides, the issues raised by health care reform will not go away. They will be central to the presidential campaign this fall. But two years in, the country is better off with the Affordable Care Act than without it."
Look harder at medical assistance cuts [Editorial]
Post Crescent, Mar. 26, 2012
"We've said before that medical assistance cuts should be a measure of last resort. It's worth noting that more people are likely to drop coverage when their premiums are raised so dramatically. It's also worth noting that those people are likely to forego care until an emergency, when costs will be much greater. And who will pickup those costs? Hospitals themselves, along with the privately insured, whose rates will increase to make up what hospitals lose."
Free Health Clinics At a Crossroads
Kaiser Health News, Mar. 25, 2012
With the health law's expansion of coverage, free clinics are at a crossroads: Should they stay outside the mainstream of the health system, remaining mostly dependent on donations and grants? Or should they start to accept Medicaid and other insurance?
Plan reverses health care reforms, destroys Medicare [Opinion]
Journal Sentinel, Mar. 24, 2012
"The Republican budget repeals the Affordable Care Act and the important provisions it includes. Furthermore, it 'reforms' Medicare by destroying it."
2012: The year of meaningful use
CMS, Mar. 23, 2012
Health IT plays a central role in building a 21st century health care system—where care is safer, better coordinated and patient-centered, where we pay for the right care, not just more care. Increasing the adoption and use of Health IT is crucial, so we’ve set an ambitious goal for 2012: get 100,000 health care providers paid under the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs by year’s end.
Jon Gruber on the premiums in health-care reform
Washington Post, Mar. 23, 2012
Wonkblog clarifies Gruber's position on premiums, having been misrepresented in The Daily Caller. "The premium any given person pays is likely to go down. But for that exact reason, the average of the premiums that everybody pays is likely to go up, as sick people who are priced out of the market right now will be able to buy insurance again. Who “everybody” is, in other words, just changed. “Everybody” got sicker, even though you didn’t get sicker."
Ryan's budget and the path to single-payer health care
Washington Post, Mar. 23, 2012
If the Affordable Care Act is repealed by the next president or rejected by the Supreme Court, Democrats will probably retrench, pursuing a strategy to expand Medicare and Medicaid on the way toward a single-payer system.
Feds to test paying for Medicaid patients with psychiatric emergencies
Capsules, Mar. 23, 2012
A group of states is testing whether Medicaid patients who seek emergency psychiatric care at private psychiatric hospitals are better off if the federal government picks up part of the costs. Right now, the federal government does not help states pay for inpatient psychiatric care for many Medicaid patients—a longstanding policy meant to discourage states from cost-shifting to the federal government and institutionalizing patients.
A Bizarre Outcome on Generic Drugs [Opinion]
The New York Times, Mar. 23, 2012
Dozens of suits against drug companies have been dismissed in federal and state courts because of a decision by the Supreme Court last year that makes it virtually impossible to sue generic manufacturers for failing to provide adequate warning of a prescription drug’s dangers. This situation is particularly bizarre because patients using the brand-name drug can sue when those using the generic form of the drug cannot
New York eyes $18 billion of Medicaid savings to be split with U.S.
Reuters, Mar. 23, 2012
New York plans to overhaul the nation's most expensive Medicaid health care system to save $18.3 billion over five years, and will ask the federal government for half of those savings, a state health department official said.
HEALTH INSURANCE RATE HIKES IN NINE STATES DEEMED EXCESSIVE BY HHS
HHS, Mar. 22, 2012
Health and Human Services (HHS) Secretary Kathleen Sebelius announced that health insurance premium increases in nine states have been deemed “unreasonable” under the rate review authority granted by the Affordable Care Act. She also released a new report today showing that, six months after HHS began reviewing proposed health insurance rate increases, consumers are already seeing results.
Affordable Care Act Works for Western Wisconsin
Congressman Ron Kind, Mar. 21, 2012
Seniors, young adults, and families right here in western Wisconsin are benefitting from important insurance protections, free preventive care and stronger Medicare benefits. And our small businesses, that have received tax credits to help them afford coverage for employees, are better able to survive and thrive, especially in a tough economy.
Madison clinic's decision to stop taking new Medicare patients could be start of new trend
Cap Times, Mar. 21, 2012
Wildwood is the first clinic in Madison and maybe even the entire state to bail out of accepting new Medicare patients. Dr. Tim Bartholow, a senior vice president with the Wisconsin Medical Society, fears it might not be the last.
New Ryan Budget Would Transform Medicare and Medicaid
Kaiser Health News, Mar. 20, 2012
Ryan makes it clear in his proposal that the cost to beneficiaries would be determined solely by competitive bidding between the private and public plans. If Medicare spending exceeded GDP plus 0.5 percent, then, other savings would have to be found in the program, and politicians have a long history of cutting payments to doctors, hospitals and other medical providers.
The case for better health coverage [Opinion]
Journal Sentinel, Mar. 20, 2012
Jari Johnston-Allen argues that benefits to cancer patients, both those already diagnosed and those diagnosed due to pushes for preventative and early detection measures under the ACA, should be primary considerations in deliberations.
Insurers at Risk in Challenge to Health Law's Medicaid Plan
Bloomberg, Mar. 20, 2012
A Supreme Court decision striking down the U.S. health-care law’s expansion of Medicaid might expose environmental and educational laws to legal challenges while hurting stocks that surged anticipating more than $600 billion in new spending over the next decade.
Generic Drugs Proving Resistant to Damage Suits
New York Times, Mar. 20, 2012
Across the country, dozens of lawsuits against generic pharmaceutical companies are being dismissed because of a Supreme Court decision last year that said the companies did not have control over what their labels said and therefore could not be sued for failing to alert patients about the risks of taking their drugs.
Walker signs Family Care expansion amid criticism
Journal Sentinel, Mar. 19, 2012
Gov. Scott Walker signed legislation that expands access to a long-term assistance program known as Family Care, but no sooner had he signed it than Walker was derided by Democrats for having his hand forced by the federal government.
Health Care Debate Returns With Intensity
New York Times, Mar. 19, 2012
The Caucus analyzes the dynamics around the health care debate between Obama and Romney and among Romney, Santorum and Gingrich in anticipation of the Supreme Court arguments.
Insurers Set Plans in Case Health Mandate is Quashed
Wall Street Journal, Mar. 19, 2012
Several officials from large health insurers said that if the mandate were struck down, their first priority would be persuading members of Congress to repeal two of the law's major insurance changes: a requirement to cover everyone regardless of his or her medical history, and limits on how much insurers can vary premiums based on age. The next step, they say, would be to set rewards for people who purchase insurance voluntarily and sanction those who don't.
Cutting Costs with Better Care for Advanced Illness
Wall Street Journal, Mar. 19, 2012
The La Crosse, Wisc.-based Gundersen Health System is part of the Coalition to Transform Advanced Care, which aims to get more health systems to adopt programs such as caring for terminally ill patients at home instead of in hospitals. Gundersen outlines such programs in a new book, Having Your Own Say, which advocates helping patients and families prepare for end-of-life decisions, and avoiding unwanted treatments while providing comfort and pain relief.
Some States Limit How Uninsured Pay for High-Risk Insurance
Kaiser Health News, Mar. 19, 2012
In many states, people with medical conditions such as HIV/AIDs, hemophilia, kidney disease and cancer can get a helping hand from government programs or nonprofits that pay the PCIP premiums on their behalf. But a handful of states have decided to prohibit third parties from picking up the tab.
A Tale of Two Health Insurance Extremes
Kaiser Health News, Mar. 19, 2012
At 25 percent, Texas has the highest rate of uninsured people in the nation. Massachusetts, where a 2006 law made coverage mandatory, has the lowest rate — less than 2 percent of people are uninsured.
Gender Gap Persists in Cost of Health Insurance
New York Times, Mar. 19, 2012
A report to be issued by the National Women’s Law Center, a research and advocacy group, reveals states that have not banned gender rating, more than 90 percent of the best-selling health plans charge women more than men.
At Center of Health Law Clash, a 1942 Case of a Farmer's Wheat
New York Times, Mar. 19, 2012
To hear the Obama administration tell it, the Filburn decision illustrates just how much leeway the federal government has under the Constitution’s commerce clause to regulate the choices individuals make in matters affecting the national economy.
Hurray for Health Reform [Opinion]
The New York Times, Mar. 18, 2012
Paul Krugman writes, "The reform is mainly aimed at Americans who fall through the cracks in our current system — an important goal in its own right. But what makes reform truly urgent is the fact that the cracks are rapidly getting wider, because fewer and fewer jobs come with health benefits; employment-based coverage actually declined even during the 'Bush boom' of 2003 to 2007, and has plunged since."
Under Pressure, New York Moves to Soften Tough Medicaid Audits
New York Times, Mar. 18, 2012
Last year, amid a crescendo of provider complaints of overzealous, nitpicking audits and unfair tactics, Gov. Andrew M. Cuomo quietly dismissed the state’s first Medicaid inspector general, James G. Sheehan, and directed Mr. Sheehan’s successor, James C. Cox, to collaborate with providers on changes to the agency’s policies and auditing methods.
Community clinics key to improving access to healthcare
Journal Sentinel, Mar. 17, 2012
Some physicians question estimates on the number of patients who seek inappropriate care at emergency departments. But no one questions that many patients do so because of the limited number of doctors in the city's low-income neighborhoods.
A Healthy Start: Protecting Great Gains for Children in the Affordable Care Act
Huffington Post Blogs, Mar. 16, 2012
"Now is the moment to add your voice in celebration and support of the Affordable Care Act and fight back attempts to weaken it. Together we must speak out against efforts to turn back the clock of progress. I hope the U.S. Supreme Court will seize the opportunity to affirm the Affordable Care Act and that Congress will continue to defeat efforts to block grant Medicaid and CHIP that would allow states to roll back eligibility and benefits for children and families who need them to survive and thrive. Every child needs a healthy start in life and our rich nation is long overdue in helping assure it."
Barrett wants Milwaukee health systems to put politics aside
Business Journal, Mar. 16, 2012
Health care systems ignored Barrett’s request recently when he requested help getting back federal funds Wisconsin Gov. Scott Walker had turned down. Wisconsin was eligible for a share of a more than $100 million Community Transformation Grant from the federal government, which would have been used to reduce chronic diseases such as diabetes and heart disease, affecting local populations.
Senate Bill Could Roll Back Consumers' Health Insurance Savings
ProPublica, Mar. 16, 2012
Sen. Mary Landrieu, D-La., introduced a bill that would change what costs companies can include in the 15 to 20 percent they are allotted for overhead, salaries and marketing. The bill focuses on payments to insurance agents and brokers. Traditionally, these commissions are bundled into the administrative costs when making the final calculation. But insurance regulators have argued that fees paid to insurance agents and brokers shouldn’t count. Such a change could mean big savings for insurance companies — and much smaller rebates for consumers.
Reform rule details Medicaid expansion
Modern Healthcare, Mar. 16, 2012
A final rule issued by HHS on Friday will create a minimum income-based eligibility standard for every state's Medicaid program, effective in 2014.
GOP Split on Health-Law Repeal Strategy
Healthwatch, Mar. 16, 2012
Republican leaders forfeited any chance of getting significant Democratic support once they opted to pay for the repeal of the Independent Payment Advisory Board by capping medical malpractice damages, and they are now facing a backlash from conservatives who worry piecemeal repeal bills can give vulnerable Democrats cover while making full repeal less likely.
Seeking Legal Interns for Summer 2012
ABC for Health is seeking volunteer, work-study eligible, or students on public interest fellowships for this summer! The position requires admission to law school. Students will provide legal research and writing support for firm attorneys that may include client interviewing and follow-up, drafting letters and memos, assisting on court filings and briefs, and facilitating projects with other agencies and legislators. Other duties include interviewing clients at intake, client counseling, and investigation of health benefits denials. Legal research and writing experience are desired, as are proficiency in Microsoft Word for Windows and a background in health care. Ability to speak Spanish and/or Hmong is a plus. To apply, please email a cover letter and resume to Brynne McBride, Assistant Director.
Support Our Efforts!
2011 was a difficult year for many, including ABC for Health. Over $300,000 in funding and funding opportunities were eliminated from our budget. Consequently, our ability to serve Wisconsin families was greatly diminished. Please consider a tax-deductible donation to ABC for Health to keep advocacy, legal services, and projects like HealthWatch Wisconsin sustainable for years to come. Thank you!
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