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Congress ‘Tip Toes’ Around Obamacare
April 29th, 2013Of the many issues involved with the actual implementation of the 2010 Affordable Care Act, aka, “Obamacare”, few are more intriguing to me than those that personally impact Members of Congress (MOCs). Here’s a good example of what I’m talking about — Today, on Capitol Hill, MOCs, along with thousands of their personal Congressional staff members, are facing a clear legal mandate that requires them to sign up for Obamacare. Read the rest of this entry »
Are US and Canadian Rx Policies Converging?
March 20th, 2013As the US pharmaceutical industry anxiously watches the rapid onset of Obamacare, certainly one of the more pressing issues is the debate over the number of drugs that will be reimbursed in each therapeutic class under the Essential Health Benefits (EHB) program. To say that this is a critical concern for the future of the US pharmaceutical industry would a gross understatement. Read the rest of this entry »
State Surprises as Obamacare Starts Up
February 3rd, 2013This past week or so, with Obamacare’s start up less than a year away, we have been treated to several entertaining vignettes as the nation’s governors begin to wrestle with the realities of the new healthcare law. Consider these:
California
In California, where substantial personal income and sales tax increases were recently passed, Governor Jerry Brown said last week that, in fact, the newly flush state perhaps shouldn’t be solely responsible for shouldering the burdens of Obamacare. Apparently now fully comprehending the cost of the program, Brown cavalierly suggested during his State of the State address that California’s counties should share the tab. Stand by for reaction to this idea from California’s 58 counties. Read the rest of this entry »
Questions About the 2013 Implementation of IPAB
December 20th, 2012With the general election behind us, the anticipated avalanche of ObamaCare regulations has begun. Last week, it was reported that more than 13,000 pages of rules and regulations have been issued by HHS since Nov. 6th. A huge amount of activity, to be sure, but as stated, not surprising. That’s because the law is scheduled to go on line January 2, 2014 and there is much left to done. It’s obviously time for HHS to move forward at full speed to implement the measure.
In the midst of this massive regulatory action, certainly one of the more interesting aspects of ObamaCare’s implementation is the case of the Independent Payment Advisory Board, or IPAB, as it is called.
Why is IPAB of particular interest? Of all the new agencies, bureaus, and institutes that ObamaCare is creating, IPAB is really the only entity in the law that is, by definition, responsible for controlling the costs of the new law’s Medicare spending. That fact, and the powers that IPAB has been given by the law to carry out its mission have made its particular implementation one of the most controversial actions of 2013. Read the rest of this entry »
Can the states afford collision with Feds on Healthcare Reform?
December 12th, 2012It goes without saying that the course of the American Affordable Care Act of 2010 has been long and tortuous. First conceived of during the early days of the Obama Administration’s first term, it took an intense, two year legislative battle to pass it; then a full on US Supreme Court review that culminated in 2012 with a controversial decision to confirm it; and, finally, and most recently, a contentious U.S. Presidential election decided in President Obama’s favor… to effectively put the ACA issue to rest.
ACA, otherwise referred to as “ObamaCare”, is now, for all intents and purposes, no longer an active public debate in the U.S. Or is it? Read the rest of this entry »
With the Election Decided, It’s Full Speed Ahead on ObamaCare
November 8th, 2012With the Presidential election decided and President Obama the clear winner, it’s time for Pharma to get down to business on the implementation of ObamaCare. Here are some of the key actions to anticipate between now and January 1, 2013.
HHS Leadership
First and foremost, the leadership at HHS, including Secretary Kathleen Sebelius, are reportedly likely to stay in place. This is the team that built the many bureaucratic machines that are designed to drive ObamaCare. These government programs, now unshackled from all the political considerations that retarded their full implementation over the last two years, are fully cleared to engage on everything. This HHS team is dedicated to finishing their mission and getting all of ObamaCare up-and-running.
So look for the Independent Payment Advisory Board (IPAB), The Center for Consumer Information and Insurance Oversight (CCIIO), Center for Medicare & Medicaid Innovation (CMMI), The Medicare Integrity Program (MIP) and a whole host of other ObamaCare acronyms to become suddenly, publicly active. Read the rest of this entry »
Sequestration: What Does it Mean for Pharma?
October 3rd, 2012Lurking in the shadows of the US General Elections is something called The Sequestration Transparency Act of 2011. Of late, you may have read the occasional article that breathlessly reports that “US defense will be halved by Sequestration” or “Air Traffic Controllers will be drastically reduced under Sequestration”, and even “Sequestration will lead to the next Great Recession if enacted”. All pretty dire stuff, for sure, and if you begin slicing and dicing these stories, there does appear to be some truth in all of them…if the Act goes into effect.
So, with near Armageddon apparently on the horizon, what in the world is this Sequestration Act and more importantly, what impact, if any, will it have an on the US Pharma? Read on, and I think you will be surprised at the answers. I was.
First of all, what the heck is a “sequestration”? According to dictionary.com, as a legal term, sequestration means “confiscation” or “seizure”. So, this law is designed to confiscate, or seize money out of the existing US budget. Interesting that we have to pass a law to take back our own money… Read the rest of this entry »
Paul Ryan and Pharma: The Inside Story
August 22nd, 2012Well, we certainly have a presidential campaign now, don’t we? Good grief. Since Rep. Paul Ryan was named the Republican VP candidate last week, all hell has broken loose! Given the intensity of the last few days, you’d think the election was tomorrow…
And at some point, you do have to ask yourself, “Really, what is causing all this instant ‘intensity’?” In fact, it appears to revolve entirely around the personality of the young man from Janesville, WI…and specifically, his views on one issue…Medicare. Read the rest of this entry »
Drug Reimbursement and the “New Medicaid”
August 9th, 2012A lot has been written about the “state option” created by the Supreme Court ruling on HCR, and what it means to American medicine. Sorting out an opinion will, to a degree, depend on whom you read and what you believe.
But regardless of where you come out on this issue, there is little doubt that the Congressional “threat” to withhold funding from those States that might not comply with the law was obliterated by Chief Justice John Roberts. Indeed, in his Majority opinion [pp. 49, 50] Roberts clearly states the responsibility for decisions regarding the “New Medicaid” will fall on the states; not the feds. Potentially, a stunning decision.
The “Ying and Yang” of the Court Decision on HCR
June 29th, 2012If you’re like me, you probably bounded out of bed on Thursday morning, took in all the news you could find about the Supreme Court and healthcare reform…and then you waited. You waited patiently for the biggest legal call in American healthcare history. And then, there it was.
What did we learn? Well, first, the mandate is confirmed. The four “liberal” justices (Ginsberg, Breyer, Kagan, and Sotomayor) were joined, somewhat surprisingly, by the Chief of the Supreme Court, Roberts, a “conservative,” in declaring the mandate could stand, because in fact, it is really a tax…and since Congress, does, indeed, have the constitutional power to levy a tax, the mandate passes constitutional muster.
All right, so the mandate really is a tax. If it is a tax, it would seem President Obama will have some explaining to do during the upcoming Presidential campaign as he was quoted several times in 2009 as saying, “It is not a tax.” Probably the most memorable denial came during an interview with ABC-TV’s George Stephanopoulos (http://tinyurl.com/mkdxrd). But that’s for another time… Read the rest of this entry »
