In Washington, time running out to address health care concerns

Based on a partnership with Urology Times, articles from the American Association of Clinical Urologists (AACU) provide updates on legislative processes and issues affecting urologists. We welcome your comments and suggestions. Contact the AACU government affairs office at 847-517-1050 or info@aacuweb.org for more information

2013 was always going to be a significant year for our nation’s health care system. Oct. 1 was chosen as the launch date for the various health insurance marketplaces established under the Affordable Care Act (ACA), also known as Obamacare. As the year comes to an end, federal lawmakers still have much to address with Obamacare’s problematic launch and time running out to pass a repeal of the fundamentally flawed Medicare sustainable growth rate (SGR) by the end of the year.

Obamacare found itself spoofed on Saturday Night Live and fodder for late night TV hosts, as individuals from around the country tried and failed to obtain health insurance through the various marketplace websites, particularly the federal website, Healthcare.gov. From day one, these websites have been plagued with technical problems, frustrating individuals seeking to enroll in one of the new health insurance plans being offered under Obamacare and preventing them from successfully enrolling. After weeks of speculation about the actual numbers, on Nov. 13, the Department of Health and Human Services reported that 106,185 people had successfully “selected” a health insurance plan through the Obamacare marketplaces. Of that number, only 26,794 successfully selected plans through the federal website, while the remainder selected plans through state marketplace sites.

Among the states that have established their own marketplaces, California led the way with 35,400 having selected plans during the first month of enrollment. Still, the numbers have been disappointing to proponents of Obamacare and well below the 500,000-enrollee goal the Obama administration had set for the first month. The Obama administration made assurances that Healthcare.gov would be running smoothly by the end of November. Open enrollment for health care plans offered through the Obamacare marketplaces currently ends March 31, 2014.

In addition to the website problems, millions of individuals from around the country have received notices that their current health insurance plans were being canceled because the plans do not comply with the essential health benefits requirements imposed under Obamacare. This came as news to many as President Obama had repeatedly assured citizens, “If you like your plan, you can keep it.” As reports continued to surface, both Republicans and Democrats in Congress introduced legislation to address these cancelations and, one way or another, allow these individuals to keep their current plans. Subsequently, on Nov. 15, President Obama announced that his administration will not enforce the penalties imposed under Obamacare for non-compliant health insurance plans through 2014, side-stepping a legislative fix that many feel is required.

Meanwhile, in Congress, two proposals to repeal SGR have been introduced, the most recent being a draft proposal released in October by the Senate Finance and House Ways and Means Committees. The other proposal, H.R. 2810, labeled the Medicare Patient Access and Quality Improvement Act of 2013, passed the House Energy and Commerce Committee on July 30 with 51-0 bipartisan approval. Indeed, the repeal of SGR has bipartisan support, but the time for obtaining a permanent fix this year is rapidly expiring. If Congress cannot reach a deal concerning SGR by the end of the year, whether temporary or permanent, Medicare reimbursement rates will be cut 24.4% in 2014.

Urologists can visit Washington and make their voices heard on Capitol Hill at the 2014 Urology Joint Advocacy Conference, co-sponsored by the AACU and AUA. It will take place March 9-11, 2014 at the Hyatt Regency on Capitol Hill, with a day set aside for Hill visits, giving urologists an opportunity to meet with representatives and their staffs and discuss the issues important to urology. Additional information can be obtained at www.jac2014.org.

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