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Category Archives: Health Care Reform

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Lesser-known CBO findings about the American Health Care Act

Posted in Affordable Care Act, Health Care Reform, Medicaid

As reported by Harris Meyer at Modern Healthcare, a deeper dive into the Congressional Budget Office (CBO) scoring of the American Health Care Act (AHCA) reveals rich data. Top-line numbers from CBO analysis of the House proposal predicted the bill would: Increase in the number of uninsured Americans by 24 million over the 10 years Reduce the… Continue Reading

Vorys Health Care Alert: A deeper look into the ACA replacement bill

Posted in Affordable Care Act, Health Care Reform, Medicaid

Please see the newest Vorys Health Care Alert for a deeper look into the House Republican’s proposed legislation to repeal and replace the Patient Protection and Affordable Care Act (ACA). If enacted as proposed, the plan would implement changes in the areas of: Insurance, mandates, penalties, and tax credits Medicaid, expansion, and per capita caps Risk pools,… Continue Reading

House Republican per-capita cap proposal for Medicaid would decrease funding, increase number of uninsured

Posted in Affordable Care Act, Health Care Reform, Medicaid

A new report from Loren Anthes at The Center for Community Solutions outlines the potential for Ohio’s Medicaid program to lose between $19 to $26 billion between 2019 and 2025 because of the House Republican’s proposed health reform legislation (the American Health Care Act); these predictions closely align with the new Congressional Budget Office (CBO) analysis… Continue Reading

House Republican health plan would shift estimated $560B in Medicaid costs to states, impact all Medicaid enrollees

Posted in Access, Affordable Care Act, Behavioral Health, Health Care Reform, Medicaid

The House Republican plan to reform Medicaid projects federal savings of more than $500 billion dollars over 10 years, and the Center on Budget and Policy Priorities, a nonpartisan research and policy institute, estimates this plan would significantly shift Medicaid costs directly to states, “effectively ending the Affordable Care Act’s (ACA) Medicaid expansion for 11 million people… Continue Reading

Payment Reform and Maryland’s All Payer Agreement with CMS

Posted in Articles, Health Care, Health Care Reform

Payment reform is considered essential to the transformation underway across the United States. Catalyst for Payment Reform (CPR) indicates that almost 90% of all private sector payments are still provided on the basis of fee-for-service. CPR defines payment reform as “payment methods that reflect or support provider performance, especially the quality and safety of care that… Continue Reading

Is One Brand of Medicaid Expansion Waiver Better than Another?

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

Different strokes for different folks as the old adage goes.  This saying, however, is particularly true when you look at the states that have chosen to expand their Medicaid programs under the Affordable Care Act (ACA) through waivers. States do not have to seek a waiver from the federal government in order to expand their… Continue Reading

New York State’s Budget Relies on Federal Medicaid Money –Expecting an Answer from CMS Soon

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

In 2012, New York Governor Andrew Cuomo submitted to the federal Centers for Medicare & Medicaid Services (CMS) an amendment to New York’s existing Partnership Plan 1115 waiver that sought to “redesign” the state’s Medicaid program.  The amendment proposed to reinvest $10 billion of the $17 billion in savings the state anticipated it would achieve… Continue Reading

Informative and Entertaining Look at Health Reform Issues for 2014

Posted in Affordable Care Act, Health Care Reform

In a move previously thought nearly impossible to pull off, Kaiser Health News recently published a list of “8 Things To Know About Obamacare in 2014” that is both informative and entertaining. This quick read highlights issues about which readers should be informed as they move into the new year, while injecting some levity into the… Continue Reading

Ringing in the New Year With Health Insurance

Posted in Affordable Care Act, Health Care Reform

So January 1, 2014, has come and gone.  While many people were busily ringing in the new year, others were celebrating a different kind of fresh start: one marked by the reassurance of having health insurance. Although the rollout of healthcare.gov and even some state health insurance marketplaces was less than ideal, Americans who need… Continue Reading

The Impact of the ACA on the Health Insurance Market – By the Numbers

Posted in Affordable Care Act, Health Care Reform

On a recent MSNBC segment, Steve Rattner shared the following slides that illustrate ways in which the health insurance market will be impacted as a result of the Affordable Care Act (ACA). The first reflects how various populations will be affected by the individual mandate to have insurance. The second indicates that most Americans who… Continue Reading

The Governor’s Big Play: Pushing Ahead on Medicaid Expansion

Posted in Affordable Care Act, Behavioral Health, Health Care, Health Care Reform, Medicaid

By Sylvia Brown and Former State Senate President Tom Niehaus Anticipation is building as the battle over Medicaid expansion moves to the unlikely arena of the state Controlling Board. On Monday, October 21 at 1:30 p.m., Governor John Kasich will try to make good on his promise to take whatever action within his power to… Continue Reading

VHCA, Vorys to Present on Health Care Reform at OPRA Fall Conference

Posted in Health Care Reform

Vorys Health Care Advisors’ Maureen Corcoran and Daphne Saneholtz and Vorys partner Suzanne Scrutton will be presenting at the Ohio Provider Resource Association Annual Fall Conference on October 8, 2013.  The presentation is titled Health Care Reform Update: The Home Stretch and will discuss provider implementation issues associated with the Affordable Care Act, policy and… Continue Reading

More Premium Information for Health Insurance Marketplace Plans Released

Posted in Affordable Care Act, Health Care Reform

The federal government recently released a report detailing premium information for qualified health plans to be sold in those 36 states (including Ohio) in which the U. S. Department of Health and Human Services (HHS) will support or fully run the Health Insurance Marketplace in 2014.  Highlights of the report include the following: Individuals will have an… Continue Reading

Physician Payment Sunshine Act Sheds Light on Payments Made to Doctors

Posted in Affordable Care Act, Health Care Reform

A little-discussed provision of the Affordable Care Act is making physicians, hospitals and manufacturers in the health care industry reconsider how they do business.  The Physician Payment Sunshine Act requires certain drug, medical device and biological manufacturers to disclose to the Centers for Medicare & Medicaid Services (CMS) any payments or other transfers of value… Continue Reading

Resources Help Illustrate Actual Marketplace Subsidy and Premium Amounts

Posted in Affordable Care Act, Health Care Reform

This Washington Post blog post does a nice job of demystifying subsidy amounts that will be available to individuals who purchase health insurance in the Marketplace (formarly known as the Exchange), and also references actual premium amounts in the states where such information has been made public.  Additionally, it links to a very helpful Kaiser… Continue Reading

Essential Health Benefits: What are they and who decides?

Posted in Affordable Care Act, Health Care Reform

As we have discussed in previous posts, beginning in 2014, under the Affordable Care Act (ACA), Medicaid plans and small group and individual plans sold inside and outside of the Health Insurance Marketplace must cover a package of 10 categories of items and services known as Essential Health Benefits (EHBs).  These categories include: Ambulatory patient… Continue Reading

Health Insurance Options in 2014

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

In a recent post, we discussed the insurance mandate itself.  That is, the requirement that most people have health insurance beginning in 2014 or face a financial penalty.  We also briefly mentioned the insurance options that will be available to you in order to fulfill this requirement.  They are— Have employer-sponsored insurance Be covered by… Continue Reading

Out of Pocket Maximums and the 2014 Transition Year

Posted in Affordable Care Act, Health Care Reform

Beginning in 2014, the Affordable Care Act (ACA) will set maximum limits on how much consumers can be required to pay out-of-pocket annually for their health care.  Under the law, the maximum amount a consumer with single coverage will pay out-of-pocket will generally be $6,350, while a family could pay up to $12,700. In 2015,… Continue Reading

Overcoming A Hurdle: Consumer Understanding Of What The Affordable Care Act Has To Offer

Posted in Affordable Care Act, Health Care Reform

Despite the recent announcement that the requirement for employers to offer health insurance to their employees has been delayed, the federal and state governments are ramping up for the largest open enrollment period in history.  Fueled by the mandate that almost every American have health insurance as of January 1, 2014, millions of previously uninsured… Continue Reading

CMS Addresses DSH Cuts; Impact on States That Do Not Expand Medicaid Remains Unclear

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that cuts federal payments to hospitals for uncompensated care.  What still remains unclear, however, is how these cuts will impact states that do not expand their Medicaid programs. The Affordable Care Act (ACA) requires significant cuts to Disproportionate Share Hospital… Continue Reading