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Over the weekend, draft regulation was leaked concerning the grandfathering of employer sponsored healthcare plans in existence prior the implementation of The Patient Protection and Affordable Care Act. The Patient Protection and Affordable Care Act (PPA) was signed into law in March and maintained a provision which exempted healthcare plans already in existence from meeting many of the new requirements of the law. However, following the leak, today regulations issued jointly with the Employee Benefits Security Administration and the Department of Health and Human Services suggested that the exempted healthcare plans could lose their statuses if they made changes in deductibles, copayments or benefits. This could mean that the more than half of healthcare plans that were grandfathered could potentially lose their status.

An Obama spokesperson stated that the goal of the administration would be to ensure that the proposed changes would not affect most plans.

The recently passed healthcare bill which aims to cover millions of uninsured Americans included several provisions that corporations are feeling the effects of, in spite of the fact that many of these conditions will not be enforced until 2014.  Specifically, one stipulation under the new law is that businesses will no longer be able to write off a federal subsidy that covers part of the cost of retiree prescription drug coverage.

CNN Money has reported that many major companies are already attempting to account for this new potential cost and as a result, are taking preemptive actions. For instance, Caterpillar is one of many companies that currently receive tax-free subsidies as an incentive to continue their drug-benefit program. Recently, they took a $100 million charge to earnings in the first quarter. This type of action is a reflection of the potential taxes Caterpillar will have to pay as a result of the change in treatment of the subsidy. Further, there is the potential that this added cost could result in some employers dropping healthcare benefits altogether and instead accepting the penalty that comes along with it.

As the days and months tick by it is very likely that we will see more unintended consequences of the healthcare bill with companies such as Caterpillar acting accordingly. And, although the healthcare reform bill has passed in Congress, action on the regulatory front will likely be the norm in the future as the effects of the healthcare bill are fully felt.

I read an interesting article posted in Knowledge@Wharton on Health Care Reform.

“America’s health care reform may be out of the emergency room, but its prognosis remains sketchy. Passage of the historic 2,400-page legislation that President Barack Obama signed into law on March 23 by no means ended the health care debate, say Wharton experts: It just splintered one massive question mark into a lot of new big ones.”

I know from my eighteen years in Congress that whenever major reform legislation is enacted, implementation will always be a difficult task. In my view, every piece of legislation is a living document which is subject to change and improvement as circumstances change in society. That is one of the advantages of our political system.

This is certainly true with the recent healthcare reform law.  The Congress has done the best they can given the circumstances that the country is facing now.  They had to produce legislation that could garner a majority vote in both houses.  It might not be the best possible result, but at least we have begun to address the health care crisis in our country.

Using a football analogy – you can’t score a touchdown every time you start with the ball on your own five yard line.  It’s better to take steps to move the ball down the field toward your ultimate goal. That is what Congress did with health care reform. The big question is how do we keep the ball moving forward. 

For reform to be truly beneficial, we must address the many details of implementation.  Much of this work will move to the executive branch agencies although you can be sure Congress will keep a close eye on the progress.  How do we ensure we are actually containing costs and reducing the deficit? How do we keep access open? How will the health insurance exchanges operate in an efficient and effective manner?  How do employers answer questions from their employees asking when they can put an adult child back on the group plan?

There is a lot of negative talk right now about deficiencies in the bill and even campaign rhetoric that the bill should be repealed.  My view is that advancing health care solutions and addressing the deficit is too important to our country to give up and go back to the five yard line.  Let’s give health care reform legislation the opportunity to work.  If it doesn’t work or if there are specific areas that need to be redesigned, then Congress should step up to make the necessary adjustments.

With the recent passage of health care reform, many people have been left wondering exactly which parts take effect at what time.  Now, there’s a very handy tool.

The Commonwealth Fund has produced a very useful guide to the implementation timeline for the health care reform bill–starting with 2010 and ending with 2018.

It’s well worth checking out.

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Cassidy CEO Marty Russo contrubutes his view on the People Priority at the National Journal Under the Influence Blog.

Cassidy CEO Marty Russo outlines three important legislative goals for Democrats on the Under the Influence experts blog.

Here’s a live stream of  today’s White House Health Care Summit:

Jordan Bernstein spoke recently at the American Health Lawyers Association conference, “Long Term Care and the Law,” which focused on nursing facilities, assisted living facilities and home health.  The session, “Healthcare Reform: Implications for Long Term Care,” examined particular provisions of the national healthcare reform legislation, their effective dates, and their specific implications for the full panoply of long term/post acute care providers (nursing homes, home health, assisted living, hospice, long term care hospitals, and rehabilitation hospitals).  Jordan made this timely presentation of high interest to the healthcare community in partnership with Joel M. Hamme, Esq. of Powers Pyles Sutter & Verville P.C.   

Issue areas that were discussed included:

• Nursing home transparency
• Medicare – payment provisions, therapies and the Advisory Board
• Medicaid – eligibility expansion and increased state flexibility
• The Community Living Assistance Services and Supports (CLASS) program and entitlement reform
• Possible sleeper provisions on training and funding, fraud and abuse, liability reform, elder justice and background checks
• Who won? Who lost? And why?

The implementation of health care reform is going to be a long term effort and one that is likely to be an ongoing topic of discussions for the foreseeable future.

Here’s an interesting presentation by Alex Lundry on the political power of  data-visualization and infographics.

As public policy debates become more and more complex, it seems to me that tools like this are going to become more and more important.

H/t to Sociological Images and Diane Levin.

A former Democratic advocacy operative who recently joined Cassidy & Associates offers his unique insight into the healthcare debate on Capitol Hill as it recently intersected talks on immigration reform.

Albert Morales, former Deputy Director of the Democratic National Committee (DNC) American Majority Partnership and now vice president at C&A, is featured in the newest episode of C&A’s online series, Boardroom Perspective. Morales discusses recent action on Capitol Hill questioning whether undocumented workers should be covered in the healthcare reform package now in the Senate.