Federal Agencies' Complicated Task: Implementing Health Reform Provisions

NPR: "The health care bill President Barack Obama signed this week is more than 2,400 pages long. Still, it doesn't contain many of the details about how it will work and how it will be enforced. The responsibility for explaining the bill falls to workers in the trenches at government agencies. Some of the nitty-gritty details that are missing include defining many of the terms used in the measure, and spelling out exactly how individuals would prove they have health insurance."

"Federal agencies including the Department of Health and Human Services and the Internal Revenue Service will begin to draft proposed rules. ... the scope of this measure is extremely broad, and coordinating regulations across government agencies will be challenging" (Kaufman, 3/25).

Kaiser Health News: "It's the first and one of the hardest tests of the Democrats' ambitious plan to overhaul the nation's health care system: in the next 90 days establishing a federally funded program to cover people turned down by private insurers because they have a pre-existing medical condition. The effort, to provide immediate relief to people who have no insurance options, will be closely watched as an early gauge of the Obama administration's ability to turn a complex new health care law into a smooth-running program."

"About two million people might be eligible for the new pool, analysts predict, though how it would operate is unclear – complicating a daunting timetable for implementation. The health care law President Barack Obama signed Tuesday offers only general guidance, making the Department of Health and Human Services responsible for creating the program" (Carey, 3/25).

Reuters reports on "a provision that sets up an independent agency to compare treatments. ... Obama and his advisers have from the beginning stressed comparative effectiveness research as an essential piece of reforming healthcare. Companies rarely compare new drugs to older treatments, but instead against placebos. By law, regulators approve drugs based on their safety and effectiveness -- not on whether they are better than other therapies" (Fox, 3/25).

Roll Call: "Senate and House Republicans are introducing bills to close a loophole in the health care reform act that may exempt leadership and committee staffers from having to buy health plans created in the act. ... The legislation would require all Congressional staffers — and top White House officials — to buy their health plans through state-run exchanges created in the act. Currently, the reform act could be interpreted to only require Members and the staffers in their personal offices to enter the exchange, according to a Congressional Research Service memo" (Yehle, 3/25).

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