Posts Tagged ‘U.S. Congress’

U.S. House Votes to Repeal Healthcare Reform 244-185

July 11, 2012 1 comment

The U.S. House today voted to repeal the Affordable Care Act 244-185.  Five Democrats voted FOR repeal and they are:
Dan Boren (D-OK 02), Larry Kissell (D-NC 08), Jim Matheson (D-UT 02), Mike McIntyre (D-NC 07), Mike Ross (D-AR 04). You can see how each member of the House voted by going here: The bill the House approved (H.R. 6079) can be read here:

Keywords:  health care insurance, health care, health plan, health policy, U.S. Congress, health care reform


Student Loan Forgiveness for Primary Care Physicians Announced

July 2, 2012 Leave a comment

Dr. Tom Price, MD of Georgia has a bill in the U.S. House geared directly at replacing the infamous health care reform bill officially known as the affordable care act. This bill is called HR 3000 “Empowering Patients First Act”. Below are key provisions of the bill. You can read the bill for yourself here:

Key Provisions
Loan forgiveness for Primary Care Providers

Federally Supported Student Loans for Medical Students

Refundable Tax Credit for low-income families

Deduction for health care costs

Credit for small employers adopting auto-enrollment

Improve beneficiary choice in S-CHIP

Financial Incentives for Treatment Compliance

Freedom of Choice, Right of Contract with Providers

Reduction in Medicaid DSH


Keywords: physician, health care reform, primary care physician, student loan, health policy

Conservative Justice Scalia: Reform without Mandate would Bankrupt Health Insurance Companies!

June 7, 2012 Leave a comment

U.S. Supreme Court Justice Antonin Scalia has come out recently saying that if the individual mandate is ruled unconstitutional, it would bankrupt health insurance companies. According to Court transcripts of the hearing on severability of the Affordable Care Act, Justice Scalia argued: “There is going to be a deficit that used to be made up by the mandatory coverage provision. All that money, has to come from somewhere…So you’re just put to the choice of, I guess bankrupting insurance companies.” (Source 1).  Bankrupting the for-profit companies of Humana, Aetna, WellPoint, Cigna, and United Healthcare might not be a bad thing as they are again under indictment for defrauding the federal government on purpose in order to get profit for their shareholders. These companies have been caught in the past doing the same thing and they have managed to defraud the government by $5 billion over the past 5 years (Source 2).

The Supreme Court is due out with their final decision very soon. They are predicted to rule against the mandate and uphold the rest of the law.




U.S. Congress Working to Replace Physician Sustainable Growth Rate

May 17, 2012 Leave a comment

The U.S. Congress is currently working on legislation to replace the physician sustainable growth rate. Since 2002, this has become a highly debated topic in Congress that has resulted in 14 CRs (short-term measure) being passed that were aimed to delay a 30% cut to physician Medicare payments. H.R. 5707 introduced and aimed at replacing the SGR.

To get things started, The U.S. Senate Finance Committee held a roundtable discussion on the matter last week. You can view the discussion at In a statement, Chairman Max Baucus (D-MT) said : “Medicare’s sustainable growth rate (SGR) formula has not worked as planned. The annual cuts the formula calls for have snowballed the problem.” Ranking member Orrin Hatch (R-UT) said in a statement: “We must provide a stable foundation for paying physicians today, not five or 10 years from now.”

On May 9, a billed aimed at replacing the SGR was introduced. H.R. 5707: Medicare Physician Payment Innovation Act of 2012 was officially introduced in the House by members Allyson Schwartz (D-PA, former hospital CEO) and Dr. Joe Heck ,DO (R-NV, physician). The bill can be read here: In order for the bill to be successful, it will need to have FULL support by all of the physicians in Congress. The physicians that need to be encouraged to pass it are: John Barrasso (R-WY), Tom Coburn (R-OK), Rand Paul (R-KY), Dan Benishek (R-MI), John Boustany (R-LA), Paul Broun (R-GA), Michael Burgess (R-TX), Larry Buschon (R-IN), Bill Cassidy (R-LA), Scott DesJarlais (R-TN), John Fleming (R-LA), Phil Gingrey (R-GA), Paul Gosar (R-AZ), Andy Harris (R-MD), Nan Hayworth (R-NY), Ron Paul (R-TX), Tom Price (R-GA), Phil Roe (R-TN), Donna Christensen (D-VI), and Jim McDermott (D-WA).

Stay tuned to this blog for further updates on this story.



Health Insurance Companies to Give Rebates to Consumers

May 2, 2012 Leave a comment

Health insurance companies in USA will be giving over $1,000,000,000 in rebates back to the consumer this year for failing to meet the required 80/20 medical loss ratio rule. This is a rule established in the Affordable Care Act that requires insurers to actually pay 80% of premium dollars to a patient’s care and not let it be used for greedy shareholder and executive profits. Profits and revenue of insurers are down nearly 5% (according to CNBC) as a direct result of the 80/20 rule. The insurance lobby can try to repeal this part of the ACA but their efforts will be futile since Health and Human Services has already implemented and adopted it as one of their own rules. The 80/20 provision (now rule) was brilliantly written by the Congressional Healthcare Caucus, Congressional Physician Caucus, U.S. Senate Health Education Labor and Pensions Committee, U.S. Senate Finance Committee, and U.S. Senate Commerce Committee back when I was writing health care policy in Congress in 2008.

Source:  CNBC


Details of Health Care Cuts and Spending in 2013 Federal Budget

February 14, 2012 Leave a comment

The Obama Administration has recently presented its 2013 Budget proposal to Congress. According to the White House and HHS websites, healthcare is expected to be effected in the following ways:


$362 billion in cuts to Medicare and Medicaid over 10 years

Drug companies to provide $156 billion in discounts on top of $80 billion in discounts used to pay for healthcare reform legislation

$63 billion in cuts to long-term care facilities (i.e. Kindred Healthcare)

$177 million cut to Children’s Hospital Graduate Medical Education programs

$327 million cut to Community Services and Preventive Health grants


Medicare spending to increase by $45 billion in 2013 and total $523 billion.  Seniors to see premiums go up in order to save $28 billion by 2022.


$385 billion in savings for Medicare and Medicaid over 10 years


$1 billion additional for implementation of healthcare reform

$2 billion for Administration on Aging

$599 million for “effectiveness” research

$8 billion for Head Start


$1 trillion in new taxes (Buffet rule, etc)


200,0000 pharma jobs to be lost according to Pharmaceutical Research and Manufacturers of America Association

278,000 hospital jobs to be lost according to American Hospital Association

Disease Management,Value-Based Payment Programs Fail to Cut Medicare Costs

January 19, 2012 Leave a comment

The non-partisan Congressional Budget Office and Department of Health and Human Services have come out stating that programs designed to cut Medicare spending have failed. Disease management coordination demonstrations and value-based payment demonstrations have not reduced Medicare costs one bit. The 34 disease management coordination programs specifically have had no affect on the reduction of hospital admissions. Value-based payment demonstrations, which allowed large multi-specialty physician groups to share in savings or offered bonuses for meeting quality metrics, created no Medicare savings at all. A complete report of CBO’S findings can be found here:

Medicare and Medicaid spending/costs are dramatically rising. According to CMS, medicare spending will reach $1.038 billion by 2020. Medicaid spending will reach $458 billion by 2020 as well. Medicare and Medicaid spending is expected to grow at 7% between 2012-2020. Expect to see HHS Secretary Kathleen Sebelius authorize and implement cuts to the programs as deep as 30% starting January 2012. The cuts are the only option Secretary Sebelius has since the programs failed to produce savings.

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