Monday, July 16, 2012


BREAKING:  The Convention on the Rights of Persons with Disabilities hearing was held yesterday and overall the hearing was very positive.  The Senate Foreign Relations Committee did not yet vote on whether to forward the treaty to the full Senate but we will let you know when that occurs.

Supreme Court Ruling.  Well by now everyone knows that the Supreme Court held that the Affordable Care Act was constitutional, with some surprising twists in that conservative Chief Justice John Roberts was the deciding vote in favor of constitutionality.  Another interesting twist was that the Court agreed that the individual mandate was unconstitutional under the Commerce Clause (which caused CNN and Fox to erroneously report that the law had fallen) but that it was constitutional under the Congressional authority to tax and spend, thereby deeming the mandate a ‘tax.’ 

Implications of Ruling.  The Commerce clause part of the Court decision could, according to some legal experts, re-define Congressional authority to regulate commerce and the Medicaid ruling (see below) could impact Congressional authority to alter state programs that are federally funded.  So while the law was upheld, analyst are now assessing some of the peripheral consequences of the Court’s logic.  Given the 5-4 decision, it’s clear that had the minority prevailed, it could have resulted in a tectonic shift of Congressional authority.  

Uncertainty removed.  Pretty much the entire health industry was treading gingerly on reform implementation awaiting the Supreme Court ruling.  Insurers, employers, and providers along with the biotech industry among them.

What’s Next for ACA?  The GOP plans to hold another vote in the House of Representatives to repeal the ACA, which will pass, but die in the Senate.  In the meantime, states and the federal government move full steam ahead to implement.  There will no doubt be additional lawsuits and other maneuvers but for now, everything moves ahead. 

Medicaid Expansion.  The one area the Court differed with the law was on the Medicaid expansion.  It upheld the right of Congress to incent state action with funding enticements but ruled that the federal government cannot punish states that opt out.  In other words, the carrot is okay, the stick is not

White House Fact Sheet.  Shortly after the ruling had sunk in the Administration sent out this fact sheet about health care.  If you want to find out where your state stands on implementation, check out this article.

Post-November elections.  Congress and the Administration will likely still have a lot of work to do after the election during a lame-duck session, focused primarily on the budget.  If the November election results in a Republican takeover of the Senate, and the House remains GOP, and Mr. Romney gets elected president, then the GOP strategy to repeal the ACA relies on the ‘budget reconciliation’ process whereby only a simple majority is necessary to pass the bill as opposed to all other legislation which is subject to a filibuster necessitating a 60 vote majority.  (Note:  the Democrats opted for this tactic when they passed the ACA originally so attempts to cry foul will fall on deaf ears).

How does health reform impact Members of Congress?  A little referenced provision of the Affordable Care Act directly impacts members of the House and Senate – currently after they retire they keep the health insurance they had as elected officials.  Under the new law, they lose that perk.  Read more here.

In other news.  The House voted, for the 33rd time, to repeal ‘Obamacare’ however as noted in this story the ‘replace’ proposal in the GOP phrase ‘repeal and replace’ has yet to be identified.  It was also recently revealed that ‘Morning Joe’ host, former Rep. Joe Scarborough, has a son who is taking advantage of Obamacare to stay on his father’s insurance rather than opt for that offered by his employer.  Same goes for a child of Massachusetts Sen. Scott Brown.

Newseum Headlines. The Newseum has collected hundreds of front pages of papers from around the world on reaction to the Supreme Court ruling.  It also has many other collections of headlines on other subjects like the 100th anniversary of the Titanic sinking.

CDMRP & new oral drug.  A new oral medication being developed for people with MS was funded in part by the Congressionally Directed Medical Research Program (CDMRP) which has long been a top priority for the National MS Society.  Currently the MS CDMRP is slated to receive $5 million for FY 2013 and we are working to ensure enactment of that level of funding.

FDA bill signed.  The House and Senate worked in a bi-partisan fashion to pass the reauthorization of the FDA user fee which has now been signed by the president.  This was a ‘must pass’ bill as it provides critical funding for the FDA. 

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