OVERNIGHT HEALTH:
The Republican primary got a lot meaner, the Monday after Texas Governor Rick Perry has issued one of the most effective ads so far linking front-runner Mitt Romney in the federal legislation to reform health care vilified by both in the GOP. Aspects of the law - in particular government funding and the requirement that everyone obtain insurance - have shaped the legislation enacted in 2006 when Romney was governor of Massachusetts.
The announcement at a point shows the image of Obama in the mirror abruptly changing to that of Romney as accidents of thunder in the background. "Even the rich can not buy back his past," says the ad. Read The Hill's story .
Fight for coverage : Now that the Institute of Medicine's recommendations for the healthcare law's essential health benefits are out, everyone wants a piece of the action. Pressure is growing on federal regulators to require that healthcare plans cover a slew of conditions, even as business groups are urging the government to keep things affordable.
Plans will have to offer the essential health benefits if they want access to federally subsidized state insurance exchanges starting in 2014. The Department of Health and Human Services is expected to finalize regulations next spring. Healthwatch's Julian Pecquet has the story .
Waivers are forever : The state of Indiana is under fire from consumer advocates for requesting a perpetual waiver from a key provision of the healthcare reform law.
The law does allow states to request a temporary reprieve from the law's medical loss ratio (MLR) requirement, but Indiana took it a step further and asked that the provision simply not apply to high-deductible health plans. Consumer Watchdog is asking HHS to reject the request, arguing that Indiana's application is "based on state politicians' ideological opposition to health reform, not the realities of the state's health care market." Healthwatch has more .
The SGR is a cliff.
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Health plan participants have the extra support of legal prosecutors if their health plan providers rescind their policies as a result of illness, thanks to a recent court decision. California health companies have already had to pay more than million in fines to regulators as a result of having rescinded health policies for sick patience.
Health companies may have hoped that the fines would make the scrutiny over their practices go away, but, instead, legal experts expect the scrutiny to continue. The California state Court of Appeal ruled in December 2009 that prosecutors would be permitted to sue health insurance companies over the insurance companies treat consumers and their members.
The recent legal ruling is a result of a lawsuit against health giant Anthem Blue Cross of California. Prosecutors argued that Anthem violated state law by selling health plan members the promise of health insurance, but then later rescinding the health coverage after health insurance plan policy holders submitted their claims for medical care.
After the lawsuit was filed, Anthem Blue Cross argued that the company's practice of rescinding health coverage fell under the jurisdiction of the California state Department of Managed Health Care; not the Los Angeles city attorney's office. The city's attorney's office filed the lawsuit in 2008. Anthem Blue Shield and the state agency filed paperwork defending Blue Cross. Blue Shield is a competitor of Blue Cross of California and faces a similar law suit by the city's attorney.
In response to Blue Cross's argument, the appellate court said that the law was "unambiguous" and gave the city attorney the right to sue the insurance company. The ruling allows the city to not only pursue its current lawsuits against insurance companies, but it also gives the city more influence down the road in other areas.
"This puts new cops on the beat," said Bryan Liang, director of the Institute of Health Law Studies at California Western School of Law in San Diego. "Lots of stuff in the standard operating practices of health plans is going to be affected by that decision.
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