In its front-page story on President Obama’s reelection, the New York Times reports, “For Mr. Obama, the result brings a ratification of his sweeping health care act, which Mr. Romney had vowed to repeal. The law will now continue on course toward nearly full implementation in 2014, promising to change significantly the way medical services are administrated nationwide.” President Obama’s victory and the Democratic Party’s retention of the Senate majority ensure that “ObamaCare is here to stay.”
Obstacles for the law still remain – Republican governors have vowed not to implement key provisions, and congressional Republicans could have some success chipping away at federal funding for implementation of the law. However, getting rid of the entire law now seems permanently out of reach.
Regulators are likely to be busy during the lame duck session, with major regulations needed to implement the law. According to those studying the health care sector, here are some of the rules likely in the coming months:
- Exchange rules – Fewer than 15 states have indicated they are planning to move forward and build their own insurance marketplaces, called exchanges, which are supposed to be up and running in every state by January 1, 2014. The Obama administration has given states a November 16 deadline to decide whether they plan to create their own exchanges or leave the task to the federal government. But, details about the federally-run exchange have not been forthcoming. Many of those details are expected in the next few months.
- Essential health benefits – The law requires that all health plans sold on state insurance exchanges include a minimum package of benefits, but the Department of Health and Human Services has not yet issued formal rules on what that package must include. Those details are expected soon.
- Medicaid – An important anticipated Medicaid regulation, describing the pay raises that primary-care providers would get in the next two years, was released last week. However, states are awaiting more regulatory clarity on issues related to the expansion of their Medicaid programs. The Supreme Court’s June decision gave states the option of expanding programs or leaving them as is. In the State of Alabama, after the Supreme Court decision, Governor Bentley has said that the Medicaid program’s future would depend on the election.
The election may not have yielded much of a change in the political landscape in Washington, but healthcare providers and insurance companies will be kept very busy for the foreseeable future as healthcare reform continues to be implemented.