State progress on health law implementation follows varying paths; Meanwhile, ACOs, waiver processes grab headlines

Media outlets report on a variety of implementation issues, including anti-trust concerns related to accountable care organizations as well as questions about the reform waiver process and a House committee chairman's efforts to reverse Medicare advantage cuts.

McClatchy: Nearly A Year Into Health Law, States Are All Over The Map
States are taking different paths to implementing the nation's new health care law, as some roar ahead while others proceed grudgingly, hoping that the courts or Congress will overturn or dilute the statute. States feel two kinds of pressure, fiscal and political. … Experts are unsure what the patchwork of different state approaches could mean to consumers once key parts of the law take effect in 2014. Nearly everyone has to have health coverage that year or face penalties (Lightman, 2/8).

CQ HealthBeat: Upton Takes Aim at Medicare Cuts, Eyes Medicaid Changes
Emphasizing that if you like your current health care you should be able to keep it, House Energy and Commerce Committee Chairman Fred Upton said Tuesday that he wants to reverse cuts in the health care law to Medicare Advantage plans and other providers. As of Jan. 1, about half of the Medicare Advantage enrollees in Michigan weren't able to continue in their plans because of the health care law, contrary to President Obama's claim that Americans could keep their existing coverage, Upton, R-Mich., told a forum sponsored by the National Journal (Reichard, 2/8).

The New York Times: Health Law Provision Raises Anti-Trust Concerns
The new health care law encourages collaboration by doctors and hospitals for cost savings, but a split has developed here as to just how far they can go without running afoul of antitrust laws (Pear, 2/8).

The Associated Press: Health Insurers Adjust To Once-Scary Reform Rule
A new health care overhaul mandate that once stirred fear among insurers is proving to be challenging — but not too challenging — as it makes its debut in 2011. Major health insurers say a provision that requires them to spend a certain percentage of the premiums they collect on care-related costs will eat into earnings this year. But Aetna Inc. and Cigna Corp. both say their profits could still grow in 2011, and Aetna also plans to start paying a significantly higher dividend to shareholders this year (Murphy, 2/8).

Modern Healthcare: Hatch Questions Berwick On Rise In Reform Waivers
Concerned about a sharp increase in the number of granted waivers from mandates in last year's health reform law, Senate Finance Committee Ranking Member Orrin Hatch (R-Utah) has asked CMS Administrator Donald Berwick for detailed information about the agency's waiver process. In a letter Tuesday to Berwick, Hatch said the waiver process "stands in stark contrast" to the administration's claims that the law reduces costs and makes health care more affordable. The waiver process had been conducted by HHS' Center for Consumer Information and Oversight, which transferred recently to the CMS (Zigmond, 2/8).

The Hill: Poll Shows HR Departments Struggling With Health Care Reform Law
Many American businesses want more guidance from the Obama administration before they make decisions about the health care benefits they offer, a new poll found, though the majority think Republicans will not succeed in repealing the reform law. The Society for Human Resource Management conducted the poll in late December, before a federal judge struck the law down and the House voted for repeal. At the time, 48 percent of respondents said they were waiting for more regulatory guidance from the administration on specific provisions of the reform law, while 13 percent said they were hoping for full repeal (Pecquet, 2/8).

Meanwhile, The New York Times offers a quick status update on legal challenges to the overhaul.

The New York Times: Ohio: Health Law Challenge On Fast Track
A second appellate court has set an expedited schedule for hearing a constitutional challenge to the new health care law (Sack, 2/8).