Fits and starts continue for health law implementation

News outlets report on a variety of aspects of the health law ranging from the IPAB and ACOs to the two states to most recently gain waivers from the Department of Health and Human Services.

Politico: Medicare Cost-Cutting Job Could Be Worst In D.C.
Wanted: nationally known health care experts to serve on controversial health care board that will make painful Medicare spending cuts. Must be willing to quit current job to do it. Also, must be willing to go through bloody and humiliating confirmation fight. That's the job description for the 15 members of the Independent Payment Advisory Board — the new panel created by President Barack Obama's health care law to come up with ways to cut Medicare spending if it grows too fast (Nather, 5/14).

Related, earlier KHN story: The IPAB: How Will It Change Medicare? (Vaida, 5/8).

The Washington Post: Partisan Fights In Congress Stall Panel On Primary-Health-Care Shortage
When the government set out to help 32 million more Americans gain health insurance, Congress and the Obama administration acknowledged that steering more people into coverage had a dark underside: If it works, it will aggravate a shortage of family doctors, internists and other kinds of primary care. So Page 519 of the sprawling 2010 law to overhaul the health-care system creates an influential commission to guide the country in matching the supply of health care workers with the need. But in the eight months since its members were named, the commission has been unable to start any work (Goldstein, 5/13).

The New York Times: Nursing Homes Seek Exemptions From Health Law
It is an oddity of American health care: Many nursing homes and home care agencies do not provide health insurance to their workers, or they pay wages so low that employees cannot afford the coverage that is offered (Pear, 5/15).

The Hill: HHS Grants Health Care Waivers To Nevada, New Hampshire
The Health and Human Services Department will let two more states — Nevada and New Hampshire — phase in health care reform rules that govern insurers' spending. The new health care law requires health plans in the individual market — people who buy coverage on their own, rather than getting it through an employer — to spend 80 percent of their premium revenues on medical costs. But states can request an adjustment if they determine that immediately implementing the new limits would drive insurers out of the state and disrupt consumers' access to care (Baker, 5/13).

Politico Pro: HHS Approved 221 New Annual Limit Waivers In April
The Obama administration in April granted 221 new temporary waivers to organizations for health care reform's annual benefit limit requirements, according to an update posted on the HHS website late Friday. With the new approvals, 1,372 businesses, unions, insurers and other organizations won't have to comply with this year's requirement to provide at least $750,000 in annual benefits (Millman, 5/13). 

Modern Healthcare: ACO Start-Up Costs Higher Than Estimated, AHA Study Says
Accountable care organizations will likely face start-up and first-year costs six to 14 times higher than HHS has estimated, according to a study released by the American Hospital Association. The study, which was based on an analysis of previous research, concluded that the various elements required to successfully manage the care of a specific population will cost between $11.6 million and $26.1 million — depending on the size of the hospital or hospital system involved in the ACO—and far more than the $1.8 million estimated by the CMS in its proposed rule (Daly, 5/14).