Overcoming challenges to health law implementation at federal, state levels

The Centers for Medicare & Medicaid Services is central to implementing the health law, which leads to questions about its capabilities and resources. Meanwhile, states await a final rule on health exchanges.

Kaiser Health News: The Hardest Job To Fill (And Keep) In Washington: CMS Chief
President Obama is fighting to save his signature health law on two fronts: in the Supreme Court and on the campaign trail. … Yet even if the president prevails, he faces another daunting challenge: implementing the law in a seamless, timely manner. The Centers for Medicare & Medicaid Services is charged with making the health law work, drafting regulations, setting up new programs and providing oversight. But for years Congress has undermined the agency's leadership and potential effectiveness, raising questions about its capabilities and resources even as the health law ramps up its responsibilities. For starters: consider the revolving door leadership at CMS (Gaul, 3/11).

CQ HealthBeat: No Sign Of Exchange Rule As Some States Hit The Pause Button On Legislation
An anxiously awaited final rule on the structure of health benefits exchanges remained stuck in regulatory limbo on Friday, following Wednesday's abrupt cancellation of a press call featuring top Health and Human Services officials. Meanwhile, an expert on state health policy says exchange action appears to be slowing in states where largely Republican lawmakers are reluctant to move before the Supreme Court decides later this year whether the health care law is constitutional (Norman, 3/9).

Politico Pro: If Court Upholds ACA, States Could Still Resist
The law is very clear: HHS has the power to set up a federal health insurance exchange in states that don't set up their own. But a federal exchange can't function solo. It needs some help from a state's Medicaid program and insurance department…HHS has the legal authority to fight back -; but it's not easy. The steps it can take are like a nuclear bomb: they're useful as a deterrent, but have fallout that the department would likely try hard to avoid. For instance, Washington could penalize a state by cutting off its Medicaid funds. But blowing holes in state budgets and taking away coverage from thousands of people would accomplish precisely the opposite of the health care law's goals (Feder, 3/12).

Billings Gazette: Health Care Law's Preventive-Care Rules Snare Insured Patients
Carmen Hodges wasn't going to get a colonoscopy screening this year until she received a letter from her insurance company urging her to "take advantage of preventive benefits paid at 100 percent." ... The nation's new Affordable Care Act requires most insurance plans to cover all costs for preventive care, including colon cancer screening. So Hodges, 57, had the procedure in November. Then the bill arrived: $3,535 (Uken, 3/11).

MedPage Today: Child Advocates Call for Fix to ACA's 'Family Glitch'
In a letter dated March 12, 2012, several groups, including the American Academy of Family Physicians, the American Academy of Pediatrics, and the Children's Hospital Association, pointed out that when the Affordable Care Act (ACA) passed, it contained a "family glitch" that fails to take into account the cost of providing health insurance for an entire family versus a single employee. ... It's significantly less expensive to cover an individual rather than the worker's whole family (Walker, 3/11).