Officials face challenges in writing new health law regulations

National Journal: Obama administration officials face a "monumental task" in writing new regulations to the health care law while keeping one eye on public perception ahead of November's midterm elections.

"Democrats wrote the law so that some of its most appealing reforms come this year — a good strategy so long as those changes happen smoothly and on time." Early reforms include allowing dependent children to remain on their parents' health plans until they turn 26 and eliminating a prescription drug spending "doughnut hole" for seniors in Medicare's prescription drug benefit. "The law provides $1 billion to help HHS implement the new law — probably not enough, said Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution. As the Medicare administrator in the Bush administration, he launched the program's huge prescription drug benefit enacted in 2003. The Congressional Budget Office has estimated that (the Department of Health and Human Services) and the Internal Revenue Service will need $10 billion to $20 billion over 10 years to carry out health reform." Other provisions in the law that HHS will have to implement by the end of the year include reducing annual Medicare payment increases for inpatient, home health, skilled nursing and hospice care; increasing the Medicaid drug rebate for brand-name drugs; making a process for approving generic biologic drugs; creating a nonprofit institute of comparative effectiveness in medical service; creating a committee to develop a medical workforce strategy and administering a 10 percent tax on tanning salon services (Werber Serafini, 4/30).

The New York Times reports on a specific provision of the health reform law — the CLASS act for long-term care insurance. Working people are eligible to enroll if they pay premiums and it will cover the long-term disabled for life after the insured pay premiums for five years. "In November, when the Congressional Budget Office analyzed CLASS, it assumed a $123 average monthly premium (less for young enrollees, more for older ones); it also assumed, conservatively, that only 5 to 6 percent of those eligible to participate actually would. If more people enroll — and Class is an opt-out program, so if your employer participates, you're automatically included unless you decline — the premiums will be lower. With fewer people in the risk pool, premiums will go higher." It will also likely pay benefit of about $75 a day for help from home health workers with the activities of daily living like eating, bathing, dressing, or using the toilet (Span, 4/29).

Earlier related KHN coverage: New Long-Term Care Insurance Will Provide Flexible Cash Benefits (Meyer, 4/15).