New reports underscore a litany of health law implementation obstacles

Obstacles to the implementation of the health overhaul abound, including lawsuits, regulatory issues, concerns about patients' choice, and, of course, costs.

The Christian Science Monitor: "President Obama signed the Patient Protection and Affordable Care Act on March 23. Within minutes, 14 state attorneys general filed lawsuits in federal courts in Virginia and Florida challenging the constitutionality of the law's 'individual mandate,' which will require nearly every American to buy health insurance or face annual fines." Now that the cases are moving forward, the Monitor takes a look at who's suing and where (Sacks, 9/29).

The Hill: "The National Association of Insurance Commissioners said Tuesday it would turn down a request from Health and Human Services Secretary Kathleen Sebelius asking for prompt action on the medical loss ratio. Sebelius sent NAIC President Jane Cline a letter Sept. 14 asking to know if the state insurance commissioners could provide HHS a final recommendation on the forms and instructions in time for the agency to issue regulations relating to the forms in October" (Pecquet, 9/29).

Los Angeles Times: "The new federal healthcare law is bringing additional demands by insurance companies that doctors and hospitals be held to higher quality standards. Although this push by insurers on quality implies that consumers will get better care because doctors and hospitals will be measured against the best performers, there may be an unintended consequence: It could leave patients with fewer choices of medical care providers, depending on which health plans they purchase" (Jaspen, 9/30).

Wall Street, too, is predicting dire unintended consequences.

NPR's blog Shots: Credit Suisse managing director Charles Boorady said at the annual Wall Street Comes to Washington conference, "Most of us agree this measure will probably boost the insured population and you could probably give it an A. But I think it gets an F on bending the cost curve up instead of down." That cuts into productivity growth, he said. But, Washington expert -- a former Medicare director -- Gail Wilensky disagreed, noting that the health sector has lead in job creation in recent years (Rovner, 9/29).

Portfolio.com adds: "The failure to contain health care costs—and the massive amount of paperwork that reform has created for businesses—is eroding political support for the administration and fueling the Republican-led effort to repeal the law. Health care costs are now by some measure the highest since 2005 and are expected to rise" (Rosenbush, 9/29).