Health law implementation issues: Challenges with exchanges, doc-owned hospitals

Health insurance exchanges are among several health law implementation issues making news.

Politico: Republican Governors Move Ahead On Health Exchanges
A small but growing number of prominent, Republican governors — including Mitch Daniels and Haley Barbour — are taking the lead to shape a key component of the health care overhaul their party fought so hard to kill. It's a delicate balancing act for Republicans who, on the one hand, oppose federal health reform, even challenging its constitutionality in federal court, and, on the other hand, are pragmatically trying to control as much of the implementation process as they can (Kliff,5/31).

Politico Pro: 'Early Innovator' States Running Behind
The Early Innovator grants, awarded in February, total $241 million, and are meant to support states for the next two years as they develop "exchange IT models that can be adopted and tailored by other states." Many of the seven states awarded Early Innovator grants, while still meeting HHS benchmarks, are struggling to move forward on other key aspects of implementation, especially passing legislation to set up the new online marketplaces for insurance (Nocera and Kliff, 5/31).

CQ HealthBeat: Urban Institute: HHS Must Issue Kid-Friendly Regs Under Health Care Law
More than 20 million children live in complicated family arrangements and the Department of Health and Human Services should take great care in making sure they have access to health insurance when the overhaul law goes into effect, says a new Urban Institute paper. The law calls for a framework of different kinds of health insurance options that relate to people's employment, income and citizenship. Some of the insurance coverage will be provided by private payers and some through public programs. And in some cases, parents and children in the same family may be eligible for different types of insurance (Norman, 5/27).

Modern Healthcare: PHA Continues To Fight Reform-Law Curbs On Doc-Owned Hospitals
Physician Hospitals of America has filed a formal notice of appeal in its ongoing effort to strike down the provisions in the Patient Protection and Affordable Care Act that critics say all but prevent openings or expansions of doctor-owned hospitals. PHA and its coplaintiff, Texas Spine and Joint Hospital, Tyler, Texas, argued in court records that Congress violated the Constitution when it included provisions in the ACA that prohibited new or expanding physician hospitals from qualifying for Medicare after March 2010 (Carlson, 5/28).