The Week’s Headlines and Underlying Realities

A couple of developments this week on Capitol Hill and in the federal executive branch warrant comment.

On the legislative side, the U.S. Senate voted this week, by a bipartisan 79-16 vote, to pass a continuing funding resolution that will keep the government operating into March.  By simply extending the 2010 continuing resolution, which did not include funding for the new health reform law, Congress has, in essence, defunded implementation of the reform measure, at least for now.

This may cause celebration in some circles and the gnashing of teeth in others.  The fact is, though, that a stopgap funding measure passed in relative haste during a lame-duck session of Congress is no substitute for a full-fledged discussion on what aspects of the Affordable Care Act should be preserved and what needs to be revisited and revised. That’s a dialogue that needs to take place in the 112th Congress.

While this action was taking place on the Hill, HHS Secretary Kathleen Sebelius was announcing new health reform regulations that would force health insurers to publicly disclose any rate increase requests of 10 percent or higher and justify them to state officials.  HHS would be able to step in and scrutinize increases if it determines states were not adequately acting upon these responsibilities.

There’s nothing wrong with transparency in coverage rate increases.  Likewise, there’s nothing objectionable in state oversight.  The vast majority of states already do so.  There is concern, though, about the prospect of injecting politics and interest group pressure on a process that should be guided solely by the need to strike a balance between affordability for consumers, the trajectory of healthcare costs and the imperative to maintain insurer solvency and viability.   Given the fact that the CMS actuary projects that health costs will continue to escalate under health reform, and sluggish economic growth is keeping many young workers out of the health insurance market, it’s inevitable that premiums will go up.  Regulations shouldn’t run counter to that reality.