galen institute semiannual report: january - june 2011
DESCRIPTION
Highlights of Galen Institute activitiesTRANSCRIPT
Other New Bureaucracies
22 1412, 3509, 5101,
10104, 10221,10334, 10413,
10501
Other New Demonstration
& Pilot Programs
26 1201, 2704, 2705, 2706, 2707, 3023, 3024, 3113, 3140, 4204, 4206, 5304,
5509 , 6112 , 6114 , 10212, 10221, 10315 , 10323 , 10326 , 10504 ,
10607
Other NewGrant Programs
59 1002, 1003 , 1311, 1322,1561, 2952, 2953 , 3501 -6 ,
3508, 4101, 4108, 4201, 4 2 0 2 , 4304 , 5102 , 5206 , 5208, 5301 -5303 , 5305,
5306 , 5309 , 5313, 5315, 5405, 5507 -8,
5604, 6703,10301
10323, 10333, 10408 -10, 10413, 10501, 10503
Loan Repayment
& Forgiveness Programs
4 5203, 5204, 5205,
5311
Other New Regulatory Programs
4 1104, 6102, 6103
Special Interest
Provisions
19 1102, 1201, 2006, 3137, 3201, 3301, 6 0 0 1 , 9 0 0 1 , 9 0 1 0 , 9 0 14 , 9 0 2 3 , 1 0 2 0 1 , 1 0 3 1 7 , 1 0 3 2 3, 1 0 3 2 4, 1 0 5 0 2 , 1 0 6 0 1 , 10901, 10905; HCERA 1101, 1103,1106, 1203, 1406
BENEFICIARIES: Mutual of Omaha (NE);Drug Cos; NJ Drug Cos;AARP; Libby Montanans;
Physician-Owned Hospitals;Univ. of CT; Medigap Plans;Longshoreman Health Plans;
Medicaid: HI, LA, MA, TN, VT; Medicare: CT, FL, MI, MT, ND
New Government
AGI: Adjusted Gross IncomeAHRQ: Agency for Healthcare Research and QualityCDC: Centers for Disease Control & PreventionCHIP: Children’s Health Insurance ProgramCLASS: Community Living Assistance Services & SupportsCMS: Centers for Medicare & Medicaid ServicesCO-OP: Consumer Operated & Oriented ProgramFFS: Fee-for-ServiceFSA: Flexible Spending ArrangementGAO: Government Accountability OfficeHCERA: Health Care & Education Reconciliation ActHHS: Health & Human Services Department
HSA: Health Savings AccountIPAB: Independent Payment Advisory BoardIRS: Internal Revenue ServiceMA-PD: Medicare Advantage Prescription DrugMedPAC: Medicare Payment Advisory CommissionMERD: Medical Early Risk DetectionEALORS: Executive Auxiliary Linked Office Regional Systems MEWA: Multiple Employer Welfare ArrangementNAIC: National Association of Insurance CommissionersNIH: National Institutes of HealthPCORI: Patient-Centered Outcomes Research InstitutePPS: Prospective Payment System
§§3001, 10335
§3011
§2602
§5605
§4302
§2602
§2602
§3013
§1411
§§1333, 10104
§§1341, 10104
§1311
§1411
§3006
§2602
§§3403, 10320
§3011
§5605
§6301
§6301
§6703
§6703
§4004
§3403, 10320
§3011
§3311
§8002
§8002
§3001
§1001
§1001
§3403
§3012
§1302
§§9004, 9005; HC
ER
A §1402
§§1401, 1412, 10105; HCERA §§1001, 1004
§§1513, 10106; HC
ER
A: §1003
§1421, 10105
§§9001, 10901; HC
ER
A §1401
§§9010, 10905; HC
ER
A §1406
§4002
§6703
§6301 §6301
§4002
§1341, 10104
§1331, 10104
§§1001, 10101
§3004
§4004
§6301
§6301
§1323; HCERA: §1204
§3026
§3026
§§1311, 10104
§8002
§8002
§§9001, 10901; HCERA §1401
§§9009, 10904; HC
ER
A §1405
§9008; HC
ER
A §1404
§3005
§§9015, 10906; HC
ER
A §1402
§1311
§1322
§3403
§1323; HCERA: §1204
§§1311, 10104
§1313, 10104
§§1331, 10104
§§1401, 10105
§1322
§6703
§§3403, 10320
§10407
§3001
§1331, 10104
§1313, 10104
§3011
§3013
§8002
§§3006, 10301
§§1501, 10106; HC
ER
A §§1002, 1004
§§1402, 1412; HC
ER
A §1001
§§1402, 1412; HCERA §1001
Prepared by: Joint Economic Committee, Republican StaffCongressman Kevin Brady, Senior House RepublicanSenator Sam Brownback, Ranking Member
Patient Protection & Affordable Care Act, P.L. 111-148;Health Care & Education Reconciliation Act, P.L. 111-152
§3004
§1421, 10105
Rationing Potential
Taxes & Monetary Fees/Penalties/Cuts
Other Expansions
Involvement in Health Insurance Market
Represents Bundles of Additional Entities
Mandates
Trust Fund(Rationing Potential)
Other New Trust Funds/Monetary Benefits
Expanded GovernmentGovernment with Expanded Authority/ Responsibility
Government Financial Entity with New Inflows/Outflows
State/Territory with Expanded Authority/Responsibility
New RelationshipsRegulations/Requirements/MandatesReporting Requirements
Oversight
Money FlowsConsultation/Advisory/Info SharingStructural Connections (Includes Existing)
Private
Unchanged Private Entity
Private Entity with New Mandates/Regulations/Responsibilities
Special Interest Provisions
§3301; HCERA §1101
§3013§6301
§§1401, 1412, 10105; HC
ER
A §§1001, 1004
§§1331, 10104
Small Business Health Options
Program§1311
NAIC§§1333, 1341,
10104
§3007
HC
ER
A §1402
§1001, 10101
§3311
§2701
§2703
§5605
§2701
§2602
§2703
§3012
§§1513, 10106; HCERA §1003
§1334, 10104
§8002
§6301
§§3004, 3005
§1513, 10106
§6703
§4102
§§1341, 10104
§10407
§10407
§2701
§1334, 10104
§§3022, 10307
§3004§3004
§8002
§§1301, 10104
§1333, 10104§§1341, 10104
§§1201, 1301, 1304
§§1201, 1301, 1304
§1342
§1301
§1001
§§1201, 1301, 1302
§1331, 10104
§1302
§§1311, 10104
§1342
§1511
§3004
§1561
§1411
§1342
§3012
§4004
§4004
§4004
§4002
§10409
§1311
§6703
§6703
§3012
§4001
§1512
§1511
§3403, 10320
§4003
§8002
§8002
§8002
§8002
§§9001, 10901; HCERA §1401 §§9001, 10901; HCERA §1401
§§1001, 10101
§9004
§9003
§§9009, 10904
§9008; HCERA §1404
§§9010, 10905; HCERA §1406
§9002
§§9005, 10902; HCERA §1403
§1501
§§1311, 10104
§§3103, 10320
§1334, 10104
§§1322, 10104
§1333, 10104
§1312
§6301
§3005
§3011
§§3021, 10305, 10306
§3026
§4001
§§3006, 10301
§1411
§4305
§1001
§§1201, 1301, 1302
§1331, 10104
§1341, 10104
§8002
§1513, 10106
§6605
§§2001-2004
§§9017, 10907
§§1501, 10106; HCERA §§1002, 1004
§§9015, 10906; HCERA §1402 §9013
§1511
§1511
§§1201, 1301
§1312
Title III
§§3201, 10318; HCERA §1102
§8002
§§3001, 10335
§6301
§§1311
§§1514, 10106
§1321
§2703
§5605
§§1311, 10104
§6301
§4001
§9002
§8002
§1414
§1411
§2701
§3403, 10320
§6703
§1331, 10104
§2602
§3403, 10320
§1512
§§1514, 10106
§1411
§1411
§§3001, 10335
§3004§3004
§3011
§3021
§3022, 10307
§3026
§2701
§2701
§2701
§2703
§4001
§4302
§3013
§1411
§4004
§6301
§6301
§6703
§3011
§4305
§10409
§3311
§3311
§3021
§3011
§3012
§8002
§3311
§§1311, 1413
§3005
§3004
§1411
§1313, 10104
§§1001, 10101
§5605
§1512
§5605
Qualified HealthPlans
§§1301, 1302,1311, 10104
HealthCare Choice
Compacts§§1333, 10104
Reinsurance Program§§1341, 10104
Value-Based Insurance Design
& Coverage of Preventive Health
Services§1001
Optional Basic Health
Program§§1331, 10104
GAO§§1401, 3001, 3403, 6301,
10105, 10320
Comptroller General§§1313, 1322MedPAC
§2602
States§§1311,1331,
1333,1341, 10104, 10407
State Surveyors
§6703
Vital Statistics Agencies
§10407
US Territories§1323; HCERA §1204
KeyNational
Indicator System Implementation
Institute§5605
Commission on Key
Indicators§5605
National Academy of Sciences
§5605
CongressMembers
& Personal Staff Mandate:
Only Exchange Coverage
§1312
NationalTraining Institute for Federal and State Surveyors
§6703
AHRQ§3012, 3013, 6031
EssentialHealth Benefits
Package§§1001,1201, 1301,
1302 PlatinumBronze
Silver Gold
Government Health Benefit
Exchanges§§1201, 1301,1302, 1311, 1312, 1313, 1321, 1323, 1334, 1411, 1413, 10104;
HCERA §1204
Internet Portal§1311
Data Collection
§1311
HHS Inspector General
§1313, 8002,10104
Eligibility Determinations
§1411
Privacy Study
§1411SecretaryHealth & Human
Services
HealthInsurance
CO-OP§§1322, 10104
CO-OP Advisory
Board§1322, 10104
Private Purchasing
Council§1322
USPreventive
Services Task Force
§1001
Health Savings Accounts§§9003, 9004
Medicare Beneficiaries
§3311
Health Insurance Policy Holder
§§1001, 10101
Small Employers§§1304, 1311, 1421, 1512,
10105
Large Employers§§1304, 1511, 1512, 1513,
1514, 10106
MedicarePart C & Part D
Insurers§3311
Large Group Market
§§1201, 1301, 1511
PremiumTax Credit Subsidies
§§1401, 1412, 10105; HCERA §§1001,
1004
Annual Fee§§9010, 10905; HCERA §1406
3.8% Investment Income Tax
HCERA §1402
HSAUse Restriction
§9003
Misuse ofHSA Funds
§9004
“CadillacPlans” Tax§§9001, 10901; HCERA §1401
Subsidies:Out-of-Pocket
Expenses§§1402, 1412;
HCERA§1001
Individuals
Mandates, Regulations,& Taxes
§§1311, 1411, 1501, 9003-9005, 9013, 9015, 9017, 10106, 10902, 10906, 10907;
HCERA §§1002, 1004, 1402, 1403
“Excessive Profits”
§§1001, 10101
Patients
MedicarePayroll Tax
Increase: 0.9%§§9015, 10906; HCERA §1402
Flexible Spending Arrangement
§9005, 10902; HCERA §1403
Only Medical Expenses
Above 10% of Income (AGI) are Tax
Deductible§9013
FSA ContributionLimit: $2,500
§§9005, 10902; HCERA§1403
RiskCorridors
§1342
Large Business Employees
§1511, 1512
Small Business Employees
§1512
MEWAHealth Plans
§§1301, 6605
Self-Insured Health Plans
§1301
Small Group Market
§1301, 1304, 1342Individual Market§1201, 1301, 1304, 1342
10% Tax On
Indoor Tanning Services:
§§9017, 10907
W2 Health
InsuranceDisclosure
§9002
Individual Mandate: Buy Health Insurance
§§1501, 10106;HCERA §§1002, 1004
Employer Mandate:
Provide Health Insurance
§§1513, 10106; HCERA §1003
Mandatory Worker Auto-
Enrollment§1511
Small Business
Health Insurance Tax Credit
§§1421, 10105
Insurance Mandates
§§1001, 1101, 1201, 1251, 10101, 10103; HCERA §2301
17
Health Insurance Companies
Mandates, Regulations, Required Benefits, &
Taxes§§1001, 1201, 1252, 1301, 1334, 1341,
3311, 9001, 9010, 10101, 10104, 10901, 10905; HCERA §§1401, 1406
Employers
Mandates, Regulations, & Taxes
§§1511, 1512, 1513, 9001, 9002, 10106, 10901; HCERA §§1003, 1401
Demonstra-tion Program
§3001Public Data Disclosure
System§3006, 10301
FFS Accountable
Care Organizations
Program§§3022, 10307
Community-Based Care Transitions
Program§3026
Hospital Quality
Reporting Program§3004, 3005
Medicaid Health Home
Program§2703
Federal Coordinated Health Care
Office§2602
Medicaid Quality
Measurement Program
§2701
State-Specific Adult Health Quality
Measures§2701
Medicaid Expansion: +16 million
§§2001-2004CBO Cost Estimate,
3/20/10
State Medicaid Agencies§§2602, 2701, 2703,
3011
MedicareCuts: $528.9bn(includes MA cuts)
Title III; CBO Cost Estimate,
3/20/10
Medicare Advantage
Cuts: $205.9bn§§3201, 10318; HCERA
§1102; CBO Cost Estimate, 3/20/10
Subsidy: Medicare Part D Drug Program “Donut Hole”
§3301; HCERA §1101
Hospital Compare Website
§3001
HospitalValue-Based Purchasing
Program§§3001, 10335
Centerfor Medicare& Medicaid Innovation
§§3021, 10305, 10306
Physician Value-Based
Payment Modifier
§§3007
Annual Fee§9008; HCERA
§1404
Hospitals§§1311, 3001, 10335
Skilled Nursing Facilities§§3006, 10310
§§3006, 10301
Ambulatory Surgical Centers
§§3006, 10301
Home Health Agencies
§3006
Medical Device Manufacturers
§§9009, 10904; HCERA §1405
Pharmaceutical Companies
§9008; HCERA §1404
Inpatient Rehabilitation
Facilities§3004
Hospice Programs
§3004
PPS-Exempt Cancer Hospitals
§3005
Medicare Administrative
Contractors§3311
Health Industry
Mandates, Regulations, Taxes, & Payment Cuts
§§1311, 3001-3006, 3311, 9008, 9009, 10327, 10331, 10335, 10904; HCERA
§§1404, 1405
Long-TermCare Hospitals
§3004
Medical Device
Excise Tax§§9009, 10904;
HCERA §1405
IPAB§3403, 10320
IPAB Consumer Advisory Council§§3403, 10320
Medicare Part A Trust
Fund§3026, 3403,
6301,9015
Medicare Part B Trust
Fund§3026, 6301
PublicHealth Quality &
Efficiency Measures Development
Program§§3013, 10304
Hours of Service Determination for Calculating
Employer Mandate Penalty
§§1513, 10106
Rules for Insurance
Claims Appeals§1001, 10101
Health IT Policy
Committee§1561
Office of Personnel
Management§§1334, 10104
President§§ 3012, 3024, 3403, 4001,
8002, 10320
Cures Acceleration
Network Review Board
§10409
National Diabetes
Report Card Program§10407
CLASS Independence
Benefit Plan§8002
CDC§§1001, 4003, 4004,
4102, 10407
NIH§§4305, 6301,
10409
National Partnership on Prevention &
Health Promotion
§4004
National Public Education
Campaign on Prevention & Health
Promotion§4004
Community Preventive
Services Task Force§4003
National Oral Health Public
Education Campaign
§4102
Cures Acceleration
Network§10409
CLASS Independence Fund Board of
Trustees§8002
Life Independence
Accounts§8002
National Diabetes Mortality Statistics Education Training Program
§10407
Eligibility Assessment
System§8002
PersonalCare Attendants
Workforce Advisory Panel
§8002
CLASS Independence
Fund§8002
CLASS Independence
Advisory Council
§8002
Black Lung Benefits Act
§1556
Office of Multi-State Qualified
Health Plans§1334, 10104
PublicHealth Service
§§3011, 4002, 4302
Surgeon General
§4001
AdvisoryGroup on
Prevention, Health Promotion, and Integrative and Public Health
§4001
PCORI Expert
Advisory Panels
§6301
PCORI Methodology
Committee§6301
PCORI Board of Governors
§6301
PCORIWebsite
§6301
State Protection &
Advocacy Systems
§8002
Justice Department
§6703
National Prevention,
Health Promotion, & Public Health
Council§4001
Prevention Website
§4004
Website“Transparency
in GovernmentӤ1552
Prevention& Public
Health Fund§4002
Interagency Working Group on Health Care
Quality§3012
PCORITrust Fund
§6301
PCORI§§6301, 10602
SocialSecurity
Administration§1411
Homeland Security
Department§1411
Labor Department
§§1001, 1302, 1311, 1511, 1512, 1513, 6605, 10101, 10106
CLASS Program
§8002
Officeof Tax
Analysis§§1331, 10104
Elder Justice
Coordinating Council
§6703
AdvisoryBoard on Elder Abuse, Neglect, & Exploitation
§6703
Multi-Disciplinary
Panels on Improving Long-
Term Care§6703
Elder Abuse, Neglect, &
Exploitation Forensic Centers
§6703
IRS§§1401, 1402, 1411, 1412 1414,
1421, 1501, 9004, 9005,10105, 10901; HCERA
§§1401, 1402
Treasury Department
§§1311, 1331, 4002, 8002, 10104
National Health Disparities Data Collection &
Reporting System
§4302
HealthCare Quality
Website§§3011, 3012
Interagency Pain Research Coordinating
Committee§4305
NationalHealth Strategy
& PrioritiesOffice
§3011
Medicaid/CHIP
Title II; §§1413, 3011
MedicareTitle III, §2602
CMS§§3013, 3021, 3026, 3403, 10305, 10306,
10320
Medicare Prescription Drug
and MA-PD Complaint System
§3311
CMS Actuary
§§1331, 3403, 10104
Your New Health Care System
Congress§§1312, 1411, 3311, 5605, 8002
Non-Hospital
Value-Based Purchasing
Program§§3006, 10301
§3004
§§3002, 10327, 10331
§§3002, 10327, 10331
§3007
§§3007
Physician Quality
Reporting System
§§3002, 10327, 10331
Physicians§§1311, 3002, 3003, 10327, 10331
Galen Institute
Semiannual Report: January – June 2011
2 • Galen Institute
PRESIDENT’S MESSAGE
Grace-Marie Turner President, Galen Institute
Dear friends:
Virtually every week, we see more and more evidence of the failure of ObamaCare and the damage it already is doing to our health sector and economy:
Nearly 80 million people are at risk of losing their health insurance at • work, according to findings of a survey of employers of all sizes by McKinsey & Company.
More than half of small businesses say they are likely to drop health • insurance when the law takes effect in 2014.
Job creation has basically flatlined over the 15 months since the law was • enacted as employers refuse to hire until they know what health coverage will cost.
Health costs continue to rise by an average of nearly $1,800 in 2010. •
Child-only health insurance policies have vanished in 19 states. •
More than half the states — 28 and counting — are challenging the law • in court, saying it violates the constitutional rights of their citizens and the sovereignty of the states.
Budget-strapped states are facing at least $118 billion in unfunded • ObamaCare mandates during the first 10 years after the law takes effect, threatening education, transportation, public safety, and other state services.
More than 1,500 waivers have been granted to give selected companies, • unions, and states relief from some of the law’s burdensome new insurance rules.
18,000 people are enrolled in high-risk pools, out of millions expected. The • cost of this program: $5 billion.
Even key Democrats are criticizing the law’s rationing panel — the • Independent Payment Advisory Board. Rep. Frank Pallone (D., N.J.), the top Democrat on the Energy and Commerce Health Subcommittee, said, “I’ve never supported it, and I would certainly be in favor of abolishing it.”
Seniors are at risk of losing access to physicians and medical care. • Medicare actuaries say that the cuts built into the law will force as many as 40 percent of providers to eventually stop seeing Medicare patients or go bankrupt.
The bureaucrats are working behind the scenes, desperately turning dials, adjusting pulleys, and pushing levers to try to make their Rube Goldberg health care contraption work. Nearly 9,000 pages of regulations already have been written to implement the 2,800-page law.
www.galen.org • 3
Cover: Joint Economic Committee staffers created this chart illustrating the bewildering array of new government agencies, regulations, and mandates created under the health overhaul law. You can download the chart from the JEC website at http://1.usa.gov/JEC-chart.
But ObamaCare is destined to fail. This law will bankrupt our country. And it will lead to a massive disruption of the delivery of health care, to less investment in medical innovation, to lower-quality medical care, to erosion of the doctor-patient relationship, and, mostly, to a loss of our freedom under ObamaCare’s police powers.
But it is law, and it must be repealed. It is vital that the American people learn about the impact it will have on families, young people, employers, doctors and patients, senior citizens, and taxpayers. As you will see from our semiannual report, we have spent virtually every waking minute at the Galen Institute working to educate people about what is coming.
Our book, Why ObamaCare Is Wrong for America, was published on the one-year anniversary of the law being signed. As you will see in these pages, it has received a great deal of attention as the vital handbook to understand “how the health care law drives up costs, puts government in charge of your decisions, and threatens your constitutional rights,” as the cover explains.
We have taken and created every opportunity to push our research and commentary to the people — through conferences, papers, speeches, radio and TV, social networking, and countless meetings and conference calls with policymakers, opinion leaders, and people in every corner of the country who will be, and already may be, impacted by this sweeping law.
We invite you to read our January to June semiannual report, which offers a month-by-month overview that highlights our activities.
This is a crucial time. The public is on our side, but time is not. Our educational campaign MUST continue unabated so the American people know what is coming. Thank you for your support and for joining us in this crucial effort to protect our freedom and regain our prosperity. This is the most important battle of our time.
Sincerely,
4 • Galen Institute
ExECUTIVE SUMMARyJanuary – June 2011
Publications
Our new book, Why ObamaCare Is Wrong for America, was released in March by Broadside Books, an imprint of HarperCollins. Grace-Marie Turner co-authored the book with James Capretta of the Ethics and Public Policy Center, Thomas Miller of the American Enterprise Institute, and Robert Moffit of The Heritage Foundation, and they have received great praise for the book from Sen. John Barrasso, Rep. John A. Boehner, Steve Forbes, George Will, and many others. Learn more at www.WrongForAmericaBook.com, and order your copy today!
More than 152 publications and news websites in 43 states brought our commentaries to more than 34 million readers over the past six months. Our pieces on the individual mandate, lawsuits against ObamaCare, the impact of the health law on the states, prescription drugs, Medicaid, and Medicare were featured in The Wall Street Journal, Green Bay Press-Gazette, The Orange County Register, National Review Online, Forbes, and Investor’s Business Daily, among others.
We released 3 papers: “Negative Consequences of Health Law Force Health Insurers to Withdraw from Markets Across the Country,” “The New Health Law: Bad for Doctors, Awful for Patients,” and “Repealing and Replacing IPAB with Better Solutions,” which are all available at www.galen.org.
Twenty-four editions of our popular Health Policy Matters newsletters were e-mailed to more than 6,300 subscribers each week, reaching federal and state policymakers, journalists, business leaders, consumers, medical professionals, and others interested in health policy.
In the News
Grace-Marie made 11 TV appearances, including interviews on FOx’s Varney & Co., Stossel, and Freedom Watch programs, and C-SPAN’s Washington Journal. And she gave more than 40 radio interviews to regional and nationally syndicated programs including The G. Gordon Liddy Show, The Dennis Prager Show, The Lou Dobbs Show, The Drew Mariani Show, and Dateline: Washington.
Articles that featured Galen’s work and quoted our scholars reached more than 19 million readers of more than 55 newspapers, blogs, and media websites, including American Medical News, Kaiser Health News, The Washington Post, Townhall, Congressional Quarterly, and Politico. Our scholars were interviewed by journalists from U.S. News and World Report, Mother Jones, Bloomberg News, and the Associated Press.
We also hosted 2 briefings for journalists: a meeting with Indiana Gov. Mitch Daniels in Washington, DC, to talk about ObamaCare’s challenges to the states, and a conference call for reporters with budget experts Doug Holtz-Eakin and Jim Capretta on helping to restore the federal government to fiscal balance.
www.galen.org • 5
Speeches and Events
Grace-Marie gave more than 25 presentations on health reform, the impact of ObamaCare, Medicaid, Medicare, and her new book, Why ObamaCare Is Wrong for America. She spoke to audiences at CPAC, the U.S. Chamber of Commerce’s Small Business Summit, and the annual meeting of the Association of Private Enterprise Education. She also spoke at events hosted by the Georgia Public Policy Foundation, Atlanta Association of Health Underwriters, Cato Institute, The Heartland Institute, Manhattan Institute, and the American Enterprise Institute.
The Galen Institute hosted several popular events:
“Health Care 2011: Advancing Health Care by Facilitating Innovation” was the third in our series of forums designed to explore the value of innovation in the health sector. Our conference began with a VIP reception hosted by Microsoft on May 4 for our speakers and Members of Congress. On May 5, our conference program included three panel discussions with industry leaders, a keynote speech by Jim Greenwood of BIO, and addresses by Sen. John Barrasso and Rep. Erik Paulsen. A video of the event is available on our website at www.galen.org.
On April 7 we hosted a forum to discuss visiting fellow Dr. Jason Fodeman’s paper on “The New Health Law: Bad for Doctors, Awful for Patients.” Our keynote speaker was Rep. Tom Price, MD, who gave remarks about the impact of ObamaCare on physicians, and we also heard from Hal Scherz, MD, and Richard Armstrong, MD, of Docs4PatientCare.
We had a terrific launch event at the National Press Club for our new book, Why ObamaCare Is Wrong for America. The event was televised on C-SPAN’s BookTV and began with a great introduction from Weekly Standard editor Bill Kristol. The launch was jointly sponsored by Grace-Marie’s co-authors, James Capretta of the Ethics and Public Policy Center, Thomas Miller of the American Enterprise Institute, and Robert Moffit of The Heritage Foundation.
On March 14 we hosted a Capitol Hill forum to evaluate “ObamaCare at year One: The Real March Madness,” co-sponsored by Independent Women’s Voice, DeFundIt.org, Let Freedom Ring, 60 Plus Association, Heritage Action for America, and American Solutions. Speakers included Sen. Tom Coburn, MD, Rep. Michele Bachmann, Rep. Steve King, and Rep. Tom Price.
Coalitions & Meetings
We continued our conference call series with the State Policy Network and the Institute for Policy Innovation with 5 new sessions for state policymakers, featuring Gov. Rick Scott, Rep. Paul Ryan, Gary Alexander, Robert Alt, Robert Natelson, James Capretta, Thomas Miller, and Robert Moffit.
Galen staff participated in more than 125 meetings, policy briefings, and conference calls to discuss health reform initiatives and policy ideas with federal and state policymakers, Congressional staffers, health industry executives, and policy experts.
6 • Galen Institute
WHY OBAMACARE IS WRONG FOR AMERICA
The book is launched!
After several months of nearly impossible deadlines, our new book, Why ObamaCare Is Wrong for America, has been released by our publisher, Broadside Books/HarperCollins, and is in actual and virtual bookstores across the country.
Grace-Marie Turner and her co-authors — Tom Miller of the American Enterprise Institute, Jim Capretta of the Ethics and Public Policy Center, and Bob Moffit of The Heritage Foundation — felt it was crucially important to write the definitive book explaining how the new health law will affect American families, taxpayers, seniors, employers, workers, doctors and patients, and many others impacted by its sweeping changes. Why ObamaCare Is Wrong for America already is making headlines and creating renewed awareness of the destruction it will bring to health care and our economy.
People who read the book will clearly understand what really is in ObamaCare — massive spending on new entitlement programs that will drive up the deficit, hundreds of billions of dollars in new taxes, unconstitutional mandates on citizens, job-killing mandates on businesses, a crushing burden on the states, and much more.
you can learn more about the book, and find links to studies, reviews, and news stories at our website, www.WrongForAmericaBook.com. And you can continue to support our work by sharing the book with your colleagues, friends, and family, and by submitting reviews to your local newspapers and websites such as Amazon.com. Please share your reviews, questions, and suggestions with us by emailing [email protected].
“Why ObamaCare Is Wrong for America is carefully researched, well written, and a must-read for anyone concerned about the future of health care in our nation. It proves without a doubt that this law will bankrupt our nation and hurt economic growth.”
— Rep. John A. Boehner
For at least the next two years, and probably beyond, a major preoccupation of American politics will be the battle to disentangle Americans from the tentacles of ObamaCare. This timely and lucid book is the thinking person’s answer to two questions: Why is this fight crucial to Americans’ health and America’s civic health? And how can it be won?
— George F. WillNationally Syndicated Columnist
Why ObamaCare Is Wrong for America “makes the case that I’ve been trying to make on the Senate floor for the last year or so that this health care law is bad for patients, it’s bad for providers — the nurses and the doctors who take care of those patients — and it’s bad for taxpayers.”
— Sen. John Barrasso, M.D.
“This succinct and lucid summary of the horrors of ObamaCare and what we the people can do about them will be an essential handbook in saving us from medical socialism and bringing true free markets to health care — which, in turn, will generate more health care at less cost!”
— Steve Forbes Forbes Magazine
Praise for Why ObamaCare Is Wrong for America
www.galen.org • 7
Health Care 2011 Advancing Health Care by Facilitating Innovation
One of the guests at our highly successful May 5 conference on innovation in health care thanked us for providing “a vehicle for those of us who believe in the marketplace as the source of solutions to exchange ideas and spark creativity.”
Virtually all of the focus in the health care debate has been on Washington’s top-down decisions about how to restructure one-sixth of our economy, and yet the real transformative changes are coming — as they always do — from the private sector.
The vitality of the American entrepreneurial spirit is poised to offer an abundance of solutions to problems in the health sector, but they are at great risk because Washington is stiffling introduction of new technologies through regulatory and payment barriers. Not only could they be delaying or even killing vital medical discoveries, but they could be shipping one of our most promising industries to other countries who see the value and potential of this vital industry sector.
Every one of our speakers at Health Care 2011 was terrific, making focused presentations about innovations in health care delivery, technologies enabling better health, and policies needed to support these transformative innovations.
Our speakers inlcuded Sen. John Barrasso; Rep. Erik Paulsen; James Greenwood; Arnon Krongrad, MD and Mary Grealy, JD; Joxel Garcia, MD, Ron Silverman, MD, and Nathan McLemore; Margaret Reagan, Bruce Artim, Kelly Slone, and William Winkenwerder, MD
8 • Galen Institute
Impact
Americans have a new Congress, and the Galen Institute is ready with ideas that put patients and doctors — not government — in charge of decisions. We were invited to several meetings on Capitol Hill in January to explore and analyze numerous policy ideas. We also talked with state legislators across the country about ways they can push back against the enormous impact the overhaul law will have on their Medicaid programs and state budgets. And we continued working on the manuscript for our book that explains what’s really in the health overhaul law and how it affects states, physicians, businesses, and people like you.
Publications
Grace-Marie Turner’s pro/con debate with Rep. Jim McDermott on whether Congress should preserve the health reform law was published by more than 50 news outlets, including the Green Bay Press-Gazette, Modesto Bee, and Duluth News Tribune. In a complementary poll offered by the Kansas City Star, 61% of readers agreed with Grace-Marie that the law should be dismantled. Other publications that featured our commentaries included:
The Atlanta Journal-Constitution:• Is health care reform a ‘government
takeover’?
USA Today:• Opposing view on health care: On the road to rationing
Orange County Register:• ObamaCare beginning to unravel
National Review Online’s The Corner:• America Comes First
National Review Online’s Critical Condition:• The Rights you Will Have
with ObamaCare
Galen in the News
We gave radio interviews to national programs such as The Lou Dobbs Show, and to local stations such as KPNW-AM in Eugene, Oregon, and KMJ-AM in Fresno, California.
We also spoke with journalists from Bloomberg News, CNS News, and Inside Healthcare Magazine. Our scholars were quoted in numerous articles about end-of-life care, the impact of the overhaul law on the states, RomneyCare, and other issues by news outlets across the country, including:
CQ HealthBeat:• Obama Plays It Safe on the State of Health Care
FOX News:• Repeal Obamacare? Americans Deeply Divided About Who
Should Handle Their Health Care
American Medical News:• Medicare about-face on end-of-life planning pay
The Washington Post:• Mitt Romney needs a better defense for
RomneyCare
JANUARy
www.galen.org • 9
Events & Meetings
More than 75 participants joined us on January 13 for another informative call in our states and Medicaid series, co-hosted by the Institute for Policy Innovation and the State Policy Network. Our keynote speaker was Gary Alexander, former Secretary of Rhode Island Health and Human Services, who talked about the state’s block grant program for Medicaid.
We were invited by several Members of Congress, state legislators, and other officials to discuss the impact of the health overhaul law and free-market solutions to reform.
Grace-Marie Turner’s pro/con debate with Rep. Jim McDermott was published by more than 50 news outlets
10 • Galen Institute
Impact
A recent Kaiser Family Foundation poll showed that Americans are increasingly confused about implementation of the health overhaul law. The danger is that the American people think that because of the November elections, the court cases declaring the law unconstitutional, and the repeal vote in the House, that ObamaCare is over. We used our commentaries, media appearances, and events this month to tell people that the law is in fact very much in place, and its destructive impact already is being felt.
Publications
Our new book, Why ObamaCare Is Wrong for America, became available online for pre-order in February.
Our commentaries on medical innovation, court challenges to the health overhaul law, state Medicaid dilemmas, and health law waivers appeared in more than two dozen publications in more than 15 states in February, including:
Juneau Empire:• States are forced to pay for measures they can’t afford
Kalamazoo Gazette:• Drug shortages jeopardize quality of care
Kaiser Health News:• Govs vs. Feds — Who Will Play The ‘Power Card’
In The Medicaid Struggle?
National Review Online’s Critical Condition:• Florida Decision Could
Accelerate ObamaCare Appeals
The Sacramento Bee:• Administration playing politics with health care
Galen in the News
Grace-Marie Turner was a guest on C-SPAN’s Washington Journal on February 7 to discuss the recent legal decisions regarding the health law. She also gave interviews to nationally syndicated radio programs City on a Hill, The Drew Mariani Show, Dateline: Washington, and others.
We spoke with journalists from Miller-McCune, Kaiser Health News, and Inside Health Policy. And our experts were quoted in several additional publications this month, including:
San Francisco Examiner:• GOP should come up with a better health
care law
Atlanta Journal-Constitution:• Utah, not D.C., points the way for Georgia
on health reform
Investor’s Business Daily:• Gov. Mitch Daniels: ObamaCare a ‘Fixers Fiesta’
FEBRUARy
www.galen.org • 11
Speeches & Events
On February 11, we hosted a media briefing in Washington, DC, for Indiana Governor Mitch Daniels to meet with journalists about pending obligations of the states regarding the health overhaul law. He said the health care overhaul law is “misguided” and “a terrible mistake” and predicts it will lead to a “slide into top-down single payer by another name.” Reason magazine published an excellent summary of some of the policy prescriptions the governor offered during our briefing.
We hosted another successful nationwide conference call in our series, co-hosted by the Institute for Policy Innovation and the State Policy Network, to educate state officials and think tanks about key health policy issues. Our keynote speakers on the February 22 call were Robert Alt, senior legal fellow and deputy director of the Center for Legal and Judicial Studies at The Heritage Foundation, and Rob Natelson of the Independence Institute, who discussed what states should do in light of the Florida court decision declaring the law unconstitutional.
Grace-Marie joined Rep. Tom Price, MD, to talk about the health reform law and how it affects Georgia at the “Health Care Prognosis and Prognostications” forum hosted by the Georgia Public Policy Foundation in Atlanta on February 4. And a week later, she joined Sen. John Barrasso at CPAC to introduce his speech on “ObamaCare: Can It Be Stopped?”
We also participated in dozens of meetings and conferences to discuss new initiatives and health policy ideas with government officials, industry leaders, member associations, and other think tanks.
Grace-Marie Turner speaks at CPAC; Indiana Gov. Mitch Daniels joins Galen for a media briefing; Grace-Marie takes calls from viewers of the Washington Journal program; C-SPAN tweets about Grace-Marie’s interview
12 • Galen Institute
Impact
The release of our new book Why ObamaCare Is Wrong for America coincided with the one-year anniversary of the law’s passage, and this helped to generate a burst of media activity, giving co-authors Grace-Marie Turner, Jim Capretta, Tom Miller, and Bob Moffit a forum to explain what we already know about the damage, dislocations, and cost of the law. We highlight below some of the coverage.
Publications
At our book launch event on March 24, Weekly Standard editor Bill Kristol said, “I’m such a fan of this book. It’s really an excellent statement … of the case against ObamaCare — which I think is the correct case in understanding ObamaCare. And it also suggests the direction one should go once it’s repealed.” Visit our website and order your copy today to learn what’s in the law, how it will affect all of us, and what we should do instead. Why ObamaCare Is Wrong for America, published by Broadside Books, an imprint of HarperCollins, is available in actual and virtual bookstores nationwide.
We also helped facilitate support for a letter to congressional leadership on premium support for Medicare, led by our Health Policy Consensus Group colleague Joe Antos. We helped garner signatures from 30 colleagues in less than 48 hours, and the letter was delivered to Speaker Boehner, Leader Pelosi, Leader Reid, and Leader McConnell.
In addition, our commentaries on the health overhaul law, prescription drugs, RomneyCare, Medicaid, and other health policy issues were featured in more than a dozen publications across the country, including:
The Wall Street Journal:• ObamaCare’s March Madness
The Washington Times:• Medicaid transforming into single-payer surprise
Townhall:• What does the FDA Avastin Decision Mean for Patients?
Richmond Times-Dispatch:• ObamaCare assaults medical progress
National Review Online’s Critical Condition:• Judge Vinson’s Master Stroke
Speeches & Events
Our popular conference call series about the impact of the health overhaul law on the states continued, this time welcoming Florida Governor Rick Scott as our keynote speaker. He talked about some of the challenges involving Medicaid and health exchanges, and provided guidance for moving forward.
We co-sponsored a conference on “ObamaCare at year One: The Real March Madness” on March 14 with Let Freedom Ring, Independent Women’s Voice, Heritage Action for America, DeFundIt.org, and 60 Plus Association. This event took a new twist on the tournament bracket by highlighting some of the worst provisions in ObamaCare.
We also had two successful book launch events at the National Press Club and on Capitol Hill. Grace-Marie joined her co-authors — Jim Capretta of the Ethics and Public Policy Center, Tom Miller of the American Enterprise Institute, and Bob Moffit of The Heritage Foundation — in panel discussions
MARCH
Get our new book at bookstores across the country, or order online at Amazon.com
www.galen.org • 13
about Why ObamaCare Is Wrong for America. The authors talked about the impact of the health overhaul law on American individuals, families, taxpayers, and businesses. you can watch a webcast of both events on our website, www.WrongForAmericaBook.com.
And Grace-Marie gave three additional speeches in March to audiences that included insurance brokers, congressional staffers, MBA students, and policy experts.
We also participated in numerous meetings at the invitation of Members of Congress and their staffs, health industry executives, and policy experts to discuss new initiatives for market-based health reform.
Galen in the News
Grace-Marie appeared on 6 television programs in March, including Varney & Co. and Freedom Watch on FOx Business, and NightTalk on WPxI-TV in Pittsburgh. And she was a guest on more than a dozen nationally syndicated radio shows, including The Dennis Miller Show, The Lou Dobbs Show, The Monica Crowley Show, and The Dennis Prager Show. We also gave interviews to Mother Jones, The Daily Caller, Townhall, Politico, and many others. Here are just a few articles that mention the work of the Galen Institute:
National Review Online:• Wrong, Baby, Wrong
Kaiser Health News:• Different Takes On The Doctor Shortage
Pittsburgh Tribune-Review:• Spreading Contagion
The Washington Examiner:• Regulation hampers the very medical
innovations we need
Grace-Marie Turner talks about the health law with Stuart Varney and his co-hosts; Grace-Marie appears on Freedom Watch; Weekly Standard editor Bill Kristol kicks off our Why ObamaCare Is Wrong for America book launch at the National Press Club in Washington, DC
14 • Galen Institute
Impact
In April, talks in Washington focused on the budget deficit, and we used this opportunity to educate policymakers and the public about the idea of “premium support” to modernize the Medicaid program. Teaming up with AEI’s Joe Antos, we garnered more than 30 signatures from experts in the policy community for our letter to Congressional leaders endorsing this concept, which gives seniors more choices of benefits in a competitive private market. We also were actively engaged in promoting our new book, Why ObamaCare Is Wrong for America, which is receiving glowing praise from policymakers and the public who are appreciative that we have produced it. As one reader said, it is “the handbook on everything we need to know about how this law is going to impact all of us.” And we released a new paper by Dr. Jason Fodeman about why ObamaCare is “Bad for doctors, awful for patients.”
Publications
Our commentaries on Medicare, prescription drugs, and the dangers of government-controlled health care reached more than 3 million readers of two dozen publications in April. Here are a few examples:
Investor’s Business Daily:• Mitt’s Mistake: ObamaCare Is Not ‘Waivable’
The New York Times:• Can Private Insurers Fix Medicare?
Real Clear Markets:• ObamaCare — Still a Clear and Present Danger
St. Augustine Record:• Doctors should decide when generic drugs
are acceptable
Townhall:• Caution — Centralization Is Dangerous to your Health
Galen in the News
Grace-Marie was a guest on the Stossel show on FOx Business, where she was interviewed about how to engage market forces in the health sector and the right way to do entitlement reform by summoning market forces rather than more government price controls and regulation. She also gave interviews on radio stations across the country, including WCHV in Virginia, KyCA in Arizona, KFxR in Texas, and WELI in Connecticut, as well as appearing on the nationally syndicated Lou Dobbs Show.
We spoke with reporters from Politico, Kaiser Health News, and the Associated Press, among others. And our work was cited in several additional publications this month, including:
The Washington Times:• Book review: How to dismantle ObamaCare
Kaiser Health News:• Obama’s Deficit Plan: A ‘Nuanced Approach’ And
‘So Partisan’
APRIL
www.galen.org • 15
Speeches & Events
Grace-Marie gave 9 speeches in April, to economists, members of Congress, MBA students, business owners, and state legislators. She spoke at the American Legislative Exchange Council’s Spring Task Force Summit in Cincinnati, the Association of Private Enterprise Education conference in The Bahamas, the Institute for Health and Productivity Management conference in Orlando, and at a book event on Why ObamaCare Is Wrong for America in New york hosted by the Manhattan Institute and e21.
On April 7, we hosted a forum where Galen visiting fellow Jason Fodeman, MD, presented his new paper on the impact on patients of the new health law: “Bad for Doctors, Awful for Patients.” Rep. Tom Price gave the opening remarks. Also giving remarks and participating in the panel discussion were Hal Scherz, MD, and Richard Armstrong, MD, of Docs4PatientCare.
We also participated in several meetings at the invitation of Members of Congress and their staffs, health industry executives, and policy experts to discuss new initiatives for market-based health reform.
Grace-Marie Turner joins colleagues at the APEE conference in Nassau; Broadside Books tweets about Grace-Marie’s op-ed; Rep. Tom Price speaks at our event for our new paper, “The New Health Law: Bad for Doctors, Awful for Patients”
16 • Galen Institute
Impact
Washington’s top debate in May focused on the battle over the future of Medicare. President Obama’s administration continued to defend cuts to Medicare, which will surely lead to lower quality care, long waiting lines for patients, and decreased access to care. House Budget Chairman Paul Ryan’s plan to save Medicare modernizes the program by offering more choices and lower costs through competition. We wrote about the advantages of Ryan’s plan, and the terrible consequences of the administration’s program cuts in our widely circulated commentary, “Should Congress, president overhaul Medicare?”
We also focused on the importance of innovation in the health sector and the avalanche of regulations companies face to get products approved and paid for, even after they are proven safe and effective, when we hosted our third annual conference on health care innovation, “Health Care 2011: Advancing Health Care by Facilitating Innovation.” Speakers explained the astonishing creativity in the health sector and the threats posed by crippling regulatory and payment barriers.
Publications
Grace-Marie Turner’s commentary about the future of Medicare, “Should Congress, president overhaul Medicare?” was featured in more than 45 publications in 22 states, including The Sacramento Bee, Green Bay Press-Gazette, Daytona Beach Sunday News-Journal, and The Denver Post.
Other commentaries on Medicaid, ObamaCare waivers, innovation, and other health policy issues were also published in newspapers and posted on media websites across the country, including:
The Washington Times:• White House waivers make splash
The Daily Caller:• States need tools to stem Medicaid’s red ink
Real Clear Markets:• Stalling the Engine of Economic Recovery
Richmond Times-Dispatch:• On Medicare, the Right Role for Congress
The American:• Doctors, Not Politicians, Should Decide
Speeches & Meetings
Much of our work in May was focused on getting attention for our book. Grace-Marie Turner, Jim Capretta, Tom Miller, and Bob Moffit spoke about Why ObamaCare Is Wrong for America at the Bloggers Briefing on Capitol Hill, hosted by The Heritage Foundation on May 3 in Washington, DC.
Grace-Marie gave 3 additional presentations on health reform this month, at the Laffer Associates 51st Washington Conference, the U.S. Chamber of Commerce’s America’s Small Business Summit 2011, and to Salem State University graduate students.
Grace-Marie participated in the Conservative Leadership Summit hosted by the Conservative Action Project in McLean, Virginia, on May 19.
She also met with several industry executives, Congressional staffers, and policy experts to discuss free-market reform initiatives, medical innovation, Medicare, and other health policy issues.
MAy
Grace-Marie Turner’s commentary was featured on Rep. Paul Ryan’s website
www.galen.org • 17
Galen in the News
Grace-Marie was a guest on Varney & Co., where she argued that Mitt Romney’s Massachusetts health care reforms will not work on a nationwide scale.
Grace-Marie was also interviewed on local radio and on several nationally syndicated radio programs such as the G. Gordon Liddy Show, Dateline: Washington, City on a Hill, America’s Morning News, and The Small Business Advocate. We also gave interviews to CQ and U.S. News and World Report. And our experts were quoted in several additional publications this month, including:
The New York Times:• Rhode Island’s Medicaid Experiment Becomes a
Talking Point for Budget Cutters
CQ Healthbeat:• Lawmaker Defends Medical Device Industry’s Views
The Providence Journal:• R.I. Medicaid agreement admired in other states
Congressional Quarterly:• Medicaid’s Home for Aging Millions
Events
On May 4, Microsoft helped kick-off our third innovations conference by hosting a VIP reception for Members of Congress, special guests, and conference speakers. On May 5, we hosted a major conference, “Health Care 2011: Advancing Health Care by Facilitating Innovation,” featuring top industry experts who gave inspiring presentations about innovations in health care delivery, technologies enabling better health, and policies needed to support these transformative innovations. Please visit our website to see the agenda, view a video of the event, and download the presentations.
On May 17, the Institute for Policy Innovation and the State Policy Network joined the Galen Institute in hosting a conference call for the authors of Why ObamaCare Is Wrong for America. They spoke with dozens of state legislators about how the health overhaul law will affect states, American families, taxpayers, seniors, employers, workers, doctors and patients, and many others impacted by its sweeping changes.
Sen. John Barrasso speaks at Galen’s innovation conference; Grace-Marie Turner’s commentary appears in The Washington Times; Grace-Marie talks about RomneyCare on Varney & Co.
18 • Galen Institute
Impact
We had two articles published early in June — in The Wall Street Journal and The New York Times — that started an animated conversation throughout the month. The first was about the McKinsey survey that we estimate could lead 78 million Americans to lose their health insurance at work as a result of ObamaCare. This created a firestorm of activity at the White House, knowing that this is truly the Achilles’ heel that would doom their health overhaul. This article was hugely popular on the WSJ website, making the top-5 list of most emailed stories, and making the top-5 list of most commented stories with more than 400 comments!
Then our NY Times piece offered a recommendation about the right place to begin for Medicare reform by focusing on better-coordinated care for poorer, sicker, older Americans whose care is financed both through Medicare and Medicaid. That led to a cascade of others agreeing that this must be a priority.
Publications
We released a new paper on the Independent Payment Advisory Board titled, “Repealing and Replacing IPAB with Better Solutions.” This paper highlights a fundamental question: Do we entrust individuals with the decisions for their own care? Or do we entrust those decisions to a government-appointed panel of experts in Washington who will have authority over hundreds of billions of dollars in Medicare spending?
Our commentaries on the dangerous consequences of the health overhaul law were featured in major news outlets in June, including:
The Wall Street Journal:• No, you Can’t Keep your Health Insurance
The New York Times:• What Medicare Services to Cut, Now — ‘Dual
Eligibles,’ Doubly Expensive
National Review Online’s Critical Condition:• Losing your Coverage
Under ObamaCare
Forbes.com:• The President’s Plan To End Medicare Part D As We
Know It
New Hampshire Union Leader:• What the mass of ObamaCare waivers
tells us about this law
National Review Online’s Critical Condition:• ObamaCare Decision May
Invite Supremes to Limit Federal Power
Galen in the News
On June 9, Senator John Barrasso’s Second Opinion address on the Senate floor was titled, “If you Like your Health Care Coverage, Cross your Fingers.” He discussed a report from the McKinsey Quarterly on “How US health care reform will affect employee benefits.” He included Grace-Marie’s WSJ op-ed on the study in his testimony, and mentioned Why ObamaCare Is Wrong for America, saying, “having read the book, I will tell you a lot of the things I’ve been talking about during the debate leading up to the vote on ObamaCare, and that I’ve been talking about afterwards as a doctor — Second Opinion — are included in [the] book.”
JUNE
Grace-Marie Turner’s commentary was one of the top-5 most popular stories on The Wall Street Journal website
www.galen.org • 19
Grace-Marie was a guest on Varney & Co., where she discussed the impact of the health law on the medical industry. We also gave interviews to Modern Healthcare and other magazines, and to several radio hosts. Grace-Marie was a guest on regional shows and nationally syndicated programs, including The Lou Dobbs Show, Dateline: America, The Small Business Advocate Show, and Up Front with Rod Grams.
And we were able to reach millions of readers through articles that mentioned Galen’s work and quoted our experts, including:
The Heritage Foundation:• Putting Patients in Harm’s Way: A Doctor’s
View of ObamaCare
Forbes’ On the Cutting Edge:• How ObamaCare Will Further Explode
the Deficit
American Medical News:• More employers consider dropping health
coverage, report says
Investor’s Business Daily’s Capital Hill:• Ryan Discusses Budget
‘Impasse’ And His Two Medicare Plans
Politico Pulse:• An IPAB Alternative
Events & Speeches
On June 23 our conference call series about state issues continued as House Budget Committee Chairman Paul Ryan discussed Medicare reform, co-hosted by Galen, the State Policy Network, and the Institute for Policy Innovation. Rep. Ryan explained the imperative for Medicare reform and provided the facts about his premium support model, which spurred a national debate after it was included in the budget plan that passed the House in April.
Grace-Marie spoke about ObamaCare, patient-centered reform solutions, Medicaid, and Medicare at the Faith & Freedom Coalition Conference, National Medicaid Congress, and events hosted by American Conservative Nation Radio Network, American Enterprise Institute, Clare Boothe Luce Policy Institute, Republican Women of Clifton, and the Greater Washington Association of Health Underwriters.
We also participated in more than 30 meetings and briefings in June with Members of Congress and their top advisors, health industry executives, reform advocates, policy experts, and political candidates.
Grace-Marie Turner with Butch Porter, Ken McClenton, and Allan Poteshman of the American Conservative Nation Radio Network
Other New Bureaucracies
22 1412, 3509, 5101,
10104, 10221,10334, 10413,
10 5 0 1
Other New Demonstration
& Pilot Programs
26 1201, 2704, 2705, 2706, 2707, 3023, 3024, 3113, 3140, 4204, 4206, 5304,
5509 , 6112 , 6114 , 10212, 10221, 10315 , 10323 , 10326 , 10504 ,
10607
Other NewGrant Programs
59 1002, 1003 , 1311, 1322,1561, 2952, 2953 , 3501 -6 ,
3508, 4101, 4108, 4201, 4 2 0 2 , 4304 , 5102 , 5206 , 5208, 5301 -5303 , 5305,
5306 , 5309 , 5313, 5315, 5405, 5507 -8,
5604, 6703,10301
10323, 10333, 10408 -10, 10413, 10501, 10503
Loan Repayment
& Forgiveness Programs
4 5203, 5204, 5205,
5311
Other New Regulatory Programs
4 1104, 6102, 6103
Special Interest
Provisions
19 1102, 1201, 2006, 3137, 3201, 3301, 6001, 9001, 9010, 9014, 9023, 10201, 10317, 10323, 10324, 10502, 10601, 10901, 10905; HCERA 1101, 1103,1106, 1203, 1406
BENEFICIARIES: Mutual of Omaha (NE);Drug Cos; NJ Drug Cos;AARP; Libby Montanans;
Physician-Owned Hospitals;Univ. of CT; Medigap Plans;Longshoreman Health Plans;
Medicaid: HI, LA, MA, TN, VT; Medicare: CT, FL, MI, MT, ND
New Government
AGI: Adjusted Gross IncomeAHRQ: Agency for Healthcare Research and QualityCDC: Centers for Disease Control & PreventionCHIP: Children’s Health Insurance ProgramCLASS: Community Living Assistance Services & SupportsCMS: Centers for Medicare & Medicaid ServicesCO-OP: Consumer Operated & Oriented ProgramFFS: Fee-for-ServiceFSA: Flexible Spending ArrangementGAO: Government Accountability OfficeHCERA: Health Care & Education Reconciliation ActHHS: Health & Human Services Department
HSA: Health Savings AccountIPAB: Independent Payment Advisory BoardIRS: Internal Revenue ServiceMA-PD: Medicare Advantage Prescription DrugMedPAC: Medicare Payment Advisory CommissionMERD: Medical Early Risk DetectionEALORS: Executive Auxiliary Linked Office Regional Systems MEWA: Multiple Employer Welfare ArrangementNAIC: National Association of Insurance CommissionersNIH: National Institutes of HealthPCORI: Patient-Centered Outcomes Research InstitutePPS: Prospective Payment System
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ER
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ER
A: §1003
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§3011
§3013
§8002
§§3006, 10301
§§1501, 10106; HC
ER
A §§1002, 1004
§§1402, 1412; HC
ER
A §1001
§§1402, 1412; HCERA §1001
Prepared by: Joint Economic Committee, Republican StaffCongressman Kevin Brady, Senior House RepublicanSenator Sam Brownback, Ranking Member
Patient Protection & Affordable Care Act, P.L. 111-148;Health Care & Education Reconciliation Act, P.L. 111-152
§3004
§1421, 10105
Rationing Potential
Taxes & Monetary Fees/Penalties/Cuts
Other Expansions
Involvement in Health Insurance Market
Represents Bundles of Additional Entities
Mandates
Trust Fund(Rationing Potential)
Other New Trust Funds/Monetary Benefits
Expanded GovernmentGovernment with Expanded Authority/ Responsibility
Government Financial Entity with New Inflows/Outflows
State/Territory with Expanded Authority/Responsibility
New RelationshipsRegulations/Requirements/MandatesReporting Requirements
Oversight
Money FlowsConsultation/Advisory/Info SharingStructural Connections (Includes Existing)
Private
Unchanged Private Entity
Private Entity with New Mandates/Regulations/Responsibilities
Special Interest Provisions
§3301; HCERA §1101
§3013§6301
§§1401, 1412, 10105; HC
ER
A §§1001, 1004
§§1331, 10104
Small Business Health Options
Program§1311
NAIC§§1333, 1341,
10104
§3007
HC
ER
A §1402
§1001, 10101
§3311
§2701
§2703
§5605
§2701
§2602
§2703
§3012
§§1513, 10106; HCERA §1003
§1334, 10104
§8002
§6301
§§3004, 3005
§1513, 10106
§6703
§4102
§§1341, 10104
§10407
§10407
§2701
§1334, 10104
§§3022, 10307
§3004§3004
§8002
§§1301, 10104
§1333, 10104
§§1341, 10104
§§1201, 1301, 1304
§§1201, 1301, 1304
§1342
§1301
§1001
§§1201, 1301, 1302
§1331, 10104
§1302
§§1311, 10104
§1342
§1511
§3004
§1561
§1411
§1342
§3012
§4004
§4004
§4004
§4002
§10409
§1311
§6703
§6703
§3012
§4001
§1512
§1511
§3403, 10320
§4003
§8002
§8002
§8002
§8002
§§9001, 10901; HCERA §1401 §§9001, 10901; HCERA §1401
§§1001, 10101
§9004
§9003
§§9009, 10904
§9008; HCERA §1404
§§9010, 10905; HCERA §1406
§9002
§§9005, 10902; HCERA §1403
§1501
§§1311, 10104
§§3103, 10320
§1334, 10104
§§1322, 10104
§1333, 10104
§1312
§6301
§3005§3011
§§3021, 10305, 10306
§3026
§4001
§§3006, 10301
§1411
§4305
§1001
§§1201, 1301, 1302
§1331, 10104
§1341, 10104
§8002
§1513, 10106
§6605
§§2001-2004
§§9017, 10907
§§1501, 10106; HCERA §§1002, 1004
§§9015, 10906; HCERA §1402 §9013
§1511
§1511
§§1201, 1301
§1312
Title III
§§3201, 10318; HCERA §1102
§8002
§§3001, 10335
§6301
§§1311
§§1514, 10106
§1321
§2703
§5605
§§1311, 10104
§6301
§4001
§9002
§8002
§1414
§1411
§2701
§3403, 10320
§6703
§1331, 10104
§2602
§3403, 10320
§1512
§§1514, 10106
§1411
§1411
§§3001, 10335
§3004§3004
§3011
§3021
§3022, 10307
§3026
§2701
§2701
§2701
§2703
§4001
§4302
§3013
§1411
§4004
§6301
§6301
§6703
§3011
§4305
§10409
§3311
§3311
§3021
§3011
§3012
§8002
§3311
§§1311, 1413
§3005
§3004
§1411
§1313, 10104
§§1001, 10101
§5605
§1512
§5605
Qualified HealthPlans
§§1301, 1302,1311, 10104
HealthCare Choice
Compacts§§1333, 10104
Reinsurance Program§§1341, 10104
Value-Based Insurance Design
& Coverage of Preventive Health
Services§1001
Optional Basic Health
Program§§1331, 10104
GAO§§1401, 3001, 3403, 6301,
10105, 10320
Comptroller General§§1313, 1322MedPAC
§2602
States§§1311,1331,
1333,1341, 10104, 10407
State Surveyors
§6703
Vital Statistics Agencies
§10407
US Territories§1323; HCERA §1204
KeyNational
Indicator System Implementation
Institute§5605
Commission on Key
Indicators§5605
National Academy of Sciences
§5605
CongressMembers
& Personal Staff Mandate:
Only Exchange Coverage
§1312
NationalTraining Institute for Federal and State Surveyors
§6703
AHRQ§3012, 3013, 6031
EssentialHealth Benefits
Package§§1001,1201, 1301,
1302 PlatinumBronze
Silver Gold
Government Health Benefit
Exchanges§§1201, 1301,1302, 1311, 1312, 1313, 1321, 1323, 1334, 1411, 1413, 10104;
HCERA §1204
Internet Portal§1311
Data Collection
§1311
HHS Inspector General
§1313, 8002,10104
Eligibility Determinations
§1411
Privacy Study
§1411SecretaryHealth & Human
Services
HealthInsurance
CO-OP§§1322, 10104
CO-OP Advisory
Board§1322, 10104
Private Purchasing
Council§1322
USPreventive
Services Task Force
§1001
Health Savings Accounts§§9003, 9004
Medicare Beneficiaries
§3311
Health Insurance Policy Holder
§§1001, 10101
Small Employers§§1304, 1311, 1421, 1512,
10105
Large Employers§§1304, 1511, 1512, 1513,
1514, 10106
MedicarePart C & Part D
Insurers§3311
Large Group Market
§§1201, 1301, 1511
PremiumTax Credit Subsidies
§§1401, 1412, 10105; HCERA §§1001,
1004
Annual Fee§§9010, 10905; HCERA §1406
3.8% Investment Income Tax
HCERA §1402
HSAUse Restriction
§9003
Misuse ofHSA Funds
§9004
“CadillacPlans” Tax§§9001, 10901; HCERA §1401
Subsidies:Out-of-Pocket
Expenses§§1402, 1412;
HCERA§1001
Individuals
Mandates, Regulations,& Taxes
§§1311, 1411, 1501, 9003-9005, 9013, 9015, 9017, 10106, 10902, 10906, 10907;
HCERA §§1002, 1004, 1402, 1403
“Excessive Profits”
§§1001, 10101
Patients
MedicarePayroll Tax
Increase: 0.9%§§9015, 10906; HCERA §1402
Flexible Spending Arrangement
§9005, 10902; HCERA §1403
Only Medical Expenses
Above 10% of Income (AGI) are Tax
Deductible§9013
FSA ContributionLimit: $2,500
§§9005, 10902; HCERA§1403
RiskCorridors
§1342
Large Business Employees
§1511, 1512
Small Business Employees
§1512
MEWAHealth Plans
§§1301, 6605
Self-Insured Health Plans
§1301
Small Group Market
§1301, 1304, 1342Individual Market§1201, 1301, 1304, 1342
10% Tax On
Indoor Tanning Services:
§§9017, 10907
W2 Health
InsuranceDisclosure
§9002
Individual Mandate: Buy Health Insurance
§§1501, 10106;HCERA §§1002, 1004
Employer Mandate:
Provide Health Insurance
§§1513, 10106; HCERA §1003
Mandatory Worker Auto-
Enrollment§1511
Small Business
Health Insurance Tax Credit
§§1421, 10105
Insurance Mandates
§§1001, 1101, 1201, 1251, 10101, 10103; HCERA §2301
17
Health Insurance Companies
Mandates, Regulations, Required Benefits, &
Taxes§§1001, 1201, 1252, 1301, 1334, 1341,
3311, 9001, 9010, 10101, 10104, 10901, 10905; HCERA §§1401, 1406
Employers
Mandates, Regulations, & Taxes
§§1511, 1512, 1513, 9001, 9002, 10106, 10901; HCERA §§1003, 1401
Demonstra-tion Program
§3001Public Data Disclosure
System§3006, 10301
FFS Accountable
Care Organizations
Program§§3022, 10307
Community-Based Care Transitions
Program§3026
Hospital Quality
Reporting Program§3004, 3005
Medicaid Health Home
Program§2703
Federal Coordinated Health Care
Office§2602
Medicaid Quality
Measurement Program
§2701
State-Specific Adult Health Quality
Measures§2701
Medicaid Expansion: +16 million
§§2001-2004CBO Cost Estimate,
3/20/10
State Medicaid Agencies§§2602, 2701, 2703,
3011
MedicareCuts: $528.9bn(includes MA cuts)
Title III; CBO Cost Estimate,
3/20/10
Medicare Advantage
Cuts: $205.9bn§§3201, 10318; HCERA
§1102; CBO Cost Estimate, 3/20/10
Subsidy: Medicare Part D Drug Program “Donut Hole”
§3301; HCERA §1101
Hospital Compare Website
§3001
HospitalValue-Based Purchasing
Program§§3001, 10335
Centerfor Medicare& Medicaid Innovation
§§3021, 10305, 10306
Physician Value-Based
Payment Modifier
§§3007
Annual Fee§9008; HCERA
§1404
Hospitals§§1311, 3001, 10335
Skilled Nursing Facilities§§3006, 10310
§§3006, 10301
Ambulatory Surgical Centers
§§3006, 10301
Home Health Agencies
§3006
Medical Device Manufacturers
§§9009, 10904; HCERA §1405
Pharmaceutical Companies
§9008; HCERA §1404
Inpatient Rehabilitation
Facilities§3004
Hospice Programs
§3004
PPS-Exempt Cancer Hospitals
§3005
Medicare Administrative
Contractors§3311
Health Industry
Mandates, Regulations, Taxes, & Payment Cuts
§§1311, 3001-3006, 3311, 9008, 9009, 10327, 10331, 10335, 10904; HCERA
§§1404, 1405
Long-TermCare Hospitals
§3004
Medical Device
Excise Tax§§9009, 10904;
HCERA §1405
IPAB§3403, 10320
IPAB Consumer Advisory Council§§3403, 10320
Medicare Part A Trust
Fund§3026, 3403,
6301,9015
Medicare Part B Trust
Fund§3026, 6301
PublicHealth Quality &
Efficiency Measures Development
Program§§3013, 10304
Hours of Service Determination for Calculating
Employer Mandate Penalty
§§1513, 10106
Rules for Insurance
Claims Appeals§1001, 10101
Health IT Policy
Committee§1561
Office of Personnel
Management§§1334, 10104
President§§ 3012, 3024, 3403, 4001,
8002, 10320
Cures Acceleration
Network Review Board
§10409
National Diabetes
Report Card Program§10407
CLASS Independence
Benefit Plan§8002
CDC§§1001, 4003, 4004,
4102, 10407
NIH§§4305, 6301,
10409
National Partnership on Prevention &
Health Promotion
§4004
National Public Education
Campaign on Prevention & Health
Promotion§4004
Community Preventive
Services Task Force§4003
National Oral Health Public
Education Campaign
§4102
Cures Acceleration
Network§10409
CLASS Independence Fund Board of
Trustees§8002
Life Independence
Accounts§8002
National Diabetes Mortality Statistics Education Training Program
§10407
Eligibility Assessment
System§8002
PersonalCare Attendants
Workforce Advisory Panel
§8002
CLASS Independence
Fund§8002
CLASS Independence
Advisory Council
§8002
Black Lung Benefits Act
§1556
Office of Multi-State Qualified
Health Plans§1334, 10104
PublicHealth Service
§§3011, 4002, 4302
Surgeon General
§4001
AdvisoryGroup on
Prevention, Health Promotion, and Integrative and Public Health
§4001
PCORI Expert
Advisory Panels
§6301
PCORI Methodology
Committee§6301
PCORI Board of Governors
§6301
PCORIWebsite
§6301
State Protection &
Advocacy Systems
§8002
Justice Department
§6703
National Prevention,
Health Promotion, & Public Health
Council§4001
Prevention Website
§4004
Website“Transparency
in GovernmentӤ1552
Prevention& Public
Health Fund§4002
Interagency Working Group on Health Care
Quality§3012
PCORITrust Fund
§6301
PCORI§§6301, 10602
SocialSecurity
Administration§1411
Homeland Security
Department§1411
Labor Department
§§1001, 1302, 1311, 1511, 1512, 1513, 6605, 10101, 10106
CLASS Program
§8002
Officeof Tax
Analysis§§1331, 10104
Elder Justice
Coordinating Council
§6703
AdvisoryBoard on Elder Abuse, Neglect, & Exploitation
§6703
Multi-Disciplinary
Panels on Improving Long-
Term Care§6703
Elder Abuse, Neglect, &
Exploitation Forensic Centers
§6703
IRS§§1401, 1402, 1411, 1412 1414,
1421, 1501, 9004, 9005,10105, 10901; HCERA
§§1401, 1402
Treasury Department
§§1311, 1331, 4002, 8002, 10104
National Health Disparities Data Collection &
Reporting System
§4302
HealthCare Quality
Website§§3011, 3012
Interagency Pain Research Coordinating
Committee§4305
NationalHealth Strategy
& PrioritiesOffice
§3011
Medicaid/CHIP
Title II; §§1413, 3011
MedicareTitle III, §2602
CMS§§3013, 3021, 3026, 3403, 10305, 10306,
10320
Medicare Prescription Drug
and MA-PD Complaint System
§3311
CMS Actuary
§§1331, 3403, 10104
Your New Health Care System
Congress§§1312, 1411, 3311, 5605, 8002
Non-Hospital
Value-Based Purchasing
Program§§3006, 10301
§3004
§§3002, 10327, 10331
§§3002, 10327, 10331
§3007
§§3007
Physician Quality
Reporting System
§§3002, 10327, 10331
Physicians§§1311, 3002, 3003, 10327, 10331
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