The baby & the bath water

If you believe Judge Vinson, the entire ACA is now unconstitutional, including many provisions that are clearly constitutional.  For example, Congress has power to regulate intellectual property and did so by granting biotech companies 12 years of market exclusivity while creating a regulatory pathway for biosimilars.  This legislation was hugely popular with the biotech sector, and clearly constitutional.  And yet, Judge Vinson says it must be tossed out.  At least in Florida.

Some state AGs claim that his ruling is the law in states other than Florida.  I have serious doubts.  But if they are right, the Wisconsin AG should be asking Wisconsin residents to kick their older kids off coverage, return extra Part D funds received this year and last, stop reporting health insurance loss ratios, pay more for preventative care in Medicare, and give back cash to Wisconsin insurance companies.  Chain restaurants in Wisconsin should be ignoring the new food labeling rules; and their hospitals and physicians should be paid under the pre-ACA Medicare payment rules.  Ouch.  That’s a pretty big baby.

A partial list of the already operative provisions of ACA that Judge Vinson claims must be destroyed:

  • High risk pools (2010)
  • Review of health plan premium increases (2010)
  • Medical loss ratio rules (2010)
  • Coverage for dependent children under 26 (2010)
  • Prohibition on lifetime caps (2010)
  • Prohibition on rescissions except for fraud (2010)
  • No pre-existing coverage exclusions for children (2010)
  • Starting to close the donut hole ($250 in 2010; $500 in 2011)
  • 50% discount for patented drugs in the donut hole (July 1, 2011)
  • Reductions in Medicare Advantage overpayments (2010)
  • Annual wellness visits in Medicare (2010)
  • Waiver of coinsurance for most preventative services in Medicare (2010)
  • Physician-owned hospital anti-referral rules (2010)
  • Medicare claims submission period reduced to 12 months (2010)
  • Recovery auditor program extended to Medicaid (2010)
  • National health care fraud and abuse data collection system (2010)
  • Enhanced student loan programs for health care practitioners (2010)
  • Chain restaurant food labeling rules (2010)
  • PBM transparency reporting (2010)
  • Increase in the Medicaid prescription drug mandatory rebate (2010)
  • Myriad adjustments to Medicare payments, including the Physician Payment Update
  • 12 years of DE for biological drugs & a regulatory pathway for biosimilars  (2010)
  • Expansions to 340B and free clinic programs (2010)
  • Enhanced tax reporting by charitable hospitals, §501(r) (2010)
  • New annual tax on drug, device and insurance companies (2009)

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