HC Reform Update from Mark Sanna: Speculation continues about the number of people who will be "residually uninsured" after the new health overhaul provision kicks in. McKinsey and Co.'s Center for U.S. Health System Reform estimates the amount could be as high as 30 to 40 million people.

HC Reform Update from Mark Sanna: When examining your health benefits for the new year, you'll probably notice that your plan has eliminated lifetime and most annual dollar limits on coverage. That was mandated by the federal health-care overhaul. But for some consumers, coverage may still be restricted: Limits on the number of doctor visits or prescriptions or other services continue to be permitted and can stymie patients' efforts to get necessary care.

HC Reform Update by Mark Sanna: Starting Jan. 1, under a new end-of-life policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.

HC Reform Update by Mark Sanna: When a proposal to encourage end-of-life planning touched off a political storm over "death panels," Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1. Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.

HC Reform Update from Mark Sanna: New, proposed regulations — which result from the health overhaul — were issued yesterday by the Department of Health and Human Services and would require health insurers to justify proposed double-digit premium increases. In addition, administration officials signaled their plan to step-up their reviews of insurance rates if state regulators are not adequately protecting consumers.

HC Reform Update from Mark Sanna: A Senate deal to fund the federal government until early March doesn't include money to enact the health-care overhaul or stepped up regulation of Wall Street, boosting Republican efforts to curb key elements of President Barack Obama's domestic agenda.

HC Reform Update from Mark Sanna: Highly anticipated regulations defining what constitutes "unreasonable" health insurance premium increases are expected any day now that federal regulators have sent them to the Office of Management and Budget for final review. Democrats' health care reform law gives the federal government greater oversight of health insurance premium increases by requiring a review and justification of steep increases. The law requires health plans to publicly justify "unreasonable" rate hikes starting with 2010 plan years, and gives states power to shut health insurers out of state health insurance exchanges starting in 2014.

HC Reform Update from Mark Sanna: A federal court judge heard oral arguments Thursday surrounding the 20-state challenge to the health overhaul. At issue are two key elements of the new law: its mandate requiring that almost everyone have health insurance and its expansions of the Medicaid program.

HC Reform Update from Mark Sanna: Under a little-known provision of the health overhaul law, insurers will be required to provide their benefits information on a standardized chart using the same plain English terms as other companies to help shoppers understand and compare complicated policies. Congress even listed some of the insurance jargon – including terms such as deductible, preferred provider, excluded services and UCR (usual, customary and reasonable) – that must be defined in a glossary that will accompany the benefit summary.

HC Reform Update from Mark Sanna: The Justice Department said Tuesday it intends to appeal to a U.S. District Court judge's ruling declaring a key part of President Obama's health care law unconstitutional. The Fourth Circuit Court of Appeals would get the case that originated in Virginia when the state filed a lawsuit saying the individual mandate is unconstitutional.

HC Reform Update from Mark Sanna: A federal district judge in Virginia ruled on Monday that the keystone provision in the Obama health care law is unconstitutional, becoming the first court in the country to invalidate any part of the sprawling act and insuring that appellate courts will receive contradictory opinions from below. Judge Henry Hudson declined the plaintiff's request to freeze implementation of the law pending appeal, meaning that there should be no immediate effect on the ongoing rollout of the law.

HC Reform Update from Mark Sanna: Five of the nation's largest health insurance companies are taking a key step toward building their own inside-the-Beltway coalition to influence implementation of the new health law and congressional efforts to change it. The companies – Aetna, Cigna, Humana, UnitedHealthcare and Wellpoint – are shopping around Washington for a public relations firm to represent them, according to a source familiar with their work. Public Strategies and APCO are among PR firms that have spoken with the insurers.

HC Reform Update from Mark Sanna: The Red Flags Rule requires creditors and certain businesses to develop and implement written identity theft prevention programs to help identify, detect and respond to patterns, practices or specific activities that could indicate identity theft. This week the House of Representatives passed S3987 that clarifies the definition of a creditor and in effect would exempt health care providers from the Red Flags Rule. The President is expected to sign the bill before the Red Flags Rule goes into effect on January 1, 2011.

HC Reform Update from Mark Sanna: The House gave final approval on Thursday to a bill that would avert a 25 percent cut in Medicare payments to doctors by freezing reimbursement rates at current levels until the end of next year. The bill goes now to President Obama, who hailed the action by Congress and promised to sign the legislation. The House vote was 409 to 2. The Senate approved the measure by unanimous consent on Wednesday.

HC Reform Update from Mark Sanna: A report released today from the National Women’s Law Center and Oregon Health and Science University reveals that more women are binge drinking, saying they downed five or more drinks at a single occasion in the past month, and fewer are being screened for cervical cancer. Over all, more women are obese, diabetic and hypertensive than just a few years ago, and more are testing positive for chlamydia, a sexually transmitted disease linked to infertility.

HC Reform Update from Mark Sanna: In an unintended consequence of the new health care law, drug companies have begun notifying children’s hospitals around the country that they no longer qualify for large discounts on drugs used to treat rare medical conditions. As a result, prices are going up for these specialized “orphan drugs,” some of which are also used to treat more common conditions. The FDA classifies more than 350 medicines as orphan drug products. Manufacturers said they could not recover the costs of developing such drugs if they were required to sell them at deeply discounted prices. A House Democrat who worked on the health care law said the situation had resulted from “an honest mistake in drafting,” and he added, “No one intended to take away any of the drug discounts that children’s hospitals already had.” The discount program is widely known as the 340B program, after the relevant section of the Public Health Service Act.

HC Reform Update from Mark Sanna: Senate leaders have reached a tentative, one-year deal on the Medicare “doc-fix,” sources close to the negotiations say. The deal pays for the must-pass patch to prevent a deep cut in Medicare doctors’ payments with changes in the tax subsidy program that some consumers will use after 2014 to buy health insurance on the new exchanges. The rest of the Senate was to review the deal Monday night with hopes of passing it with a unanimous consent agreement later this week, possibly on Wednesday. But it could get pushback from liberal Democrats in the House or Senate. Democrats are under pressure to pass a full-year patch of the doc-fix during the lame duck session, because Republicans are already eyeing it as a vehicle to tie to repeal efforts in the next congress.

HC Reform Update from Mark Sanna: An Office of Personnel Management plan to launch a comprehensive database of federal workers' health care records has raised the ire of some privacy advocates, employee unions and consumer groups. OPM is organizing a research database of insurance claims filed by the eight million workers and dependents enrolled in the Federal Employees Health Benefits Program, as well as participants in two other federally administered programs. The claims data, which will be supplied by the private insurers that participate in the FEHBP, will help OPM figure out ways to lower costs, improve quality and fight fraud, the agency has said.

HC Reform Update from Mark Sanna: The state Department of Insurance, after a rare public hearing, has rejected the 20% rate increase sought by Anthem Blue Cross and Blue Shield for individual market plans that cover some 48,000 clients, a decision that maintains the current premium prices. This is a great victory for insurance consumers in the state of Connecticut, said Healthcare Advocate Kevin Lembo, who said the ruling calls into question increases approved earlier in this fall, in which one plan saw a 47% rate increase. ... Anthem spokeswoman Sarah Yeager said the insurer was reviewing the ruling and said it shares the concerns 'of our members over the rising cost and rate of utilization of health care services and the corresponding adverse impact on insurance premiums.

HC Reform Update from Mark Sanna: News outlets report that as the presidential debt commission plans to vote today, the final recommendations could shape the debate on how budgeteers treat Medicare, Medicaid and health care costs in the future -- regardless of the vote tally.

HC Reform Update from Mark Sanna: The Red Flags Rule requires creditors and certain businesses to develop and implement written identity theft prevention programs to help identify, detect and respond to patterns, practices or specific activities that could indicate identity theft. The applicability of the rule to health care providers has been debated over the past several months. On Tuesday, the Senate passed legislation that would exempt health care providers from the Red Flags Rule.

HC Reform Update from Mark Sanna: It’s official. The drug industry’s chief lobbyists - the Pharmaceutical Research and Manufacturers of America - raised and spent at least $101.2 million in 2009 on advocacy efforts during the contentious health care debate, according to IRS documents the group filed in mid-November.

HC Reform Update from Mark Sanna: For the second time in two months, a federal judge in Virginia has upheld the constitutionality of the new health care law, ruling on Tuesday that the requirement that most Americans obtain medical coverage falls within Congress’s authority to regulate interstate commerce. The judge, Norman K. Moon of Federal District Court, who sits in Lynchburg, Va., issued a 54-page ruling that granted the government’s request to dismiss a lawsuit brought by Liberty University, the private Christian college founded by the Rev. Jerry Falwell. Last month, in a separate case, Judge George C. Steeh of Federal District Court in Detroit also upheld the law.

HC Reform Update from Mark Sanna: The House on Monday is scheduled to take up a $1-billion measure delaying by one month a 23% cut in federal Medicare reimbursements to doctors. The payment reduction is scheduled to go into effect Wednesday if members of the House don't act. The Senate approved the legislation earlier this month. A 1997 law requires that doctors' Medicare rates be adjusted each year based on the health of the economy, with the goal of keeping the program in the black. Rate cuts have been blocked 10 times in the last eight years, including four times this year. Some senators have said they are working on a measure that would extend the current payment rates through 2011.

HC Reform Update from Mark Sanna: Florida Republican lawmakers are reviving a proposed constitutional amendment that takes aim at a major part of the federal health overhaul. The proposal, if ultimately approved by voters during the 2012 elections, is aimed at allowing Floridians to opt out of a federal requirement that they buy health insurance or face financial penalties.

HC Reform Update from Mark Sanna: As the Obama administration presses ahead with the health care law, officials are bracing for the possibility that a federal judge in Virginia will soon reject its central provision as unconstitutional. The novel question before the courts is whether the government can require citizens to buy a commercial product like health insurance.

HC Reform Update from Mark Sanna: A majority of Americans want the Congress to keep the new health care law or actually expand it, despite Republican claims that they have a mandate from the people to kill it, according to a new McClatchy-Marist poll. The post-election survey showed that 51% of registered voters want to keep the law or change it to do more, while 44% want to change it to do less or repeal it altogether.

HC Reform Update from Mark Sanna: The Obama administration issued rules on Monday defining a promise to consumers in the new federal health-care law that insurers will spend at least $4 out of $5 they collect in premiums on medical services and other efforts to improve patients' health.

HC Reform Update from Mark Sanna: The Obama administration released regulations this morning detailing a health law requirement. The medical loss ratio, also know as MLR, rule requires insurance companies to spend at least 80 cents of the premium dollar on medical care and quality. For employer plans covering more than 50 people, the requirement is 85 cents. Part of the new health care law, the rule is meant to give consumers a better deal. Administration officials said it will prevent insurers from wasting valuable premiums on overhead, marketing and executive bonuses. 'These new rules are an important step to hold insurance companies accountable and increase value for consumers,” said Health and Human Services Secretary Kathleen Sebelius.

HC Reform Update from Mark Sanna: Eight months into the new law there is a growing frenzy of mergers involving hospitals, clinics and doctor groups eager to share costs and savings, and cash in on the incentives. They, in turn, have deployed a small army of lawyers and lobbyists trying to persuade the Obama administration to relax or waive a body of older laws intended to thwart health care monopolies, and to protect against shoddy care and fraudulent billing of patients or Medicare.

HC Reform Update from Mark Sanna: The Senate on Thursday passed a bill to postpone a 23% cut in Medicare payments to doctors, scheduled to take effect on Dec. 1. The bill would block the cut until Jan. 1. The one-month reprieve goes now to the House, which is expected to approve it. The action followed a bipartisan agreement reached by the chairman of the Senate Finance Committee, Max Baucus, Democrat of Montana, and the senior Republican on the panel, Senator Charles E. Grassley of Iowa. With the agreement, the senators said in a joint statement, “seniors and military families can be confident they will be able to see a doctor and get the medicines they need.’’

HC Reform Update from Mark Sanna: Doctors flooded Congress on Wednesday with telephone calls, urging lawmakers to prevent the 23 percent cut in Medicare payments scheduled to take effect next month. Many physicians have posted placards in their offices saying, “Your doctor may have to stop seeing Medicare patients” if Congress does not act. Administration officials want lawmakers to stop the cut for at least 13 months. But the lame-duck Congress appears unlikely to grant such a lengthy reprieve.

HC Reform Update by Mark Sanna: 80 out of 100 children with ear infections will get better on their own in about three days, according to a review of 135 previously published studies in today's Journal of the AMA. Prescribing antibiotics improves that cure rate only slightly, to 92 of 100 children, the review says. The benefits of antibiotics seem even smaller in light of their side effects: 3-10 children will develop a medication-related rash; 5-10 more will get diarrhea.

HC Reform Update from Mark Sanna: One of every seven Medicare beneficiaries who is hospitalized is harmed as a result of problems with the medical care there, according to a new study from the Office of Inspector General for the Department of Health and Human Services. The study said unexpected adverse events added at least $4.4 billion a year to government health costs and contributed to the deaths of about 180,000 patients a year.

HC Reform Update from Mark Sanna: A leading Senate Democrat vowed Friday to introduce legislation killing a part of the new healthcare reform law that imposes new tax-filing requirements on small businesses. Sen. Max Baucus (D-Mont.), chairman of the Finance Committee and a leading architect of the reform law, said a provision requiring businesses to report more purchases to the IRS will impose undue paperwork burdens on companies amid an economic downturn when they can least afford it. Baucus, who had pushed legislation scaling back the requirement earlier in the year, now wants it repealed in full.

HC Reform Update from Mark Sanna: No bargaining, no deals, no compromise — that's the hard-line stance that Republicans have staked in the days since seizing control of the House. Their prescription for the sluggish economy — lower taxes, huge spending cuts, less regulation, and repeal of the sweeping healthcare law just taking effect — excites the party's conservative base. But a long and ugly fight with President Obama and Senate Democrats, starting with next week's lame-duck session, could end up alienating the large number of Americans more interested in jobs than ideological battles.

HC Reform Update from Mark Sanna: Upcoming change to flexible spending accounts, means consumers will no longer be able to set aside pretax dollars in that account to use for medicines bought without a doctor's prescription and creates a "loophole" that may allow consumers to use FSA dollars on over-the-counter medication if they obtain a prescription for it. The loophole may lead to a lot of extra trips to the doctor, overburdening doctors to write prescriptions for drugs such as aspirin.

HC Reform Update from Mark Sanna: Minnesota Gov. Tim Pawlenty, a Republican, stepped up his attack on the law in a move widely perceived as a stage dressing for his potential 2012 presidential run. Pawlenty and Gov. Donald Carcieri, Republican of Rhode Island, filed court papers opposing the health overhaul on Thursday arguing "the governors are safeguarding their citizens from 'federal abuse of the spending power.' They argue the law places liabilities on states through a Medicaid expansion." The amicus brief was filed in a Florida court where 20 other states are suing to block the overhaul. The governor had already issued an executive order banning state agencies from seeking health overhaul related funds without specific permission.

HC Reform Update from Mark Sanna: According to a new report by the Centers for Disease Control and Prevention, 49.9 million people ages 18 to 64," or about 26.2 percent of the adult population, "had no medical coverage for at least part of the past 12 months. … Moreover, when children 17 and under are factored in, the number of Americans uninsured for at least part of a year span numbered 59.1 million.

HC Reform Update by Mark Sanna: The U.S. Supreme Court on Monday rejected a long-shot request for a review of the Obama administration's health-care overhaul before the matter has been fully litigated. The high court's rejection of the health-care challenge, brought by a conservative legal group in California, wasn't a surprise. …The high court almost never hears cases before they have been fully litigated in the lower courts, and it hadn't asked the Obama administration to file legal papers responding to the appeal.

HC Reform Update from Mark Sanna: Congressional Republicans said on Sunday they plan a full-scale assault against President Barack Obama's healthcare overhaul next year but acknowledged it could take until after the 2012 presidential election to repeal it. Representative Paul Ryan, expected to become chairman of the House Budget Committee chairman, said his fellow Republicans will try to deny funding for implementation of the healthcare legislation and hold hearings to point out its shortcomings when the new Congress convenes in January.

HC Reform Update from Mark Sanna: Trying to spur enrollment in a new health insurance program for uninsured people with pre-existing medical conditions, the federal government is doing something private insurers almost never do: slashing rates. That announcement Friday came as the government released the latest enrollment figures for these high risk insurance pools, which have attracted far fewer customers than expected. The program, established under the health law, began signing up enrollees in August and September. Not surprisingly, the states with lower rates have had higher enrollment.

HC Reform Update by Mark Sanna: While repealing the new law remains the first order of business for angry Republicans, most acknowledge it’s a long shot, considering President Barack Obama’s veto power. Still, they’ll possess some powerful tools to challenge the law if they win a majority in the House and take over leadership of the committees. Key Republicans are threatening to withhold funding for overhaul initiatives and to relentlessly pursue hearings and oversight investigations to challenge administration officials’ regulations and communications with the public. Committee chairmen have subpoena power, although holding the gavel is usually enough to get officials into the witness chair.

HC Reform Update by Mark Sanna: Republicans may in fact prefer to "tinker and tweak" the law to keep the debate fresh in the minds of voters in hopes of unseating Obama in 2012. Republicans could use the oversight authority of Congress to slow down or block regulations, essentially tying up the instruction manual for the overhaul. Expect flyspeck scrutiny of agencies implementing the law. GOP lawmakers may be able to pick off unpopular provisions. … Another target is a yet-to-be-named board with the power to make Medicare cuts.

HC Reform Update by Mark Sanna: With major gains in Congress, in governors’ races and in statehouses across the country, Republicans will continue to push for repeal or significant changes to the health care law. President Obama says while he is open to making some modifications, he and Democrats will resist major changes to the measure.

HC Reform Update from Mark Sanna: The Democrats’ ambitious health care overhaul is facing roadblocks from newly elected state officials who harshly criticized it while campaigning and who are now in a position to make good on their promises. While unable to overturn the federal law, the newly elected officials will be under pressure to act. They could slow the pace of implementation, lean on congressional delegations to repeal or change the legislation, seek waivers from some of its provisions, veto state legislation related to it and appoint like-minded people to important positions, such as insurance commissioner slots.

HC Reform Update from Mark Sanna: Two federal courts have ruled that the Obama administration is using overly strict standards to determine whether older Americans are entitled to Medicare coverage of skilled nursing home care and home health care. Medicare will pay for those services if they are needed to maintain a person’s ability to perform routine activities of daily living or to prevent deterioration of the person’s condition, the courts said. Medicare beneficiaries do not have to prove that their condition will improve, as the government sometimes contends, the courts said.

HC Reform Update by Mark Sanna: Middle-aged smokers are far more likely than nonsmokers to develop dementia later in life, and heavy smokers — those who go through more than two packs a day — are at more than double the risk, a new study reports. After adjusting for other factors, the researchers that pack-a-day smokers were 37% more likely than nonsmokers to develop dementia, and the risks went up sharply with increased smoking; 44% for one to two packs a day; and twice the risk for more than two packs.

HC Reform Update from Mark Sanna: With the elections less than one week away, ads making claims about the health law are flooding the airwaves. Many Democrats continue to not mention health reform, while Republicans criticize the law as too large, too expensive and intrusive into Americans’ lives. But President Barack Obama and some Democrats are promoting the law’s immediate consumer benefits and say it will improve the quality of health care for all Americans.

HC Reform Update from Mark Sanna: This election season, spending on anti-health reform ads has outpaced spending on pro-reform ads more than five to one. On the federal campaign level, candidates and outside groups have spent nearly $92 million on ads attacking reform, while voices in favor of reform have spent just over $19 million, according to Evan Tracey of the Campaign Media Analysis Group.

HC Reform Update from Mark Sanna: Nursing mothers will not be allowed to use their tax-sheltered health care accounts to pay for breast pumps and other supplies. That is because the IRS has ruled that breast-feeding does not have enough health benefits to quality as a form of medical care. With all the changes the health care overhaul will bring in the coming years, it nonetheless will leave those regulations intact when new rules for flexible spending accounts go into effect in January. Those allow millions of Americans to set aside part of their pretax earnings to pay for unreimbursed medical expenses.

HC Reform Update from Mark Sanna: Some of the sickest patients can run up hospital charges as high as $18,000 a day, with average stays of almost three weeks, according to a new government report on the cost of hospital care. The report, from the Agency for Healthcare Research and Quality, used data from a nationwide sampling of patients in 2008 to analyze the two million most expensive stays.

HC Reform Update from Mark Sanna: November 15 marks the beginning of the open enrollment season for private Medicare plans, including Part D, the prescription drug plan. Officials at the Centers for Medicare and Medicaid Services say they have taken steps to streamline this year’s plan options – including eliminating some plans they consider duplicative. The changes, officials say, were part of an effort to ease seniors’ confusion.

HC Reform Update from Mark Sanna: The Obama administration will not be compiling a federal health record on all citizens, including each individual’s body mass index, as some candidates are claiming. The administration is offering incentives to doctors to record various vital statistics in electronic medical records and report the data in the aggregate, to help understand national health trends.

HC Reform Update from Mark Sanna: As many as 1 in 3 American adults could have diabetes by 2050, federal officials said Friday in a new projection that represents a threefold increase. The CDC estimates that 1 in 10 have diabetes now, but the number could grow to 1 in 5 or even 1 in 3 by midcentury if current trends continue. The last estimate put the number at 39 million in 2050. The new estimate takes it to the range of 76 million to 100 million.

HC Reform Update from Mark Sanna: Insurance regulators unanimously approved controversial rules Thursday governing how much insurers must spend on patients’ medical care – without adopting any of several last-minute amendments some consumer advocates had feared would gut key provisions. The recommendations will now go to HHS Secretary Kathleen Sebelius, who has final say.

HC Reform Update from Mark Sanna: All eyes will be on this week’s annual meeting of the National Association of Insurance Commissioners, which is taking place in Orlando. When the state insurance regulators are expected to unveil their final recommendations later this week on how the nation’s health insurers will have to meet new spending standards under the new health care law.

HC Reform Update from Mark Sanna: The Food and Drug Administration issued a warning this week linking long-term use of popular osteoporosis drugs to an unusual fracture of the thigh bone. The agency asked patients taking the drugs, known as bisphosphonates, to report any thigh or groin pain to their doctors. At the same time, the F.D.A. safety announcement emphasized that people should continue taking the drugs unless their doctors advise otherwise.

HC Reform Update from Mark Sanna: Health insurers can't have different rules for when individual policies are sold for children with medical problems than for healthy kids, HHS Secretary Kathleen Sebelius said in a letter to the National Association of Insurance Commissioners. Some insurers want to allow healthy children to enroll year-round but only have a limited "open season" for ones with pre-existing conditions. Such an approach is legally questionable and "inconsistent with the language and intent" of the health care law, Sebelius wrote.

HC Reform Update from Mark Sanna: In a foreboding ruling for the Obama administration, a federal judge in Florida decreed Thursday that a legal challenge to the new health care law by officials from 20 states could move forward and warned that he would have to be persuaded that its keystone provision — a requirement that most Americans obtain insurance — is constitutional.

HC Reform Update from Mark Sanna: By inventing 118 bogus health clinics in 25 states, prosecutors said, a band of Armenian-American gangsters billed Medicare for more than $100 million, and managed to collect $35 million over at least four years. The US attorney in Manhattan, called it the “single largest Medicare fraud ever perpetrated by a single criminal enterprise.” Eighteen people were charged in the Medicare indictment unsealed on Wednesday, part of a larger ring of 44 people prosecutors said had engaged in a variety of swindles, including bilking auto insurance companies by falsifying, staging or exaggerating the severity of fender-benders. Charges included racketeering, health care fraud, identity theft, money laundering and bank fraud. Forty-one of the defendants had been arrested as of Wednesday afternoon.

HC Reform Update from Mark Sanna: The Obama administration announced Tuesday it will delay for one year a provision of the health law that requires employers to report the value of an employee's health plan on tax forms. The White House says the extra time is necessary to give employers time to prepare to comply with the requirement. Instead of a mandatory reporting requirement, the IRS' draft 2011 W-2 tax form includes an optional line for employers to report the cost of employer-sponsored health insurance coverage.

HC Reform Update from Mark Sanna: The safety of vaccines is at the heart of a case expected to be heard on Tuesday by the United States Supreme Court, one that could have implications for hundreds of lawsuits that contend there is a link between vaccines and autism. At issue is whether a no-fault system established by Congress about 25 years ago to compensate children and others injured by commonly used vaccines should protect manufacturers from virtually all product liability lawsuits.

HC Reform Update from Mark Sanna: The global drug market will grow 5 to 7% in 2011, to $880 billion, as higher spending in nations like China, Brazil and India makes up for slow growth and patent losses in the United States, according to a forecast released last week by IMS Health, an industry data company.

HC Reform Update from Mark Sanna: Republicans think they have a winning issue in health care reform, calling for its repeal and slamming the new law as big government gone haywire—even before most of its provisions have taken effect. A new poll suggests it's not so clear-cut, and some Democrats seem to agree.

HC Reform Update from Mark Sanna: This week, FTC Chairman Jon Leibowitz told a meeting of health industry representatives that his agency would explore an "expedited review process" for hospitals and doctors looking to determine if new partnerships they form to provide care would violate antitrust laws. A key part of the new health law encourages the development of "accountable care organizations" that would allow doctors to team up with each other and with hospitals, in new ways, to provide medical services. Health care providers want to make sure their ACOs won’t be accused of stifling competition or trying to fix prices when they bargain with insurance companies. Insurers, meanwhile, are expressing concern that providers could use the leverage of ACOs to demand higher prices.

HC Reform Update from Mark Sanna: A federal judge in Michigan on Thursday dismissed one of more than 15 legal challenges to the new health care law, becoming the first to rule that the law is constitutional. Two other cases with higher profiles, one in Florida and one in Virginia, are headed toward hearings on the issues that were decided in Michigan. The central question, which may ultimately fall to the Supreme Court, is whether the Commerce Clause of the Constitution gives Congress the authority to require citizens to obtain a commercial product, namely health insurance.

HC Reform Update from Mark Sanna: The Obama administration is granting companies like McDonald’s and some insurers waivers to maintain even minimal coverage far below the new law’s standards. About 30 insurers, employers and union plans, responsible for covering about one million people, were given one-year waivers on the new rules that phase out annual limits on coverage for limited-benefit plans, also known as “mini-meds.”

HC Reform Update from Mark Sanna: A new report from The Institute of Medicine released today may give nurses with advanced degrees a potent weapon in their perennial battle to get the authority to practice without a doctor's oversight. The report says nurses should take on a larger and more independent role in providing health care in America. It calls for the elimination of "regulatory and institutional obstacles" including limits on nurses "scope of practice".

HC Reform Update from Mark Sanna: Healthcare.gov, the website created by the new health law to be a one-stop consumer resource, unveiled detailed cost and benefits information about health plans available in the individual insurance market. It's the first time such data have been made public - either by the government or industry. The site will also list the percentage of applications turned down and of people who are charged more than that health plan’s advertised price.

HC Reform Update from Mark Sanna: Since January, the nation's five largest insurers and the industry's Washington-based lobbying arm have given three times more money to Republican lawmakers and political action committees than to Democrats." In 2009, the industry was largely split in its donations to Democrats and Republicans.

HC Reform Update by Mark Sanna: Medicare enrollment season is approaching, and many experts say they believe it promises to be a turbulent one — “a perfect storm.” In some areas, there will be dozens, even hundreds, of coverage options. The choices must be reviewed not just by current enrollees and a crush of baby boomers newly eligible for the government-run insurance program.

HC Reform Update by Mark Sanna: A group of Texas pharmacies has filed a lawsuit against CVS Caremark, the nation’s largest pharmacy health care provider, saying it violates racketeering and privacy laws. The Texas lawsuit accuses CVS Caremark of gaining too much control over patient information, including files from the independent pharmacies that have to hand over patient information for insurance disputes. The lawsuit also says CVS uses that information for direct marketing to patients and doctors at the behest of pharmaceutical companies.

HC Reform Update from Mark Sanna: The Principal Financial Group announced on Thursday that it planned to stop selling health insurance, another sign of upheaval emerging among insurers as the new federal health law starts to take effect. Principal’s decision closely tracks moves by other insurers that have indicated in recent weeks that they plan to drop out of certain segments of the market, like the business of selling child-only policies. State regulators say some insurance companies are already threatening to leave particular markets because of the new law.

HC Reform Update from Mark Sanna: William C. Weldon, the chief executive of Johnson & Johnson, is expected to acknowledge to lawmakers on Capitol Hill on Thursday that the company mishandled the removal of certain medicines from store shelves last year. He also planned to announce that after a recall of children’s liquid medicines, new batches would begin to reach stores as early as next week.

HC Reform Update from Mark Sanna: Economists at George Washington University have tabulated the cost of obesity and discovered a surprising gender gap: It’s more expensive for a woman to be obese than for a man. While a man racks up $2,646 annually in extra expenses if he is obese, a woman’s obesity costs her $4,879, almost twice as much. Much of the gender gap is due to lower wages for obese women, who earn less relative to similar working women who are not obese. The study also found that the more overweight you are, the more expensive life gets. The incremental costs faced by obese women are nine times higher than those for overweight women. For obese men, the costs are six times higher than those of overweight men.

HC Reform Update from Mark Sanna: This month, the Centers for Disease Control and Prevention issued a comprehensive nationwide behavioral study of fruit and vegetable consumption. Only 26% of the nation’s adults eat vegetables three or more times a day, it concluded. The number of dinners prepared at home that included a salad was 17%; in 1994, it was 22%.

HC Reform Update from Mark Sanna: Last Thursday marked six months since the health care bill became law. The law is not perfect, but the difference it is making in the lives of people who have been denied insurance due to a pre-existing condition and seniors struggling with prescription drug costs is significant. No one should lose their health care just because they get sick, or be forced to pay all their medical costs out of pocket because they have hit a “lifetime cap,” and this legislation ends these practices.

HC Reform Update from Mark Sanna: About 16.6 million workers are employed by small businesses that are eligible for health insurance tax credits under the new health care law. However, a report by the Commonwealth Fund estimated that only 3.4 million of those workers are at firms that would take advantage of the tax credit. For the most part, those are firms that already offer their employees health insurance. Those firms that do not offer coverage are unlikely to consider the tax breaks enough of a financial incentive to start doing so, according to the report's authors.

HC Reform Update from Mark Sanna: For young Americans with no health insurance, Thursday was an important day: those younger than 26 were able to join their parents’ plans under the recently enacted health care overhaul. Previously, children were dropped from their parents’ policies what 19 or 23 if they were full time students. Young people make up the largest group of uninsured Americans, although they are healthier and cheaper to insure. And they are much less likely to vote.

HC Reform Update from Mark Sanna: For many families, health care relief begins today. Starting now, insurance companies will no longer be permitted to exclude children because of pre-existing health conditions, which the White House said could enable 72,000 uninsured to gain coverage. Insurers also will be prohibited from imposing lifetime limits on benefits. The law will now forbid insurers to drop sick and costly customers after discovering technical mistakes on applications. It requires that they offer coverage to children under 26 on their parents’ policies. It establishes a menu of preventive procedures that must be covered without co-payments. And it allows consumers who join a new plan to keep their own doctors and to appeal insurance company reimbursement decisions to a third party.

HC Reform Update from Mark Sanna: The Obama administration announced Tuesday that average premiums for private Medicare Advantage plans, which insure about 1/4 of all beneficiaries, will decline slightly next year, even as insurers provide additional benefits required by the new health care law. By contrast, commercial insurance premiums for many people under 65 and many small businesses are increasing 10%-25% or more.

HC Reform Update from Mark Sanna: Republicans, hopeful of picking up substantial numbers of seats in the Congressional elections, are developing plans to try to repeal or roll back the new health care law. Republicans say they will try to withhold money that federal officials need to administer and enforce the law and are expected to include specifics in an election agenda they intend to issue Thursday.

HC Reform Update from Mark Sanna: Starting this week you could see significant changes to your health insurance coverage. This is due to health care reform. It will impact thousands of people including companies and how they pay for benefits and what you ultimately pay for health insurance. Effective this week, insurance companies cannot put a dollar limit on benefits such as hospital or lab services and coverage for dependents is going up to 26 years of age. Also you'll get preventative care without a deductable or co-pay.

HC Reform Update from Mark Sanna: For the first time since 1987, the number of people in this country with health insurance went down. In 2009, 253.6 million people in this country had coverage compared with 255.1 million the year before, says a report on poverty just out from the U.S. Census Bureau. All told, 50.7 million Americans didn't have health insurance last year.

HC Reform Update from Mark Sanna: Starting this month, all new health care plans must pay for preventive care, including physicals and other wellness programs. The government has set aside $200 million in grant money over five years to help small employers provide programs like smoking cessation, nutrition, physical fitness and stress management. Companies with fewer than 100 employees may apply for grants, which are administered by the federal Department of Health and Human Services.

HC Reform Update from Mark Sanna: Researchers from the University of North Carolina at Chapel Hill asked nutrition educators from more than 100 medical schools to describe the nutrition instruction offered to their students. While the researchers learned that almost all schools require exposure to nutrition, only about a quarter offered the recommended 25 hours of instruction. While a majority of medical schools tend to intersperse lectures on nutrition in standard, required courses, like biochemistry or physiology, only a quarter of the schools managed to have a single course dedicated to the topic.

HC Reform Update from Mark Sanna: If the new health care legislation remains intact, it could offer real money for a lot of Americans. Or so says a Families USA report released on Tuesday that estimates that nearly 29 million people will be eligible for tax credits under the law if they are buying private health insurance beginning in 2014. The report calculates that the credits could reduce family income taxes more than $110 billion in 2014 alone.

HC Reform Update from Mark Sanna: A federal judge indicated on Tuesday that he would give a green light to a lawsuit filed by elected officials from 20 states who are challenging the constitutionality of the new health care law and its requirement that most individuals obtain medical insurance. Experts on both sides expect the challenges to eventually present the Supreme Court with a landmark opportunity. “Our whole system of federalism rests on the decisions of this case,” said Florida’s attorney general, Bill McCollum, a Republican who is the lead plaintiff in the lawsuit.

HC Reform Update from Mark Sanna: Twenty-five out of 32 highly paid consultants to medical device companies in 2007, or their publishers, failed to reveal the financial connections in journal articles the following year, according to a study released on Monday. The study, published on the Web site of The Archives of Internal Medicine, focused on 32 medical doctors and doctoral researchers who were each paid at least $1 million in 2007 and published one or more journal articles the next year.

HC Reform Update from Mark Sanna: The first real changes to health coverage are scheduled to go into effect next week, Sept. 23 — six months after President Obama signed the law. These include guaranteeing coverage with pre-existing medical conditions, ending lifetime limits and raising annual limits on insurance payments, and allowing young adults to stay on their parents’ health plans until age 26.

HC Reform Update from Mark Sanna: Many Democrats have joined Republicans in pushing for the repeal of a tax provision in the new health care law that imposes a huge information-reporting burden on small businesses. To improve compliance, the law requires businesses to file a 1099 tax form identifying anyone to whom they pay $600 or more for goods or merchandise in a year. Businesses will also have to send copies of the form to their vendors, suppliers and contractors.

HC Reform Update from Mark Sanna: While the nation’s economic recovery is slower than expected and overall unemployment is 9.6%, the health care industry is experiencing job growth. Data from the Bureau of Labor Statistics (BLS) indicate that job losses since the downturn (12/07) total 8.4 million; in the same period, health care employment increased 732,000.

HC Reform Update from Mark Sanna: According to the U.S. Centers for Disease Control and Prevention, in 2009, 67.5%of adults ate fruit less than two times daily and 73.7% ate vegetables less than three times per day. The goals of Healthy People 2010 were for 75% of people to eat at least two servings of fruit and 50% to eat at least three servings of vegetables every day. The report is published in the Sept. 10 issue of the CDC's Morbidity and Mortality Weekly Report.

HC Reform Update from Mark Sanna: A new government study says President Obama’s health care law will have negligible effects on total national health spending in the next 10 years, neither slowing nor fueling the explosive growth of medical costs. About 32.5 million people will gain coverage, and health spending will grow slightly faster than projected under prior law — at an annual rate of 6.3%, rather than 6.1%, the report said.

HC Reform Update from Mark Sanna: In a snapshot of systemic waste, researchers have calculated that more than half of the 354 million doctor visits made each year for acute medical care, like for fevers, stomachaches and coughs, are not with a patient’s primary physician, and that more than a quarter take place in hospital emergency rooms. The authors of the study, which was published Tuesday in the journal Health Affairs, said it highlighted a significant question about the new federal health care law: can access to primary care be maintained, much less improved, when an already inadequate and inefficient system takes on an expected 32 million newly insured customers?

HC Reform Update by Mark Sanna: On average, the total cost of a family health insurance policy rose just 3 percent last year, to $13,770 in annual premiums, according to a survey of employer health benefits released on Thursday by the Kaiser Family Foundation, a nonprofit research group. As a result, the employee contribution toward family coverage rose an average of 14 percent, or almost $500, from what employees paid last year.

HC Reform Update from Mark Sanna: The specialty pharmaceutical company Allergan has agreed to pay $600 million to settle civil and criminal accusations that it illegally marketed Botox, the drug used in antiwrinkle injections, for medical uses for which the drug had not been approved. Allergan, based in Irvine, Calif., also agreed to pay $225 million to resolve civil charges that it had caused false claims to be submitted to Medicare and Medicaid. “The significance of the case is that Allergan promoted Botox for off-label uses, uses that were not approved by the F.D.A. as being safe and effective,” said Marcella Auerbach, a lawyer representing two whistle-blowers in the case.

HC Reform Update from Mark Sanna: Even as Congress moves to expand health insurance coverage to millions of Americans, it's doing little to ensure there will be enough primary care doctors to meet the expected surge in demand for treatment, experts say. The American Academy of Family Physicians predicts that the shortage of family doctors will reach 40,000 in the next 10 years, as medical schools send about half the needed number of graduates into primary care medicine. The overall shortage of doctors is expected to grow to nearly 160,000 by 2025, according to the Association of American Medical Colleges.

HC Reform Update from Mark Sanna: Agents and brokers are so concerned they will be viewed as redundant under the new law that they successfully lobbied to get state insurance commissioners to publicly acknowledge their importance. At a meeting of the powerful National Association of Insurance Commissioners (NAIC) last week in Seattle, 25 commissioners sponsored a resolution stating that implementation of health reform should "recognize and protect the indispensable role that licensed insurance professionals play in serving consumers."

HC Reform Update from Mark Sanna: Unlike physicians in primary care, the number of physician assistants and nurse practitioners are on the rise. According to the American Academy of Physician Assistants, there were 74,100 physician assistants in practice in 2008, the most recent census available. It's projected to be the second-fastest-growing health profession, after home health aides, in the coming decade. As of 2010, there are 135,000 practicing nurse practitioners, according to the American Academy of Nurse Practitioners, with an additional 8,000 being added to the ranks each year.

HC Reform Update from Mark Sanna: More than 10 million people are enrolled in high-deductible health plans linked to health savings accounts, up from 6.1 million in 2008, according to a recent survey by America’s Health Insurance Plans, an industry trade group. To open a health savings account, you must be enrolled in a qualified health insurance plan with a deductible of at least $1,200 for an individual or $2,400 for a family. In return for accepting the higher deductible, you are allowed to deposit pretax dollars in the H.S.A., which are used to pay your out-of-pocket medical costs. This year, singles may contribute a maximum of $3,050 to an H.S.A. and families can deposit up to $6,150. Earnings on the account are also tax-free, and no taxes are paid on withdrawals used for qualified medical expenses.

HC Reform Update from Mark Sanna: Federal official say the average Medicare drug benefit plan will cost $30 a month next year, a $1-a-month increase from this year’s average premium. The officials portrayed the estimated new cost as a very small price increase, while saying many older Americans will pay less out-of-pocket for brand-name drugs under the new health care law.

HC Reform Update from Mark Sanna: The American public’s confidence in the health care system rose markedly after passage of the sprawling legislative package this year, according to a survey released by the Robert Wood Johnson Foundation. But the measurement of confidence quickly settled back to historical levels, according to the survey, as families turned from rhetoric to reality.

HC Reform Update from Mark Sanna: The Obama administration is rewriting new rules on medical privacy after criticism from consumer groups and members of Congress. According to the new rules, health care providers and insurers have to notify patients of a privacy breach only if they find that the violation posed a significant risk of financial, reputational or other harm to the individual.

HC Reform Update from Mark Sanna: A federal advisory panel on Thursday voted narrowly to recommend allowing Eli Lilly to market its antidepressant, Cymbalta, for some chronic pain conditions affecting millions of Americans, particularly lower back pain. The scientific advisory panel to the FDA voted 8 to 6 in favor of expanding approved uses of Cymbalta.

HC Reform Update from Mark Sanna: According to a recent article in Forbes magazine, one way to relieve the shortage of providers that the medical industry has created would be for the AMA to abandon its aggressive game of turf-protection and allow nurses, midwives, physician assistants and practitioners of alternative therapies such as chiropractors, to offer standard treatments for routine illnesses without physician supervision.

HC Reform Update from Mark Sanna: In yet another setback in efforts to treat Alzheimer’s disease, Eli Lilly & Company announced on Tuesday that it had halted development of an experimental treatment after the compound, called semagacestat, actually made patients worse in two late-stage clinical trials.

HC Reform Update from Mark Sanna: The National Association of Insurance Commissioners, the state officials who regulate the conduct of insurance companies, are holding their summer meeting this week in Seattle. 65 Democratic members of Congress have sent a letter to the insurance commissioners asking them to develop strict definitions of “quality improvement,” a provision in the health care law.

HC Reform Update from Mark Sanna: A single senator — Christopher Bond, Republican of Missouri — is blocking a bill that would ensure a reliable supply of medical isotopes while reducing the risk of nuclear terrorism. There are no reactors in this country that make the isotope, so supplies have to be imported, primarily from aging reactors in Canada and Europe. The Senate leadership needs to pry it loose.

HC Reform Update from Mark Sanna: Faced with the need to review insurance rates and enforce a panoply of new rights granted to consumers, states are scrambling to make sure they have the necessary legal authority to carry out the responsibilities being placed on them by the new health care law. Insurance commissioners in about half the states say they do not have clear authority to enforce consumer protection standards that take effect next month.

HC Reform Update from Mark Sanna: At least a dozen major drug and device makers are under investigation by federal prosecutors and securities regulators in a broadening bribery inquiry into whether the companies made illegal payments to doctors and health officials in foreign countries. Of even greater concern to prosecutors in the United States are unusually large payments made to foreign doctors who oversee the growing number of clinical trials that drug and device makers conduct abroad.

HC Reform Update by Mark Sanna: Doctors at three health centers in Massachusetts have begun advising patients to eat “prescription produce” from local farmers’ markets, in an effort to fight obesity in children of low-income families. Now they will give coupons amounting to $1 a day for each member of a patient’s family to promote healthy meals.

HC Reform Update by Mark Sanna: The most anticipated health care event of the week is a vote in the House of Representatives on a bill to send aid to states to prevent cuts to Medicaid and teacher layoffs. The Senate approved the $26b measure last Thursday. Now House members are returning briefly to Washington from their August breaks to vote on the bill, which includes $16 b for Medicaid.

HC Reform Update by Mark Sanna: The Obama administration is investigating pay practices throughout the health care industry after finding that many hospitals and nursing homes do not pay proper overtime to nurses and other employees who work more than 40 hours a week. Hospitals around the country have paid millions of dollars in back wages to settle claims by the government and their employees.

HC Reform Update by Mark Sanna: The Senate on Thursday approved a long-awaited child nutrition act that intends to feed more hungry kids and make school food more nutritious, and it provides for $4.5 billion over the next decade to make that happen. Called the Healthy, Hunger-Free Kids Act, it passed the Senate unanimously and now moves on to the House, where passage is also expected.

HC Reform Update by Mark Sanna: Americans are continuing to get fatter and fatter, with obesity rates reaching 30% or more in nine states last year, as opposed to only three states in 2007, health officials reported on Tuesday. The increases mean that 2.4 million more people became obese from 2007 to 2009, bringing the total to 72.5 million, or 26.7% of the population.

HC Reform Update by Mark Sanna: A federal judge has refused to block a challenge to the Obama administration’s health care law brought by the Commonwealth of Virginia. Virginia is arguing that Congress, in passing a measure that requires people to buy insurance or face a penalty, exceeded its limits under the Constitution’s Commerce Clause and tax powers.

HC Reform Update by Mark Sanna: The federal Health and Human Services agency is celebrating the 45th anniversary of Medicare with a host of features, including a television advertisement featuring none other than Andy Griffith. Mr. Griffith promises that better protections for Medicare beneficiaries are coming, under the new health care law.

HC Reform Update by Mark Sanna: This week Aetna and WellPoint will follow UnitedHealth Group in reporting their second-quarter earnings. UnitedHealth, which announced its results last week, set the bar high for its fellow companies by reporting a 31 percent increase in profits for the three months that ended June 30.

HC Reform Update by Mark Sanna: One of the hottest concepts to emerge from the discussions about how best to overhaul the nation’s health care system is accountable care organizations. The idea is to encourage groups of doctors or hospitals to work together to oversee medical care so quality improves and costs go down. Having captured the fancy of Washington, the organizations are even a part of the new health care law.

HC Reform Update by Mark Sanna: A steep drop-off in private funds illustrates the competition under way for money as public health priorities shift. Shortly after the first lady kicked off the “Let’s Move” program, the administration awarded more funds to fight obesity than tobacco through two big new money sources for preventive health. The funds, totaling $1.15 billion, came from economic stimulus and health care reform legislation. They still provided more than $200 million for tobacco-use prevention, but much more to grapple with obesity.

HC Reform Update by Mark Sanna: Two weeks after taking office, Dr. Donald Berwick the new chief of CMS is struggling to tamp down a furor over past statements in which he discussed the rationing of health care and expressed affection for the British health care system. He is finding his ability to do his job clouded by the circumstances of his appointment, with many Republicans in open revolt over President Obama’s decision to place him in the post without a Senate confirmation vote.

HC Reform Update by Mark Sanna: The new health care law requires health insurers to spend at least 80% of every dollar collected in premiums on the welfare of patients. The calculation of the medical-loss ratio is crucial to insurance companies, because the law requires them to refund money to consumers if they spend too much on administrative costs. An intense effort is now under way by insurance companies to retool this provision and state regulators are only now deciding what precisely it means.

HC Reform Update by Mark Sanna: Lucky Charms. Froot Loops. Cocoa Pebbles. A frozen dinner with corn dog and fries. McDonald’s Happy Meals have all been identified by food companies as healthy choices they can advertise to children under a 3-year-old initiative by the food industry to fight childhood obesity. Now an effort by the federal government to forge tougher advertising standards that favor more healthful products has become stalled amid industry opposition and deep divisions among regulators.

HC Reform Update by Mark Sanna: As insurers try to steer more patients to doctors deemed less expensive or judged to provide better care, physicians and medical organizations are questioning the accuracy of these evaluations. In a sharply worded letter sent Monday to the nation’s largest health insurance companies, the AMA and 47 medical societies called on the insurers to make public how they assessed doctors’ performance and to allow the insurers’ methods to be reviewed by independent parties.

HC Reform Update by Mark Sanna: The American College of Obstetricians and Gynecologists has issued a new set of medical guidelines, which state that most women who have had Caesarean sections in the past can safely give birth the normal way later. In recent years hospitals, doctors and insurers have been refusing to let them even try, insisting on repeat Caesareans instead.

HC Reform Update by Mark Sanna: Michelle Obama has enlisted Major League Baseball and its players’ association for a new public service advertising campaign to promote her program to eliminate childhood obesity. The campaign consists of 30 television and 30 radio spots, customized for each of the league’s teams. Other versions of television and radio ads will be distributed nationally in markets with no local team.

HC Reform Update by Mark Sanna: Less than four months after Congress approved historic health care reform legislation, the Obama administration has been making good progress in bringing some early benefits to fruition and issuing rules to guide the reform process. Despite all of the critics’ hype and scare tactics, some polls suggest that the public perception of reform is slowly improving.

HC Reform Update by Mark Sanna: As the Obama administration begins to enact the new national health care law, the country’s biggest insurers are promoting affordable plans with reduced premiums that require participants to use a narrower selection of doctors or hospitals. This could come as a surprise to many who remember the repeated assurances from President Obama and other officials that consumers would retain a variety of health-care choices.

HC Reform Update by Mark Sanna: Federal authorities said Friday that they had arrested dozens of suspects in five states on charges of defrauding Medicare of a total of $251 million. Several doctors and nurses were among those arrested in Miami, New York, Detroit, Houston and Baton Rouge, La., accused of billing Medicare for unnecessary equipment, physical therapy and H.I.V. treatments that patients typically never received. Ninety-four suspects were indicted, and the authorities said 36 people had been arrested as of Friday morning.

HC Reform Update by Mark Sanna: The White House on Wednesday issued new rules requiring health insurance companies to provide free coverage for dozens of screenings, laboratory tests and other types of preventive care. The rules will eliminate co-payments, deductibles and other charges for blood pressure, diabetes and cholesterol tests; many cancer screenings; routine vaccinations; prenatal care; and regular wellness visits for infants and children. Other services that must be offered at no charge include counseling to help people stop smoking; screening and counseling for obesity; and tests for infection with the virus that causes AIDS. The rules apply to new health plans that begin coverage after Sept. 23 and to existing health plans that make significant changes after that date.

HC Reform Update by Mark Sanna: The federal government issued new rules Tuesday that will reward doctors for the “meaningful use” of electronic health records. Doctors will have to meet 15 specific requirements, plus 5 chosen from a list of 10 objectives. For example, doctors will have to use electronic systems to record patients’ sex, race, date of birth; their height, weight and blood pressure; their medications; and their smoking behavior. A doctor can receive up to $44,000 under Medicare and $63,750 under Medicaid. Starting in 2015, doctors will be subject to financial penalties if they are not using electronic health records.

HC Reform Update by Mark Sanna: The F.D.A. on Thursday is considering the first in a new generation of proposed diet pills. Analysts say Qnexa, from Vivus, is the front-runner in the $100 billion obesity market, if only because it is first to the F.D.A. Two other companies are in line for F.D.A. diet pill reviews later this year. But the field is fraught with safety issues.

HC Reform Update by Mark Sanna: Spending on postgraduate education for doctors declined for the second year in a row, as did biomedical industry support for the programs, according to a report from the Accreditation Council for Continuing Medical Education. Commercial support declined to $856 million in 2009, from $1 billion and $1.2 billion the previous two years. Industry financing from drug and device companies has come under attack for perceived conflicts of interest.

HC Reform Update by Mark Sanna: The Obama administration is sending $250 checks to more than 300,000 older Americans who paid higher drug costs in the Medicare coverage gap known as the “doughnut hole” officials announced Thursday. The one-time, tax-free checks are the first tangible benefit of the health care package that became law this year.

HC Reform Update by Mark Sanna: The government is preparing to issue new rules that will make it substantially easier for veterans who have been found to have post-traumatic stress disorder to receive disability benefits, a change that could affect hundreds of thousands of veterans from the wars in Iraq, Afghanistan and Vietnam.

HC Reform Update by Mark Sanna: On July 1, the House of Representatives passed a bill that would crack down on a devious tactic used by some pharmaceutical companies. The tactic, known as “pay for delay,” involves business deals in which the makers of patented brand-name drugs pay generic competitors to delay the introduction of cheaper alternatives. Now it will be up to the Senate to approve the bill.

HC Reform Update by Mark Sanna: According to Kevin Volpp, director of University of Pennsylvania's Center for Health Incentives, even when other benefits were cut during the recession, companies continue to add wellness programs. Now, with health care reform ready to kick in, more employers are poised to dangle financial incentives and use creative measures to get their workers healthier by participating in corporate wellness programs.

HC Reform Update by Mark Sanna: The nation’s drug makers have eliminated nearly 35,000 positions in the first half of this year, second only to government in cutting jobs, according to a new report by Challenger, Gray and Christmas, a Chicago-based outplacement consulting firm. Still, the industry faces the prospect of more job losses to support the bottom line as patents expire on prominent drugs within the next year.

HC Reform Update by Mark Sanna: President Obama gets high marks, even from some Republicans, for the way he has begun carrying out the new health care law in the 100 days since it was signed. And a new poll suggests a small increase in favorable views of the measure since May. This week the administration unveiled a Web site, HealthCare.gov, where consumers can obtain information about public and private health insurance options in their states.

HC Reform Update by Mark Sanna: In Virginia, the federal government faced off in open court Thursday against the first of the 21 states that are seeking to invalidate the law by challenging the requirement that most Americans obtain insurance. Their central argument is that the Commerce Clause of the Constitution cannot be interpreted to allow government penalties on Americans for refusing to buy a product.

HC Reform Update by Mark Sanna: A new 10% tax on indoor UV tanning services goes into effect today. The tanning tax is one of the tax provisions funding the national health care reform bill that passed in March. It's estimated the tax will raise $2.7 billion over the next 10 years. The tax does not apply to spray tans or tanning products. The Indoor Tanning Association is currently building support to repeal the new tax.

HC Reform Update by Mark Sanna: The new health law established temporary state high-risk “pools,” where people who are uninsurable elsewhere because of pre-existing medical conditions can get coverage. The new high-risk pools will only be open to people who’ve been uninsured for at least six months. But it’s important to act quickly. Applications are being accepted now for coverage starting Aug. 1

HC Reform Update by Mark Sanna: With a nudge from the new health care law and pressure from Medicare, hospitals, doctors and nurses are struggling to prepare for explosive growth in the numbers of high-risk elderly patients. More than 40% of adult patients in acute care hospital beds are 65 or older. Seventy million Americans will have turned 65 by 2030.

HC Reform Update by Mark Sanna: Starting this fall, patients in all health plans can contest claim denials in an independent state-level review procedure. The provision does not apply to “grandfathered” plans — those in existence on March 23. Nor does the new law make it any easier for consumers to sue for punitive damages or for pain and suffering.

HC Reform Update by Mark Sanna: The Obama administration is poised to award contracts worth hundreds of millions of dollars to about 20 states to run new insurance pools for people with serious medical problems. In another 20 states, where local officials chose not to participate, the federal government will run the pools through a private nonprofit entity. Applications will be available to the public in many states on Thursday.

HC Reform Update by Mark Sanna: The House on Thursday approved a six-month plan to prevent a steep cut in doctors’ fees paid by Medicare. The $6.4 billion measure reverses a 21 percent cut in physician payments. Medicare officials had announced on Friday that they would begin processing claims for June at the lower rate, raising pressure on the House to accept the short-term adjustment.

HC Reform Update by Mark Sanna: In the latest effort to break up the often cozy relationship between doctors and the medical industry, the University of Michigan Medical School has become the first to decide that it will no longer take any money from drug and device makers to pay for coursework doctors need to renew their medical licenses.

HC Reform Update by Mark Sanna: On Tuesday, President Obama unveiled new regulations effective this year that should end some insurance companies’ worst practices, such as rescinding policies for frivolous reasons after a person becomes sick and a ban on lifetime coverage limits.

HC Reform Update by Mark Sanna: President Obama, whose vilification of insurers helped push a landmark health care overhaul through Congress, plans to sternly warn industry executives at a White House meeting on Tuesday against imposing hefty rate increases in anticipation of tightening regulation under the new law.

HC Reform Update by Mark Sanna: On Friday, the Senate passed HR 3962 which delays the scheduled 21% Medicare fee decrease and allows for a 2.2% Medicare fee increase from June 1, 2010 through November 30, 2010. The House of Representatives is scheduled to vote on this bill Tuesday evening.

HC Reform Update by Mark Sanna: The Justice Department has asked a federal judge to dismiss a lawsuit by 20 states challenging President Obama’s health care overhaul. Government lawyers say the health care overhaul cannot be moved from the elected branches of government into the courts without a genuine constitutional issue, which they maintain is lacking in this case.

HC Reform Update by Mark Sanna: A final vote by the Senate is expected this week on a House bill which stops a scheduled 21% Medicare fee decrease. In anticipation of this vote, the CMS has reported that they will continue to hold claims through June 17th. If Congress has not taken final action by June 18th, claims will be paid with the 21% fee decrease applied.

HC Reform Update by Mark Sanna: The National Association of Insurance Commissioners reported today that health insurance companies will cancel policies and leave the individual insurance market in some states because of a provision of the new health care law that requires insurers to spend more of each premium dollar for the benefit of consumers and that the federal government should take steps to prevent disruption of the market.

HC Reform Update by Mark Sanna: Today, the White House will issue new rules that strongly discourage employers from cutting health insurance benefits or increasing the costs of coverage to employees. The rules limit the changes that employers can make if they want to be exempt from certain provisions of the health care law passed by Congress in March.

HC Reform Update by Mark Sanna: With the passage of the new health care law, whenever people renew their policies or sign up for new ones after Sept. 23, after which time insurers can only rescind coverage if someone commits fraud — by lying on an application, for example. The new law also requires health plans to provide certain preventive services free of charge for plan members, another provision that goes into effect after Sept. 23. But this provision only applies to new health plans. If you currently have coverage, your plan will be grandfathered and will not be subject to that provision.

HC Reform Update by Mark Sanna: Tracy Watts, a partner at Mercer Health and Benefits estimates that changes made in response to the health law will add an extra 2-3% in cost increases this year, pressuring employers to engage in even more cost-sharing with employees — whether through higher premiums, higher deductibles, co-payments or other out-of-pocket costs.

HC Reform Update by Mark Sanna: A start-up financed by prominent venture capitalists and the Cleveland Clinic, Castlight Health, aims to change that by building a search engine for health care prices. Patients using Castlight could search for doctors that offer a service nearby and find out how much they will charge, depending on their insurance coverage. Price transparency could significantly change the way health care is bought in the United States.

HC Reform Update by Mark Sanna: President Obama dipped back into the volatile politics of health care on Tuesday, using a televised question-and-answer session to attack his Republican critics and remind retirees that the check — a new $250 rebate to help them pay for prescription drugs — is about to go in the mail.

HC Reform Update by Mark Sanna: Federal incentive payments to help doctors buy equipment to computerize medical records become available to doctors in January. To qualify for up to $18K next year and $44K over 5 years, doctors have to meet 25 criteria. In meetings at the White House this week, doctors and hospital executives voiced concern that the proposed standards are impossibly high and the risk of failure is great.

HC Reform Update by Mark Sanna: President Obama and his allies, concerned about deep skepticism over his landmark health care overhaul, are orchestrating an elaborate campaign to sell the public on the law, including a new tax-exempt group that will spend millions of dollars on advertising to beat back attacks on the measure and Democrats who voted for it.

HC Reform Update by Mark Sanna: This week the American Chiropractic Association announced that it has obtained absolute proof a campaign is being launched by major elements of organized medicine to repeal the pro-chiropractic “provider non-discrimination” provision (Section 2706) that the ACA successfully included in the recently enacted national health reform bill.

HC Reform Update by Mark Sanna: After a meeting with insurance executives last week, Kathleen Sebelius, secretary of HHS, says she is seeking a public-private partnership to carry out the health care law. She said she would “look for opportunities to work with insurance companies while also keeping a close watch to make sure they treat their customers fairly.”

HC Reform Update by Mark Sanna: In selling the health care overhaul to Congress, the Obama administration cited a research group at Dartmouth College to claim that it could not only cut billions in wasteful health care spending but make people healthier by doing so. The mistaken belief that the research proves that cheaper care is better care is widespread, but a growing number of health policy researchers are stating that cuts, if not made carefully, could cost lives.

HC Reform Update by Mark Sanna: Starting in 2013, some people will see an increase in Medicare withholding from their paychecks. Specifically, the new law increases the Medicare Part A tax rate on wages by 0.9 percent, to 2.35 percent, for singles with adjusted gross incomes over $200,000 and married couples filing jointly whose income exceeds $250,000.

HC Reform Update by Mark Sanna: Although some insurance companies announced that adult children could stay on family plans starting months sooner than the law requires, many employers are choosing to wait to implement the changes. Instead of modifying health plans now, they plan to wait to provide the extended coverage until they are legally required to do so in January 2011.

HC Reform Update by Mark Sanna: Kathleen Sebelius, the secretary of HHS, said Thursday that employers should immediately offer or continue health insurance coverage for workers’ children up to the age of 26, at little or no additional cost. At the request of the Obama administration, more than 65 insurers have already agreed to allow young adults to stay on their parents’ policies before the insurers are required to do so, under the new law, later this year or early next year.

HC Reform Update by Mark Sanna: The new health care law does not allocate nearly enough money to cover the estimated 5.6 million to 7 million Americans with pre-existing medical conditions who will qualify for temporary high-risk insurance pools. According to a report by the Center for Studying Health System Change the $5 billion earmarked for the pools might cover as few as 200,000 people a year.

HC Reform Update by Mark Sanna: A provision in the new health law allows adult children to stay on their parents’ health plans applies until they turn age 26. They don’t have to be full-time students, nor financially dependent on their parents. They can live out of state and have a job. If the adult child is offered health insurance on the job, he or she can no longer remain on the parents’ policy.

HC Reform Update by Mark Sanna: According to a report from the Commonwealth Fund, a private health policy foundation, most of the 13.7 million uninsured young adults could gain coverage in 2014 — either through public programs like Medicaid or by buying private policies on competitive insurance exchanges established by the new health care law.

HC Reform Update by Mark Sanna: According to a study of the new health care law by Mercer, 33% of employers with 50 or more employees may face tax penalties because they offer health insurance considered unaffordable to some employees. Coverage is deemed unaffordable if the workers’ share of premiums consumes more than 9.5% of their household income.

HC Reform Update by Mark Sanna: There are several ways that the new health law will trim Medicare over the next 10 years. A reduction in payments to the Medicare Advantage plans that about a quarter of Medicare beneficiaries belong to will mean a savings of $136 billion over 10 years. Some plans will likely shut down entirely, while others may no longer offer some of the extras, like gym memberships or vision and dental coverage.

HC Reform Update by Mark Sanna: The number of states jointly suing to overturn the new health care reform law on constitutional grounds swelled to 20 last week. It is the latest reminder that politicians will continue to posture and demagogue the issue through the November elections and beyond.

HC Reform Update by Mark Sanna: Coca-Cola, PepsiCo, and the soda industry, are trying to defeat a soda tax now before the District of Columbia Council. The industry has succeeded recently in beating back similar taxes in NY and PA and in keeping one out of the federal health overhaul bill. Washington Council members are set to vote on the issue next week.

HC Reform Update by Mark Sanna: Starting in 2014, insurers will be required to offer a clearly defined package of essential health benefits. Consumers will be able to choose from four different levels of color-coded coverage — platinum (which will pay 90% of the cost of services), gold (80%), silver (70%) or bronze (60%). Young adults can opt for even less coverage. Policies will be priced accordingly.

HC Reform Update from Mark Sanna: Today Dartmouth College announced that it is poised to keep the country moving forward on health care reform. An anonymous donation of $35 million will establish the Dartmouth Center for Health Care Delivery Science. Its goal will be to find and teach ways to improve health care quality while lowering costs.

HC Reform Update by Mark Sanna: Health insurance companies are lobbying federal and state officials in an effort to shape regulations that will define “unreasonable” premium increases and require them to pay rebates to consumers if the companies do not spend enough on patient care.

HC Reform Update by Mark Sanna: With the aim of depoliticizing a largely Republican assault, the leading lobbying group for small businesses, the National Federation of Independent Business, has joined officials from 20 states in their legal challenge to the new health care law.

HC Reform Update by Mark Sanna: Hospice benefits won’t change under the new law. The House provision that would have required plans to offer voluntary end-of-life counseling — which led to the infamous “death panel” claims that government bureaucrats would be empowered to give the thumbs up or thumbs down to care for the critically ill — was dropped.

HC Reform Update by Mark Sanna: Since the new legislation passed, a dozen lawsuits have been filed in federal courts by states who challenge it. They question whether Congress can regulate inactivity — by levying a tax penalty on those who do not obtain health insurance. If so, what would prevent the government from mandating all manner of acts in the national interest, say regular exercise or buying an American car?

HC Reform Update from Mark Sanna: Starting in 2014 the new health care law will allow employers to offer premium discounts and other incentives of up to 30% of the cost of employees’ health coverage (and up to 50% in some instances) if workers participate in wellness programs and meet health targets.

HC Reform Update by Mark Sanna: The Community Living Assistance Services and Supports Act, or Class Act, the first national plan to help the great majority of Americans who have no insurance for long-term care, became law in March. Even though there was little fanfare. To be eligible, participants must pay premiums for a vesting period of 5 years before they can receive benefits, and they have to continue working for 3 of those years.

HC Reform Update by Mark Sanna: The White House announced Tuesday that it would help pay medical bills for early retirees who have health insurance provided by their former employers. The purpose of the temporary $5 billion program, authorized by the new health care law, is to reverse the erosion of employer-sponsored insurance. Under the program, the federal government can reimburse employers for 80% of the cost of claims from $15,000 to $90,000 a year for a retired worker who is 55 or older and not eligible for Medicare. The program will run from June 1 of this year to Jan. 1, 2014, when many early retirees, like millions of other Americans, will be able to enroll in health plans offered through new state-based markets known as insurance exchanges.

HC Reform Update from Mark Sanna: By 2020, the new health law will close the “doughnut hole,” that gap in Medicare Part D prescription drug coverage during which beneficiaries are responsible for paying 100 percent of their costs. In 2010, the doughnut hole generally occurs when total drug costs are between $2,830 and $6,440. Once spending surpasses that amount, catastrophic coverage kicks in and beneficiaries pay 5 percent of the cost.

HC Reform Update by Mark Sanna: Americans are already starting to see the benefits of health care reform. The new law requires health insurance companies — starting in September — to end their most indefensible practice: rescinding coverage after a policyholder gets sick. In recent days insurers have rushed to announce that they will end rescissions immediately.

HC Reform Update by Mark Sanna: Athenahealth, a provider of Internet-based business services for medical offices, released the results of a national survey of 1,000 physicians. Nearly 2/3 of doctors felt that the current health care environment was detrimental to the delivery of care, and more than half believed that the care quality would decline over the next 5 years. Less than 1/5 of doctors felt they could make clinical decisions based on what was best for the patient rather than on what payers were willing to cover. And an overwhelming majority believed that getting reimbursed was becoming increasingly complex and burdensome.

HC Reform Update by Mark Sanna: Anthem Blue Cross, the insurance giant that was criticized by President Obama when it proposed increasing rates for Californians by as much as 39%, withdrew plans for the proposed increase this week. Anthem made the decision following an independent audit, which decided that the company’s justification for increasing rates was based on flawed data.

HC Reform Update by Mark Sanna: Of all the changes wrought by the new health care law, none is more sweeping than the transformation of Medicaid. Of the 32 million uninsured Americans expected to gain health coverage under the new law, as many as 20 million will be insured by Medicaid, experts estimate. Asset tests will be largely eliminated, so workers who lose their jobs can get health coverage even if they own their homes or have money saved for retirement. (Illegal immigrants will not be eligible.)

HC Reform Update by Mark Sanna: When major companies declared that a provision of the new health care law would hurt earnings, Democrats were skeptical. But after investigating, House Democrats have concluded that the companies were right to tell investors and the government about the expected adverse effects of the law on their financial results. At issue is a section of the law that eliminates a tax break available to companies that provide drug benefits to retirees as part of their insurance coverage. The tax change, expected to generate $4.5 billion of revenue over the next 10 years, will help offset the cost of providing coverage to the uninsured.

HC Reform Update by Mark Sanna: A government analysis of the new health care law says it will not slow the overall growth of health spending because the expansion of insurance and services to 34 million people will offset cost reductions in Medicare and other programs. The study, by the chief Medicare actuary, Richard S. Foster, said, “Overall national health expenditures under the health reform act would increase by a total of $311 billion compared with the amounts that would otherwise be spent from 2010 to 2019.”

HC Reform by Mark Sanna: The new health law did not overturn the insurance industry's exemption from antitrust law, but a separate bill passed by the House may yet do so.After the health law was signed, the House overwhelmingly passed another freestanding bill that would eliminate the insurer antitrust exemption.

HC Reform Update by Mark Sanna: Fearing that health insurance premiums may shoot up in the next few years, Senate Democrats laid a foundation for federal regulation of rates that would “provide an important check on unjustified premiums. Senator Dianne Feinstein (D-CA) introduced a bill that would give the secretary of health and human services the power to review premiums and block “any rate increase found to be unreasonable.”

4/21/10 HC Reform Update by Mark Sanna: It’s likely that your insurer will be able to continue to limit physical therapy and mental health benefits under the new health law. Existing health plans won’t ever have to provide the “essential health benefits” that will be mandatory in the health insurance exchanges and for individual and small group plans starting in 2014.

4/20/10 HC Reform Update by Mark Sanna: A combination of rising health insurance premiums and falling wages has hit middle-income people especially hard, causing them to lose health insurance coverage faster than workers both poorer and richer than they are, according to a recent report from the Robert Wood Johnson Foundation.

4/19/10 HC Reform Update by Mark Sanna: The success of the new health care law depends to a large degree on a handful of Obama administration officials, who are scrambling to make the transition from waging political war on Capitol Hill to managing one of the most profound changes in social policy in generations. Jay Angoff, a longtime consumer advocate and nemesis of the insurance industry, will lead efforts to regulate insurers and insurance markets. Jeanne M. Lambrew, an idealistic veteran of the Clinton White House, is carrying out provisions of the law aimed at expanding coverage. Phyllis C. Borzi, a top Labor Department official, will police the conduct of employers, who provide health benefits to more than 150 million Americans.

4/18/10 HC Reform Update by Mark Sanna: Mindful that the new health care law’s ability to slow rising medical costs will depend to a great extent on how it is put in effect, President Obama is assembling a high-level team to carry out key elements of the overhaul and is considering moving faster than the law requires to put them into action. The president has tapped Pete Rouse to oversee what one insider described as an “elaborate implementation plan.

4/16/10 HC Reform Update by Mark Sanna: President Obama on Thursday ordered his health secretary to issue new rules aimed at granting hospital visiting rights to same-sex partners. The rule changes, which will also make it easier for gay men and lesbians to make medical decisions on behalf of their partners. The new rules affect any hospital that participates in Medicare or Medicaid.

4/15/10 HC Reform Update by Mark Sanna: Starting in September, adult children younger than 26 can be added to their parent’s health policy. Some plans already extend coverage to adult dependents as long as they are full-time students. Health and Human Services still must announce the exact eligibility requirements.

4/14/10 HC Reform Update by Mark Sanna: The insurance commissioner of Georgia has chosen not to comply with a federal request to create a state pool for high-risk insurance plans, opening a new front in the resistance by state Republican officials to the new federal health care law. The commissioner, John W. Oxendine, who is a Republican candidate for governor, appears to be one of the first politicians in the country to take that stance

4/13/10 HC Reform Update by Mark Sanna: In a new report, the Congressional Research Service says the law may have significant unintended consequences for the “personal health insurance coverage” of senators, representatives and their staff members. The law may “remove members of Congress and Congressional staff” from their current coverage, in the Federal Employees Health Benefits Program, before any alternatives are available. In addition, Congress did not designate anyone to resolve these “ambiguities” or to help arrange health insurance for members of Congress in the future.

4/12/10 HC Reform Update by Mark Sanna: Although one potential improvement in preventive medicine coverage will not take effect until 2014, it could be worth a few thousand dollars to you and your family when it happens. Beginning that year, the new law will let employers offer wellness incentives to their workers of up to 30% (raised from 20% currently) of a plan’s total premium — both the employer’s and worker’s portions. That would be up from the current limit of 20% of the total premium.

4/10/10 HC Reform Update by Mark Sanna: Representative Bart Stupak of Michigan, who played a central role with fellow anti-abortion Democrats in negotiating a compromise in the final hours of the health care debate, intends to announce today that he will not seek re-election, a senior party official confirmed. Mr. Stupak, a nine-term incumbent, has been under intense pressure from anti-abortion groups since the health care bill passed last month.

4/8/10 HC Reform Update by Mark Sanna: The new health care legislation created a high-risk insurance program will act as a temporary stopgap until 2014 for people who cannot get coverage because of pre-existing medical conditions. After that time, insurers will be required to take all comers, and who will sign up for coverage through a state or regional insurance exchange. The new program should be available in July.

4/7/10 HC Reform Update by Mark Sanna: The secretary of health and human services, Kathleen Sebelius, wrote to state officials on Tuesday to urge that they take action against “scam artists” reportedly marketing fake insurance policies to exploit the new law overhauling the health care system. She described reports of people setting up toll-free telephone numbers and going door-to-door peddling phony policies, in some cases falsely claiming that the new law established a limited enrollment period for buying government-subsidized insurance.

4/6/10 HC Reform Update by Mark Sanna: On Friday, the secretary of health and human services, Kathleen Sebelius, sent a letter to governors and state insurance commissioners asking whether they were interested in creating high-risk insurance pools to help cover the uninsured from now to 2014 when new government-regulated insurance exchanges begin to operate and regulations take effect.

4/5/10 HC Reform Update by Mark Sanna: Congress tucked several provisions into the new health care legislation designed to reduce the huge toll of preventable diseases. Chain restaurants will have to provide nutrition information on their menus. Employers must provide “reasonable break time” for nursing mothers. Health insurance companies will have to cover all recommended screenings, preventive care and vaccines, without charging co-payments or deductibles. Medicare beneficiaries will get free annual physicals. Medicaid will cover drugs and counseling to help pregnant women stop smoking. And a new federal trust fund will pay for more bicycle paths, playgrounds, sidewalks and hiking trails.

4/3/10 HC Reform Update by Mark Sanna: In one of its first steps to carry out the new health care law, the Obama administration announced Friday that it was establishing a temporary insurance pool where uninsured people with medical problems could buy coverage at reduced rates. Federal health officials said the program would be available from late June of this year to Jan. 1, 2014.

3/31/10 HC Reform Update by Mark Sanna: Under pressure from the White House, health insurance companies said Tuesday that they would comply with rules to be issued soon by the Obama administration requiring them to cover children with pre-existing medical problems. Karen M. Ignagni, president of America’s Health Insurance Plans, a trade group. Accordingly, she said, “we await and will fully comply with” the rules.

3/30/10 HC Reform Update by Mark Sanna: Now that Congress has adopted the big health care legislation, a lot of people are looking for more information about the bill in hopes of figuring out what it means for them, or how their members of Congress voted. A special section in today’s New York Times helps you make sense of the health care overhaul. http://www.nytimes.com/2010/03/30/health/30well.html?ref=health

3/29/10 HC Reform Update by Mark Sanna: Despite the new health law, some insurers say they do not have to cover some children with pre-existing conditions yet. The fine print of the law differs from the larger political message. If a company sells insurance, it will have to cover pre-existing conditions for children covered by the policy. But it does not have to sell to somebody with a pre-existing condition. And the insurer could increase premiums to cover the additional cost.

3/27/10 HC Reform Update by Mark Sanna: Speaker Nancy Pelosi signed the budget reconciliation bill that includes final revisions to the health care legislation on Friday, calling the bill “a matter of trust” between the two chambers of Congress. To complete the legislation, the House on Sunday adopted the base health care bill passed by the Senate on Dec. 24th, but only on the promise that the Senate would follow through and adopt a package of changes.

3/26/10 HC Reform Update by Mark Sanna: Congress on Thursday gave final approval to a package of changes to the health care overhaul, capping a bitter partisan battle. The bill, which Democratic leaders hailed as a landmark achievement, now goes to President Obama for his signature. The final House vote was 220 to 207, and the Senate vote was 56 to 43, with the Republicans unanimously opposed in both chambers.

3/25/10 HC Reform Update by Mark Sanna: With the Senate working through an all-night session on a package of changes to the Democrats’ sweeping health care legislation, Republicans early Thursday morning identified parliamentary problems with at least two provisions that will require the measure to be sent back to the House for yet another vote, once the Senate adopts it.

3/24/10 HC Reform Update by Mark Sanna: With the strokes of 20 pens, President Obama signed his landmark health care overhaul — the most expansive social legislation enacted in decades — into law on Tuesday, saying it enshrines “the core principle that everybody should have some basic security when it comes to their health care.”

3/22/10 HC Reform Update by Mark Sanna: President Obama will sign a landmark $875 billion health care reform bill into law at the White House on Tuesday. The bill passed the House of Representatives late Sunday night. A separate package of changes passed by the House on Sunday still needs to be approved by the Senate. The Senate cannot begin debate on the package before Obama signs the underlying bill into law.

3/21/10 HC Reform Update by Mark Sanna: The White House and anti-abortion Democrats led by Bart Stupak (D-Mich) have reached a deal on preventing the use of tax dollars for health care abortions. President Obama will sign an executive order that no federal funds will be used to help pay for abortions in the Obama Health Care Reform Bill. It's now apparent the White House has the 216 votes to pass the bill.