Molina Health Advocacy Newsletter Molina Healthcare, Inc THE DECISION On June 28, 2012, the United States Supreme Court issued its opinion on the litigation involving the constitutionality of the Affordable Care Act (ACA), National Federation of Independent Business et al. v. Sebelius. The Court addressed four issues: (1) whether the Anti-Injunction Act barred the suit; (2) whether the individual mandate reflected a constitutional exercise of Congress s Commerce Clause authority; (3) whether the individual mandate reflected a constitutional exercise of Congress s Taxing Clause authority; and (4) whether the Act s Medicaid expansion was constitutional. Since the individual mandate was upheld, the Court did not need to reach the issue of its severability. The Court upheld the individual mandate and the ACA s Medicaid expansion, although it did prohibit the Federal Government from withdrawing existing Medicaid funds from states that do not implement the Medicaid expansion. Of most importance to Molina is the ruling as it regards the Medicaid expansion. A brief summary is below. The Court addressed the expansion of the Medicaid program by the ACA, which requires states August 2012 The Voice in Healthcare to provide coverage to all individuals under the age of 65 with incomes below 133 percent of the federal poverty line (FPL). The ACA provides federal funding for 100 percent of the costs of the expansion through 2016, which phases down to 90 percent of the costs in 2020 and thereafter. The law included a provision that held that states that fail to provide the expanded coverage would be penalized by losing all existing federal funding for Medicaid, not just funding for the new recipients. The Court upheld the Medicaid expansion as a reasonable exercise of the federal government s power under the Spending Clause of the Constitution but that the Federal Government does not have the power to coerce states into action and that the possibility of losing all federal funding for Medicaid was a gun to the head of states. As a result, the court struck down the ACA provision giving the Secretary of Health and Human Services authority to withhold existing Medicaid funding if a state does not provide the expanded coverage. States will have the option to expand eligibility as provided under the ACA or may decide not to do so and continue to implement Medicaid programs under existing Medicaid rules. This will put states in a tricky position as those uninsured Americans with very low incomes (under 100% of FPL or $25,000/year for a family of four) will not be eligible for tax subsidies to purchase incurance on their own through a state-based insurance exchange in 2014. This group of people will then put a strain on the healthcare system and continue to access services primarily through the emergency room prevention of http://advocacy.molinahealthcare.com which was a primary goal of the ACA when it was introduced in Congress. Since the court s ruling, Republican Governors in a number of states have declared that their states will not be accepting the additional federal funding to expand Medicaid. Among these states are Texas, Wisconsin, Louisiana, South Carolina, Iowa and Florida. A number of other Governors have taken the wait and see approach and holding their cards until the November Presidential election assuming that if Mitt Romney is elected the entire bill will be repealed. Only time will tell if the declarations against the expansion prove to be anything more than political posturing UPDATE: EXCISE TAX There are two bills pending in the House. that would repeal the premium tax on insurance companies which is part of the ACA. One introduced by Rep. and Dr. Charles Boustany (R-LA-7), H.R. 1370, has 149 cosponsors, and has been referred to both Health Subcommittees of the Energy and Commerce and the Ways and Means Committees. There is a companion bill in the Senate introduced by Sen. and Dr. John Barrasso (R-WY). The second one introduced by Rep. and Dr. Tom Price (R-GA-6), H.R. 3000, has 40 cosponsors and would repeal the ACA. The House GOP held a vote to repeal the ACA on July 12. It passed 244 185 mostly along party lines except for five Democrats who voted with the Republicans, including Rep. Jim Matheson (D-UT-2). It is unlikely that the Senate will pass the bill before the election.
Molina Health Advocacy Newsletter 2 Molina Days at our State Capitols and the US Capitol 2012 brought two firsts: the first Molina Day in Madison, Wisconsin where MHWI employees introduced Molina and what they do for the state to their state officials, and the first US Capitol Molina Day for leaders from Molina Medicaid Solutions who talked to their congressional delegations about what MMS brings to their states, and the excise tax issue. Additionally, state capitol Molina Days were held in NM, UT, OH, MI, CA, FL, and WA, where state officials were briefed on why expanding Medicaid Managed Care (MMC) to the Aged, Blind, and Disabled (ABD) population and the dual eligible populations can save money for the state long term. In the Spring, Plan Presidents as well as Molina s CEO, Dr. Mario Molina, and Molina s COO, Terry Bayer, came to Washington DC to talk to their federal congressional officials about the excise tax included in the ACA. They also talked about expansion of MMC to include the dual eligible populations across the United States. This year over 100 Congressional offices have been visited by Molina constituents to discuss repealing the Excise Tax in the ACA. Wisconsin State Senator Leah Vukmer, Chairwoman of the Committee on Health, in a photo from Wisconsin Molina Day with Plan President Stephen Harris and Government Contracts Director Melissa Henderson. During MHFL s Molina Day Plan President David Pollack, Health Analysis Manager Ivan Vega, and Provider Inquiry R&R Director Betty Thomas met with Florida State Rep. and Dr. Donald Renaut who serves on several committees with jurisdiction over health issues. During MMS Molina Day, David Pingree (WV); Del Bell (ID); Ruth Ann Panepinto (WV); Susan Baird (NJ); Norm Nichols (LA); Cindy Coulombe (ME); and Frank Milnes (NJ) pause to have their photo taken in front of the US Capitol.
Molina Health Advocacy Newsletter 3 ELECTIONS 2012 This November, you will have an opportunity to cast your vote for President. Additionally, all members of the US House, 1/3 of the US Senate, 11governors, and all state legislatures except for AL, LA, MS, RI, and VA are up for election. Before it is too late, please go to the Molina Advocacy website and click on the Register to Vote icon. Then click on your state and print the registration form, fill it out, sign it and mail it in. It is time for all of us to have our voice heard by voting November 6. VOTE NOVEMBER 6, 2012 HEALTH INSURANCE EXCHANGES http://advocacy.molinahealthcare.com ACA includes the establishment of Health Insurance Exchanges which are to be web-based systems similar to Travelocity or Expedia that facilitate individual and small business purchase of health insurance. Individual states can design their own exchange as long as it provides enrollment and consumer assistance, eligibility determinations for public programs and subsidies, oversight of Qualified Health Plans and can administer the exchange. Exchanges are to be self-sustaining by January 1, 2015. Below is a look at where many states stand in establishing their exchange. Status of Molina States to Establish Exchanges as of May 2012 Legislation signed into law post passage of ACA State Exchange in existence prior to ACA Legislation passed one or both houses Legislation pending in one or both houses Legislation failed/no gubernatorial action Gubernatorial veto Decision not to establish an Exchange at this time Sources: National Conference of State Legislatures, Federal Health Reform: State Legislative Tracking Database. The Commonwealth Fund.
Molina Health Advocacy Newsletter 4 Right: Cindy Coulombe, Interim Account Manager for MMS ME and Business Architect, meets with Sen. Susan Collins (R- ME) Below: Rep. Shelley Moore Capito (R- WV-2) and her staff meet with David Pingree, AVP, MMS and Ruth Ann Panepinto, Account Manager for MMS WV Below: April Alexander, Director, Regional State Affairs (NM), and New Mexico Plan President, Lynn Allen, flank Senator Tom Udall (D-NM) for a photo
Molina Health Advocacy Newsletter Voter Registration Deadlines in Molina States for Nov. 6th election VOTE NOVEMBER 6, 2012 CA Postmarked 15 days before election day FL Postmarked 29 days before election day ID Postmarked or in person 25 days prior to election day LA ME MI Received 30 days before election (meaning in Voter registrar s office) Received 21 days before election day or you can register in person on Election Day Postmark 30 days before election day MO NJ NM OH TX UT VA WA WV WI Received 28 days before election day Received 29 days before election day Postmarked 28 days before election day Postmarked 30 days before election day Postmarked 30 days before election Postmarked 30 before election day or received 15 days either in person or on line Postmarked 29 days before election day Postmarked or received 30 before election day by mail or on line or in person up to 8 days before Postmarked 21 days before election day Postmarked 20 days before or in person 5 days before election day but you can also register on election day New MHC Plan President Richard Chambers meets with California Rep. Dan Lungren off the floor of the House Chamber in the Capitol. MHO Plan President Amy Clubbs talks with Ohio Rep. Steve Stivers in his office.