Slideshow The 5 most important health care stories of 2011 and 2012

  • December 15 2011, 11:03am EST
5 Images Total

Dropping health coverage under PPACA

Two conflicting surveys were released in June. A McKinsey survey projected 30% of employers would likely stop offering health insurance once PPACA provisions kick in, while a Lockton survey pinged the number at 18%, similar to other surveys during 2011. There was much controversy over the McKinsey survey, with D.C.-based online outlet Talking Points Memo finding from internal sources that the McKinsey survey “wasn't designed in away that would allow it to be peer review published or cited academically.” McKinsey responded defending its methodology and saying comparing the results to other research on the topic is unfair.

Keeping more of your FSA

In July, Sens. Ben Cardin (D-Md.) and Mike Enzi (R-Wyo.) introduced legislation that would allow consumers to pay taxes on and withdraw their remaining funds from their FSAs. The bill was referred to the Committee on Finance and is stalled there. However, critics remained under-whelmed by the proposal. At the time Paul Dennett, senior vice president of health care reform for the American Benefits Council told EBA he would have preferred Congress “allow unused FSA dollars to simply remain in an individual’s FSA to meet future health care needs, or perhaps rolled over into an HSA when that option is available, too.”

Content Continues Below

Unlimited opportunity in 2012 with a PPACA ruling

In November, the interim final rules came out for accountable care organizations, which streamline home health care by having individual physicians and home health care organizations working together. “Assuming PPACA gets upheld and assuming the ASOs take off and it actually proves to be a viable method of reducing cost, there are almost unlimited opportunities for expansion there,” says Mercedes Varasteh Dordeski, a health care law specialist and associate with Troy, Mich.-based Frank Haron Weiner PLC.

Most significant development

“The most significant development is the HHS proposed regulations on health care exchanges,” of which a framework was released in July, says Brian Pinheiro, an employer compensation law specialist and partner with Philadelphia-based Ballard Spahr LLP. “States need to set up these exchanges in advance of 2014,” he says. “. . . Of course, everything is contingent on the Supreme Court’s decision."

Content Continues Below

The biggest decision

By far, the biggest health news in 2012 will come from the Supreme Court. In November, the high court announced it would hear certain cases on the law, with a ruling expected in spring 2012. At issue is the individual mandate, a central tenet of health care reform, Pinheiro says.
Mark C. Nielsen, who specializes in health care law and is principal with Washington-based Groom Law Group says that the “crystal ball question” of how the court will rule “is dangerous [as] no one knows how they are going to rule until the nine justices sit in the conference room together and make a decision.” Yet, he says he wouldn’t be surprised if the court upholds the individual mandate provision after the Justices parse through 60 years of inconsistent case law.