Health Overhaul Could Double Community Health Centers' Caseload - Kaiser Health News

By Michelle Andrews

Community health centers serve 20 million people every year, and that number is expected to double by 2015, thanks to an $11 billion infusion from the health-care overhaul and $2 billion in federal stimulus funds.

If you're a middle-income worker with health insurance through your job, chances are these centers have been under your radar, since their target clients are low-income and uninsured people. But as the number of uninsured has risen to 50 million, more people than ever are struggling to get and pay for health care, and community health centers are an affordable option. As they expand, they're adding new services and new locations nationwide.

Although their mission is to provide a primary-care safety net for people in underserved areas, no one is ever turned away from a community health center. People with incomes up to 200 percent of the federal poverty level ($44,700 for a family of four in 2011) pay on a sliding scale; uninsured people with higher incomes pay the full cost of care, which is generally comparable to costs in the private sector. The centers accept Medicaid and Medicare in addition to many private insurance plans.

The new health care law is full of incentives to encourage doctors to provide "medical homes" for their patients, with coordinated care and close patient monitoring to stay on top of necessary preventive services. But community health centers have always taken this approach, say experts.

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Economists Oppose Plans to Convert Medicaid to Block Grant

Dear Speaker Boehner, Minority Leader Pelosi, Majority Leader Reid, and Minority Leader McConnell,

We write this letter to oppose plans to convert Medicaid to a block grant and to cut Medicaid benefits.

These changes would do nothing to improve quality but would ration care to millions of America’s most vulnerable citizens.

Medicaid supports health care for nearly 60 million people, including 30 million children. Two-thirds of Medicaid expenditures support services for impoverished people who are elderly or who suffer from disabilities. By spreading the cost of care between federal and state budgets, Medicaid helps state governments maintain services during economic downturns.

Looming budget deficits have led some to propose capping federal spending by converting Medicaid into a blockgrant program. We recognize the challenges posed by budget deficits. Actions must be taken to close those deficits.

Yet block granting Medicaid is both unfair and unwise. During economic downturns it would expose states to the full costs of increasing enrollments just when their revenues are falling. The inevitable result would be curtailed services, reduced eligibility, and increased charges that many low-income patients would be unable to pay, forcing them to forego care or placing burdens for uncompensated care on hospitals and physicians.

Furthermore, a decision to tie the block grant to an economic index (the Consumer Price Index adjusted for population growth) that grows more slowly than medical care spending or actual Medicaid expenditures would cause steady erosion in all of these dimensions.

The only effective and equitable way to curb total health care spending, and the only way to address the fiscal burdens of that care, is to support systemic health reform. The best current hope for doing so is the Affordable Care Act, which should be implemented with vigor.

List of Economists Who Signed the Letter

State-Based, Single-Payer Health Care — A Solution for the United States? | Health Policy and Reform

by William C. Hsiao, Ph.D.

The United States faces two major problems in the health care arena: the swelling ranks of the uninsured and soaring costs. The Patient Protection and Affordable Care Act (ACA) makes great strides in addressing the former problem but offers only modest pilot efforts to address the latter. Experience in countries such as Taiwan and Canada shows that single-payer health care systems can achieve universal coverage and control inflation of health care costs. Because of strong political opposition, however, the U.S. Congress never seriously considered a single-payer approach during the recent reform debate. Now Vermont, wishing to solve the intertwined problems of costs and access through systemic reform, is turning in that direction. Vermont Governor Peter Shumlin campaigned on a platform of single-payer health care, and Democratic legislative leaders are committed to this approach.

In Vermont, the status quo in health care has become untenable. Despite numerous reforms over the past 15 years, Vermont’s health care costs are escalating rapidly, straining the state budget, household incomes, and employers’ bottom lines. More than 7% of Vermonters are uninsured, and another 15% have inadequate insurance.

The Vermont Legislature passed Act 128 in May 2010 authorizing a study to find the most viable and practical systemic solutions to these problems.¹ The goals are clear and ambitious: Vermont wants to achieve universal coverage, reduce the rate of cost increases, and create a primary care–focused, integrated delivery system. The question is how to achieve those goals. My team of health system analysts at the Harvard School of Public Health was commissioned by the Vermont Legislature to develop and evaluate three options for health system reform and determine which option would best achieve the stated goals.
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Launching Accountable Care Organizations — The Proposed Rule for the Medicare Shared Savings Program | Health Policy and Reform

by Donald M. Berwick, M.D., M.P.P in NEJM

A common criticism of U.S. health care is the fragmented nature of its payment and delivery systems. Because in many settings no single group of participants — physicians, hospitals, public or private payers, or employers — takes full responsibility for guiding the health of a patient or community, care is distributed across many sites, and integration among them may be deficient. Fragmentation leads to waste and duplication — and unnecessarily high costs.

Section 3022 of the Affordable Care Act (ACA) establishes the Medicare Shared Savings Program for accountable care organizations (ACOs) as a potential solution.¹ The creation of ACOs is one of the first delivery-reform initiatives that will be implemented under the ACA. Its purpose is to foster change in patient care so as to accelerate progress toward a three-part aim: better care for individuals, better health for populations, and slower growth in costs through improvements in care. Under the law, an ACO will assume responsibility for the care of a clearly defined population of Medicare beneficiaries attributed to it on the basis of their patterns of use of primary care. If an ACO succeeds in both delivering high-quality care and reducing the cost of that care to a level below what would otherwise have been expected, it will share in the Medicare savings it achieves.

On March 31, 2011, the Department of Health and Human Services took a major step toward establishing ACOs by issuing a notice of proposed rule-making that will define how physicians, hospitals, and other key constituents can adopt this new organizational form. The issuing of the proposed rule follows months of obtaining informal and formal input from throughout the health care delivery system, but at this point the rule is only a proposal. The Centers for Medicare and Medicaid Services (CMS) will carefully review the comments we receive in response to the proposed rule before issuing a final rule later this year.

A critical foundation of the proposed rule is its unwavering focus on patients. We envision that successful ACOs will honor individual preferences and will engage patients in shared decision making about diagnostic and therapeutic options. Information management — making sure patients and all health care providers have the right information at the point of care — will be a core competency of ACOs. Held to rigorous quality standards (see table), ACOs will be expected to be proactive in their orientation and to regularly reach out to patients to help them meet their needs for preventive and chronic health care. Patients who seek care at their ACO will know that their physicians are part of that ACO, but as beneficiaries of fee-for-service Medicare, they will continue to be free to seek care from any Medicare provider they wish. They will not be locked into seeing only particular health care providers.
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Does the GOP Have a Health Plan? | John Goodman's Health Policy Blog | NCPA.org

by John Goodman in his Health Policy blog

The Republicans have no plan to insure the uninsured. How do I know that? A New York Times editorial told me. So did Ezra Klein, writing in The Washington Post. Matt Miller, also writing in the Post, went further. “I’m willing to repeal ObamaCare,” he wrote, provided the Republicans can “cover the same number of uninsured” and “do it at a lower cost.”
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The McCain plan, for all those suffering from collective amnesia, proposed to replace all existing health care tax and spending subsidies with a universal health grant, structured like a refundable tax credit. The Patients’ Choice Act version of the idea is sponsored by Tom Coburn (R-OK) and Paul Ryan (R-WI). It promises $2,300 (individual) or $5,700 (family) to everyone who isn’t enrolled in a government health plan.
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Under the McCain/Coburn/Ryan approach, the first $5,700 a family spends on health insurance is courtesy of Uncle Sam. To have the kind of coverage a typical large corporation has, employees and employers would have to kick in about $6,300 more (with unsubsidized money). Not everyone may choose, or be able, to do that. Some might add $3,300 of their own money and buy a $9,000 plan. Some might settle for whatever catastrophic coverage $5,700 will buy. But everybody — and I mean everybody who doesn’t turn down a free lunch — would have protection against large medical bills.
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Medicare Rights Center's Health Reform & Medicare Webinar

The Medicare Rights Center’s free webinar, Health Reform and Medicare, is now available as a recorded presentation on its web site.

Medicare Rights Center President Joe Baker discussed Medicare changes arising from the Affordable Care Act, including:

- Medicare Part D prescription benefit improvements
- Expansion of Medicare-covered services
- Long-term care services and supports
- Changes to Medicare private health plans (Medicare Advantage)
- And much more

Webinar viewers will be able to hear a recording of the presentation while following along with a slideshow.

Click here to view this webinar.

The Medicare Rights Center is the largest independent source of health care information and assistance in the United States for people with Medicare. Visit them at www.medicarerights.org.

ACA Webinar on Care Transitions in Action: From Hospital to Home in Two Communities

On Wednesday, March 30, the Administration on Aging (AoA) will continue its series of webinars focused on the Patient Protection and Affordable Care Act of 2010 (also known as the Affordable Care Act, or ACA) and its impact on the aging network, taking a closer look at two communities actively engaged in care transitions work. 

Title:  Care Transitions in Action: From Hospital to Home in Two Communities

Date:  Wednesday, March 30, 2:00-3:30 p.m. Eastern

Description:
This next session in our ACA webinar series will explore care transitions partnerships between hospitals and area agencies on aging in two communities in more depth.  How did their partnerships develop?  What have their successes and challenges been? And finally, what do their results look like?

Speakers:
Kyle Allen, D.O., AGSF, Summa Health System, Akron, OH

Robyn Golden, LCSW, Rush University Medical Center, Chicago, IL

Robert Mapes, AgeOptions, Oak Park, IL

Joseph Ruby, Area Agency on Aging 10B, Inc., Uniontown, OH
   
Moderator:     Marisa Scala-Foley, Administration on Aging


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To register for the online event
-------------------------------------------------------
1. Go to https://aoa-events.webex.com/aoa-events/onstage/g.php?d=663084836&t=a
2. Click "Register".
3. On the registration form, enter your information and then click "Submit".

Once your registration is approved, you will receive a confirmation email message with instructions on how to join the event.

Please note: Space is limited, so please register as early as possible.  This webinar will also be recorded and posted on the AoA web site (www.AoA.gov) soon after the webinar.   

More Small Businesses Offering Health Care To Employees Thanks To Obamacare - Rick Ungar - The Policy Page - Forbes

by Rick Ungar

The first statistics are coming in and, to the surprise of a great many, Obamacare might just be working to bring health care to working Americans precisely as promised.

The major health insurance companies around the country are reporting a significant increase in small businesses offering health care benefits to their employees.

Why?

Because the tax cut created in the new health care reform law providing small businesses with an incentive to give health benefits to employees is working.
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Implementation Timeline - Kaiser Health Reform

The implementation timeline is an interactive tool designed to explain how and when the provisions of the health reform law will be implemented over the next several years.

You can show or hide all the changes occurring in a year by clicking on that year. Click on a provision to get more information about it. Customize the timeline by checking and unchecking specific topics.
More/Link to Interactive Tool

Time to Fill the Doughnuts — Health Care Reform and Medicare Part D | Health Policy and Reform

By William H. Shrank, M.D., M.S.H.S., and Niteesh K. Choudhry, M.D., Ph.D.

The passage of the Affordable Care Act (ACA) in March 2010 promised to put an end to the “doughnut hole,” the gap in prescription-drug coverage that is the most controversial component of the Medicare Part D benefit.¹ Several months ago, seniors who had reached the spending threshold that marked the beginning of their doughnut hole began to receive their $250 rebate checks. Incrementally between now and 2020, the coverage gap will be filled with subsidies from manufacturers of brand-name drugs and from the federal government. Thus, the ACA, like Part D itself, has expanded coverage for prescription medications — but it has done so in a complex manner that owes more to political wrangling than to any straightforward effort to promote health and cost-effective medication use. The plan for filling in the doughnut hole will most likely confuse many beneficiaries and, at least temporarily, work against cost consciousness, and providers and payers will need to assist patients in navigating the benefit and identifying affordable medications in the years leading up to 2020.
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Medicaid Program-Payment Adjustment for Provider-Preventable Conditions Including Health Care-Acquired Conditions

This proposed rule would implement section 2702 of the Patient Protection and Affordable Care Act of 2010 which directs the Secretary of Health and Human Services to issue Medicaid regulations effective as of July 1, 2011 prohibiting Federal payments to States under section 1903 of the Social Security Act for any amounts expended for providing medical assistance for health care-acquired conditions. It would also authorize States to identify other provider-preventable conditions for which Medicaid payment would be prohibited.

DATES: To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on March 18, 2011.

Full Federal Register Notice

AoA Patient Protection and Affordable Care Act Webinar Series

On Wednesday, February 23, the Administration on Aging (AoA) will continue its series of webinars focused on the Patient Protection and Affordable Care Act of 2010 (also known as the Affordable Care Act, or ACA) and its impact on the aging network, delving further into the topic of care transitions. 

Title:  Care Transitions: Building the Business Case

Date:  Wednesday, February 23, 2:00-3:30 pm Eastern

Description:
Another key component to developing a care transition program in your community is building the financial systems necessary for billing for the services that your agency provides.  This next session in our ACA webinar series will explore why this is an important issue for your agency, how you can assess your current financial systems and build a bundled rate for the services that you provide.

Speakers:
Robert Logan, Administration on Aging
Costas Miskis, Administration on Aging
Ken Wilson, Council on Aging of Southwestern Ohio

Moderator:
Marisa Scala-Foley, Administration on Aging

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To register for the online event
-------------------------------------------------------
1. Go to https://aoa-events.webex.com/aoa-events/onstage/g.php?d=663033785&t=a
2. Click "Register".
3. On the registration form, enter your information and then click "Submit".

Once your registration is approved, you will receive a confirmation email message with instructions on how to join the event.

Please note: Space is limited, so please register as early as possible.  This webinar will also be recorded and posted on the AoA web site (www.AoA.gov) soon after the webinar.   

HR 397 Reform Americans Can Afford Act of 2011

 To repeal the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 and to take meaningful steps to lower health care costs and increase access to health insurance coverage without raising taxes, cutting Medicare benefits for seniors, adding to the national deficit, intervening in the doctor-patient relationship, or instituting a government takeover of health care.

Sponsor: Rep. Walter Herger [R-CA2] 13 Cosponsors

Full Text

Status:

Occurred: Introduced Jan 24, 2011
Occurred: Referred to Committee View Committee Assignments
Not Yet Occurred: Reported by Committee ...
Not Yet Occurred: House Vote ...
Not Yet Occurred: Senate Vote ...
Not Yet Occurred: Signed by President ...

This bill is in the first step in the legislative process. Introduced bills and resolutions first go to committees that deliberate, investigate, and revise them before they go to general debate. The majority of bills and resolutions never make it out of committee. [Last Updated: Jan 27, 2011 6:21AM]

Appointments AnnouncedTo Methodology Committee Of The Patient-Centered Outcomes Research Institute (PCORI)

Gene L. Dodaro, Comptroller General of the United States and head of the U.S. Government Accountability Office (GAO), today announced the appointment of 15 members to the Methodology Committee of the Patient-Centered Outcomes Research Institute (PCORI).

 

“The Methodology Committee has the responsibility of helping PCORI develop and update methodological standards and guidance for comparative clinical effectiveness research.  The  men and women named today bring impressive credentials and experience to this important task,” Dodaro said.

 

The Patient Protection and Affordable Care Act authorized PCORI as a non-profit corporation to assist patients, clinicians, purchasers, and policymakers in making informed health decisions by providing quality, relevant evidence on how best to prevent, diagnose, treat, and monitor diseases and other health conditions.

 

The Act directs the Comptroller General to appoint up to 15 members to PCORI’s Methodology Committee.  In addition to the 15 members appointed today, the Director of the Agency for Healthcare Research and Quality and the Director of the National Institutes of Health, or their designees, will also serve on the committee.

 

The members appointed to the Methodology Committee are:

 

•     Naomi Aronson, PhD, Executive Director, Blue Cross and Blue Shield Association Technology Evaluation Center.

 

•     Ethan Basch, MD, MSc, medical oncologist and health services researcher, Department of Medicine and Department of Epidemiology, Memorial Sloan-Kettering Cancer Center.

 

•     Alfred Berg, MD, MPH, Professor, Department of Family Medicine, University of Washington.

 

•     David Flum, MD, MPH, Professor, Department of Surgery and Adjunct Professor, Department of Health Services, University of Washington Schools of Medicine and Public Health; Attending physician, General Surgery, University of Washington Medical Center.

 

•     Sherine Gabriel, MD, MSc, Professor of Medicine and of Epidemiology, and the William J. and Charles H. Mayo Professor, Mayo Clinic.

 

•     Steven Goodman, MD, PhD, Professor of Oncology, of Pediatrics, of Epidemiology and of Biostatistics, Johns Hopkins School of Medicine and Bloomberg School of Public Health. 

 

•     Mark Helfand, MD, MS, MPH, Professor of Medicine and of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University; Staff physician, Portland VA Medical Center.

 

•     John Ioannidis, MD, DSc, the C.F. Rehnborg Professor in Disease Prevention, Professor of Medicine and Director, Stanford Prevention Research Center, Stanford University School of Medicine. 

 

•     David Meltzer, MD, PhD,  Director, Center for Health and the Social Sciences, Chief of the Section of Hospital Medicine, and Associate Professor, Department of Medicine, Department of Economics, and Graduate School of Public Policy Studies, University of Chicago.

 

•     Brian Mittman, PhD, Director, VA Center for Implementation Practice and Research Support, Department of Veterans Affairs Greater Los Angeles Healthcare System. 

 

•     Robin Newhouse, PhD, RN, Assistant Dean, Doctor of Nursing Practice Program and Associate Professor, Organizational Systems and Adult Health, University of Maryland School of Nursing. 

 

•     Sharon-Lise Normand, MSc, PhD, Professor of Health Care Policy, Harvard Medical School and Professor of Biostatistics, Harvard School of Public Health. 

 

•     Sebastian Schneeweiss, MD, ScD, Associate Professor, Department of Medicine, Harvard Medical School and Associate Professor, Department of Epidemiology, Harvard School of Public Health;  Vice Chief and Director,  Drug Evaluation and Outcomes Research, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital.

 

•     Mary Tinetti, MD, Professor of Medicine, Epidemiology, and Public Health, Division of Geriatrics, Yale University School of Medicine;  Director, Program on Aging, Yale University School of Medicine.

 

•     Clyde Yancy, MD, MSc, Chief, Cardiology, Northwestern University Feinberg School of Medicine; Associate Director, The Bluhm Cardiovascular Institute, Northwestern Memorial Hospital.

 

 

Attached are brief biographies of the new committee members. The official announcement of the appointments will be published in the Federal Register. For more information, contact Mary Giffin of GAO's Health Care team at (202) 512-7114 or Chuck Young in GAO's Office of Public Affairs at (202) 512-4800, or visit the GAO Health Care Advisory Committees web page at http://www.gao.gov/about/hcac/index.html. The Act requires the Comptroller General to disclose any conflicts of interest in appointing members of the Methodology Committee on GAO’s website. Please click here (http://www.gao.gov/about/hcac/pcori_methodology_comm_conflicts.html) for more information.

 

The Comptroller General is required to disclose any conflicts of interest on GAO’s website. Please click here (http://www.gao.gov/about/hcac/pcori_methodology_comm_conflicts.html) for a list of the Methodology Committee members’ associations the Comptroller General has determined fit within the Act’s definition of a “conflict of interest.”

H. J. Res. 19: Disapproving a rule submitted by the Department of Health and Human Services relating to "Health... (GovTrack.us)

Disapproving a rule submitted by the Department of Health and Human Services relating to "Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient Protection and Affordable Care Act".

Sponsor:	Rep. John Carter [R-TX31](no cosponsors) Cosponsors:
Text:	Full Text
Status:	Introduced Jan 12, 2011 Referred to Committee View Committee Assignments Reported by Committee ... House Vote ... Senate Vote ... This resolution is in the first step in the legislative process. Introduced bills and resolutions first go to committees that deliberate, investigate, and revise them before they go to general debate. The majority of bills and resolutions never make it out of committee. If this joint resolution proposes an amendment to the Constitution, three-fourths of the states must ratify the proposal. A joint resolution, if not amending the constitution, may also be signed into law by the president. [Last Updated: Jan 13, 2011 6:12AM]
Last Action:	Jan 12, 2011: Referred to the House Committee on Energy and Commerce.

Status Updates

Governors Want Reform Law Changed So They Can Reduce Medicaid Coverage | Hospital Financial and Business News

 Written by Leigh Page

Republican governors are demanding changes in the healthcare reform law so that states would be able to cut Medicaid enrollment and balance their budgets, according to a report by the Wall Street Journal.

Thirty-three Republican governors and governors-elect plan to send a letter to the White House and congressional leaders today requesting the change. Currently, the reform law would remove federal funding from states that drop Medicaid enrollees.
Full Article

H.R. 191: To amend the Patient Protection and Affordable Care Act to establish a public health insurance option (GovTrack.us)

Sponsor:	Rep. Lynn Woolsey [D-CA6]show cosponsors (46) Cosponsors: Gary Ackerman [D-NY5] Tammy Baldwin [D-WI2] Michael Capuano [D-MA8] Steve Cohen [D-TN9] John Conyers [D-MI14] Rosa DeLauro [D-CT3] Donna Edwards [D-MD4] Keith Ellison [D-MN5] Eliot Engel [D-NY17] Sam Farr [D-CA17] Chaka Fattah [D-PA2] Bob Filner [D-CA51] Barney Frank [D-MA4] John Garamendi [D-CA10] Raul Grijalva [D-AZ7] Luis Gutiérrez [D-IL4] Alcee Hastings [D-FL23] Brian Higgins [D-NY27] Maurice Hinchey [D-NY22] Mazie Hirono [D-HI2] Rush Holt [D-NJ12] Michael Honda [D-CA15] Sheila Jackson-Lee [D-TX18] Henry Johnson [D-GA4] Barbara Lee [D-CA9] Zoe Lofgren [D-CA16] Ben Luján [D-NM3] Doris Matsui [D-CA5] George Miller [D-CA7] Gwen Moore [D-WI4] Christopher Murphy [D-CT5] Jerrold Nadler [D-NY8] John Olver [D-MA1] Chellie Pingree [D-ME1] Laura Richardson [D-CA37] Steven Rothman [D-NJ9] Timothy Ryan [D-OH17] John Sarbanes [D-MD3] Janice Schakowsky [D-IL9] Robert Scott [D-VA3] Louise Slaughter [D-NY28] Fortney Stark [D-CA13] Michael Thompson [D-CA1] Paul Tonko [D-NY21] Niki Tsongas [D-MA5] Anthony Weiner [D-NY9]
Text:	The text of this legislation is not yet available on GovTrack. It may not have been made available by the Government Printing Office yet.
Status:	Introduced Jan 5, 2011 Referred to Committee View Committee Assignments Reported by Committee ... House Vote ... Senate Vote ... Signed by President ... This bill is in the first step in the legislative process. Introduced bills and resolutions first go to committees that deliberate, investigate, and revise them before they go to general debate. The majority of bills and resolutions never make it out of committee. [Last Updated: Jan 7, 2011 6:19AM]
Last Action:	Jan 5, 2011: Referred to the House Committee on Energy and Commerce.

Current Status

H.R. 127: To deauthorize appropriation of funds to carry out the Patient Protection and Affordable Care Act... (GovTrack.us)

To deauthorize appropriation of funds to carry out the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010.

Sponsor:	Rep. Tom Graves [R-GA9]hide cosponsors Cosponsors: Michele Bachmann [R-MN6] Paul Broun [R-GA10] Dan Burton [R-IN5] Jason Chaffetz [R-UT3] Mike Coffman [R-CO6] John Culberson [R-TX7] Lynn Jenkins [R-KS2] Walter Jones [R-NC3] Donald Manzullo [R-IL16] Lynn Westmoreland [R-GA3]
Text:	The text of this legislation is not yet available on GovTrack. It may not have been made available by the Government Printing Office yet.
Status:	Introduced Jan 5, 2011 Referred to Committee View Committee Assignments Reported by Committee ... House Vote ... Senate Vote ... Signed by President ... This bill is in the first step in the legislative process. Introduced bills and resolutions first go to committees that deliberate, investigate, and revise them before they go to general debate. The majority of bills and resolutions never make it out of committee. [Last Updated: Jan 7, 2011 6:16AM]
Last Action:	Jan 5, 2011: Referred to House House Administration

Current Status

H.R. 118: To amend the Patient Protection and Affordable Care Act to permit a State to elect not to... (GovTrack.us)

To amend the Patient Protection and Affordable Care Act to permit a State to elect not to establish an American Health Benefit Exchange.

Sponsor:	Rep. John Fleming [R-LA4](no cosponsors) Cosponsors:
Text:	The text of this legislation is not yet available on GovTrack. It may not have been made available by the Government Printing Office yet.
Status:	Introduced Jan 5, 2011 Referred to Committee View Committee Assignments Reported by Committee ... House Vote ... Senate Vote ... Signed by President ... This bill is in the first step in the legislative process. Introduced bills and resolutions first go to committees that deliberate, investigate, and revise them before they go to general debate. The majority of bills and resolutions never make it out of committee. [Last Updated: Jan 6, 2011 11:24AM]
Last Action:	Jan 5, 2011: Referred to the House Committee on Energy and Commerce.

Current Status