Health reform had a big year in 2010, when it passed Congress and a slew of consumer-friendly provisions came online. And it’ll have another big year in 2014. That’s when the individual mandate kicks in, pre-existing conditions end and Medicaid expands to cover 16 million more Americans. But 2012 won’t be all quiet on the health-care front: The Obama administration is laying a policy foundation for 2014, while health reform opponents try to stop the law altogether. Here are five key dates to mark on your health reform calendar (you do have one of those, don’t you?):
Jan. 1: The ACOs go live. We’ve written a decent amount here at Wonkblog about the Accountable Care Organization regulations, health reform’s big attempt to bring down the cost of health care by paying for quality of care, rather than just quantity. On Jan. 1, 32 health-care systems went live as Accountable Care Organization “pioneers,” and will begin accepting a flat fee for all care related to a small group of their Medicare patients. Their experiment could end fee-for-service medicine — or, if it fails, send lawmakers back to the drawing board.
March 26: The Supreme Court hears oral arguments on the Affordable Care Act. The crucial debate will be over whether the mandated purchase of health insurance is constitutional and, if it isn’t, whether or not the rest of the law can still stand. After the Supreme Court hears the case in March, expect a decision by early summer.
Oct. 1: Reforming Medicare payments — again. ACOs will probably get the most attention this year, but two other regulations go live in the fall that also stand to reform how health-care providers get paid. New “value-based purchasing” policies start tying hospitals’ Medicare payments to performance metrics. Another regulation will ding hospitals for patients that are readmitted for a complication that could have been prevented, a bid to reduce unnecessary medical errors that lead to higher costs.
Nov. 3: The 2012 election. As Harvard’s David Blumenthal wrote recently in the New England Journal of Medicine, 2012 will be a “watershed election for health care.” Republican control of the presidency and Congress could clear the way to repealing big parts of the health reform law (albeit not as easily as some Republican candidates have suggested). Democratic retention of the White House, meanwhile, essentially ensures that much of the law will be implemented.
Dec. 31: The big health exchange deadline. States have had about three years to lay the foundation for health insurance exchanges, the new marketplaces that will go live in 2014. States must have the Obama administration certify, by the end of this year, that they’ve made enough progress to launch in 2014. If not, the feds will come in and do it themselves.