Health Reform Implementation: When Sausage-Making Moves Downtown

Now that the Patient Protection and Affordable Care Act is law, what’s happening behind the scenes (as well as in public) to implement it? This briefing, cosponsored by the Alliance and the Robert Wood Johnson Foundation, provided an overview of federal policymaking and the efforts by stakeholders and others to affect final policies pertaining to the health reform law.

The session looked into key tools and levers available to the federal government, including formal rulemaking and other policy processes. It used various provisions in the law as examples – near-term provisions, such as high-risk pools and coverage for young-adult dependents, as well as others coming farther down the road, such as changes to Medicaid eligibility.

What particular challenges need to be overcome by the federal government to implement various provisions in the law? What can we learn from previous examples of how legislative milestones in Medicare, Medicaid, CHIP and other programs moved from enactment to enforceable policy? How does rulemaking work, and how do stakeholders and consumers participate in the process? When do “interim final” rules apply, as they did in implementing the young adult coverage provision?

Panelists were: Katherine Hayes of George Washington University’s Department of Health Policy and former legislative assistant to Sen. John H. Chafee and the Senate Finance Subcommittee on Health. Gail Wilensky of Project HOPE and former administrator of what is now the Center for Medicare and Medicaid Services, and Linda Fishman of the American Hospital Association. Ed Howard of the Alliance moderated.

Speaker Presentations

Gail Wilensky’s Presentation (PowerPoint)
Katherine Hayes’ Presentation (PowerPoint)
Linda Fishman’s Presentation (PowerPoint)