Health Reform Calendar 2012

Thanks to Sarah Kliff, who writes for Ezra Klein’s Wonkblog over at the Washington Post for her summary of key health reform dates to watch in 2012. Most Americans don’t keep a close on eye on the implementation process after a law has passed, and with something as big as the Affordable Care Act, it can be especially challenging to know what’s happening when. Most folks know that the law was enacted in 2010, and many of them know that the law doesn’t take full effect until 2014, but aside from those mile-markers, things can seem like a mess.

This year, however, stands to be a big one for health reform, and one of the key dates is already behind us. On January 1, the accountable care organizations, or ACOs, came online, with the goal of controlling costs by paying for comprehensive delivery of high quality care. It’s a demonstration project that could move the country away from fee-for-service and towards patient-centered models of health care. That is, if it works, which we won’t know for a while.

Next up, at the end of March, the Supreme Court will hear oral arguments about the constitutionality of the Affordable Care Act, which I’ve written about several times already. The expectation is that a decision will be handed down in early summer.

The final big events of the year take place in the fall and early winter. On October 1, additional Medicare payment reforms will be implemented which will further change how hospitals get paid. This includes things like “pay for performance” and penalties for avoidable rehospitalizations. Then things get interesting. November 3 is election day, and the outcome will go a long way in determining the future of health reform implementation. If the GOP nominee takes the White House and the Republicans retain control of the House and/or gain control of the Senate, the ACA will likely be derailed. I don’t think that the law will be repealed under such conditions, but it may effectively be killed by cutting funding, tying the executive branch in knots, and other such strategies that choke out implementation. On the other hand, if Obama is re-elected, things are likely to move forward, regardless of the outcome of the Supreme Court decision.

In the latter case, December 31, the last day of the year, will retain its current importance as the deadline by which states must have received approval from the Obama administration for their health insurance exchange. Remember: States were permitted to design their own exchanges that met federal minimums. If they failed to do so, Uncle Sam promises to step in and do it for them. When the ball drops in Times Square to usher in 2013, we’ll know which states stepped up, and which stepped out.