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Overview:

In this section we provide timely commentary on hot topics in health policy.  We will consider different questions as relevance rises and falls.

This information was provided by HealthCare.gov beginning with the passage of the Affordable Care Act (PPACA) in March 2010. Please note that the timeline is organized so that the most current update is at the top.

March 1, 2012 - Understanding and Fighting Health Disparities. Click here for more information.

January 1, 2012 – Encouraging Integrated Health Systems. Click here for more information.

October 1, 2011 – New Innovations to Bring Down Costs. Click here for more information.

January 1, 2011 – Free Preventive Care for Seniors. Click here for more information.

January 1, 2011 – Prescription Drug Discounts. Click here for more information.

September 23, 2010 – Prohibiting Denying Coverage of Children Based on Pre-Existing Conditions. Click here for more information.

September 23, 2010 – Prohibiting Insurance Companies from Rescinding Coverage. Click here for more information.

September 23, 2010 – Providing Free Preventive Care. Click here for more information.

September 23, 2010 – Extending Coverage for Young Adults. Click here for more information.

July 1, 2010 – Providing Access to Insurance for Uninsured Americans with Pre-Existing Conditions. Click here to view more information.

June 1, 2010 – Expanding Coverage for Early Retirees. Click here for more information.

April 1, 2010 – Allowing States to Cover More People on Medicaid. Click here for more information.

March 23, 2010 – The Affordable Care Act Become Law. Click here for more information.

Health Care Law Timeline

This information was provided by CNN.com beginning with President Obama’s declaration of health care reform. Please note that the timeline is organized so that the most current update is at the top.

July 11, 2012 –  The House votes 244-185 to repeal the health care law.

June 28, 2012 –  The Supreme Court rules to uphold the health care law.

March 26, 2012 –  The Supreme Court begins three days of oral arguments over the constitutionality of the  health care law.

November 14, 2011 –  The Supreme Court agrees to hear a legal challenge to the health care law after being petitioned 26 states, led by Florida.

November 8, 2011 –  The United States Court of Appeals in Washington, DC rules that the health care law is constitutional.

August 12, 2011 –  The 11th Circut Court of Appeals in Washington, DC rules that parts of the health care law are unconstitutional.

March 23, 2010 – President Obama signs the health care bill into law.

March 21, 2010 –  The Senate passes a version of the bill. A separate package of changes expanded the reach of the measure is passes the House over unanimous GOP opposition.

February 25, 2010 –  President Obama holds a televised health care summit with leaders of both parties to explain the health care bill.

December 24, 2009 –  The Senate passes the health care bill 60-39.

November 7, 2009 –  The House of Representatives passes a version of the health care bill by a vote of 220-215.

October 13, 2009 –  The Senate Finance Committee approves Chairman Max Baucus’ America’s Health Future Act.

September 29, 2009 –  The Senate Finance rejects two amendments that include a government-run public health insurance option.

July 31, 2009 –  The Affordable Choice Act passes the House Committee on Energy and Commerce by a vote of 31 to 28.

July 15, 2009 –  The Affordable Choices Act passes the Senate’s Health, Education, Labor, and Pensions Committees. This bill includes over 160 Republican amendments accepted during the month-long mark-up.

April 21, 2009 -Senate Finance Committee Chairman Max Baucus and Ranking member Chuck Grassley hold the first of three round tables of health policy experts to discuss health care legislation.

March 5, 2009 –  The Obama administration holds its first health care summit.

February 24, 2009 –  President Barack Obama declares “so let there be no doubt: Health care reform cannot wait, it must not wait, and it will not wait another year.”

The Kaiser Family Foundation produces regularly updated briefs tracking exchange implementation progress in the various states: click here for more information.

Kaiser Family Foundation also has posted an interesting issue brief on the current state (or lack) of competition in most state small group and individual markets. Click here to view the brief.

Jo Ann Volk and Sabrina Corlette of the Georgetown Health Policy Institute have written a useful paper laying out options for health benefit exchanges to be designed to improve clinical quality in the delivery system. Click here for more information.

The National Association of Insurance Commissioners (NAIC) has statutory and ongoing advisory roles to play in making PPACA implementation workable, their activities can be monitored at this website.

(1) How to make guaranteed issue, modified community rating, and other needed insurance market reforms work if the Supreme Court decides the individual mandate is indeed unconstitutional?

(2) How can Medicaid provider payment rates be increased without adding strain to tight state budget?

The Community Transformation Grants (CTG) program will support community-level efforts to reduce chronic diseases such as heart disease, cancer, stroke, and diabetes. By promoting healthy lifestyles, especially among population groups experiencing the greatest burden of chronic disease, these grants will help improve health, reduce health disparities, and control health care spending.

Approximately $103 million in prevention funding has been awarded to 61 states and communities serving approximately 120 million Americans. These awards are distributed among state and local government agencies, tribes and territories, and state and local non-profit organizations within 36 states, including seven tribes and one territory. At least 20 percent of grant funds will be directed to rural and frontier areas. {end of first entry}

Steven Woolf and Paula Braverman have a very timely article on the relative contributions of health care vs. social determinants of health and have outlined a comprehensive approach to policy that is worthy of serious attention. Click here to view the article.

Virtually the entire November issue of Health Affairs is devoted to links between community development and health improvement possibilities and challenges. Click here to view the November Issue.

See our slider entry for a thorough report of all the issues the supreme court will rule on next spring or summer.   Tim Jost, a law professor at Washington and Lee, has written a nice summary and explanation of the recent impactful ruling out of the DC Circuit Court of Appeals, in which a well-known conservative judge ruled the individual mandate is constitutional.

Also, please check out our question of the month to see our polling on the subject.

Debate Item # 2: Is the Individual Mandate Necessary?

Center Director Len Nichols, and others, have written extensively on this question.  A recent summary of earlier work is here. Recent controversy on the question has been fueled by a recent study by Lewin Group researchers .  Be sure and read Wake Forest Law Professor Mark Hall’s reaction to this paper before making up your own mind.

Debate Item # 3: Is it Possible to Lower Costs without Rationing Care?

Much commentary exists on this topic as well.  Good places to start include work by the Brookings Institute’s Engleberg Center for Health Care Reform and by the Commonwealth Fund .Along with some  healthy skepticism from a former Medicare Administrator, Gail Wilensky .

Don Berwick’s NEJM recent piece on the final ACO rule can be found here

R. M.J. Bohmer, “The Four Habit of High Value Health Care Organizations,” can be found here

David Miller and colleagues’ estimate of the potential savings to Medicare of a feasible bundled payment program can be found here

Peter Hussey and colleagues report on the slow progress and potential pitfalls of one of the most promising bundling models, PROMETHEUS. For more information, please click this here.

The purpose of health policy research is to improve health policy debates, policy development, and implementation. CHPRE work is directed at the national, state, and local levels, for all three have unique roles to play in enabling health policy to improve real people’s lives. We research both health insurance and delivery system topics, wherein population health is an increasingly important focus since comprehensive health reform has become national policy (at least for now).

Delivery System,

Insurance markets,

Public health

Click GMU Research Table  for a detailed chart of George Mason University Research.

Heibatollah Baghi, PhD Associate Professor
Global and Community Health

Application of statistical & psychometric modeling techniques in healthcare using LISERL; investigation of job analysis methodologies for licensure and certification examination in nursing practice;computer-adaptive testing; item response theory; experimental design and applied multivariate statistics.

Recent publications include: Kowitlawakul, Y., Baghi, H., & Kopac, C. A. (2011). Psychometrics evaluation of the nurses’ attitudes toward eICU scale.Journal of Nursing Measurement 19(1), 17-27. Alemi, F., and Baghi, H. (2010). Measurement of substance abuse treatment outcomes. Quality Management in Health Care 19(2), 1-8.

Carl Botan, PhD Professor Director of the PhD Program, Communication
Communication, a department within The College of Humanities and Social Sciences

Strategic communication campaigns, including health campaigns. Research interests include: emergency preparedness and response, anti-terrorism work, public health campaigns, social marketing and climate change communication. He is concerned with how to make such campaigns more effective and with the social role and ethical issues involved in such campaigns.

Dr. Botan is the Faculty/Director of the PhD Program in Communication

Andrew Carle, M.H.S.A. Executive-in-Residence, Assistant Professor Director, Senior Housing Administration
Health Administration and Policy

Mr. Carle is the Director of the Program in Senior Housing Administration, which is designed to provide graduates with the operational, marketing, resident care, and hospitality services skills required to become effective leaders and managers of senior housing communities. Equally important, the program provides exposure to and understanding of the unique philosophy of senior housing relative to choice, dignity, autonomy, and quality of life for older adults.

Mr. Carle’s book Moments, Memories, and Mission: Stories from the Field of Assisted Living, received a Silver Award during the 15th Annual National Mature Market Media competition. Click here to view more information about the book.

William Cartwright, PhD Assistant Professor, retired
Health Administration and Policy

Dr. Cartwright’s research focuses on the economics of drug abuse prevention and treatment.

Alison Evans Cuellar, PhD Associate Professor
Health Administration and Policy

Dr. Cuellar’s research interests include: hospital systems, Medicaid, mental health care delivery, and justice involved populations.

Carol Filak, PhD Director of Mason Student Health Services

Dr. Filak’s research examines the impact of a community, immunity health education campaign on college students’ compliance with required and recommended immunizations.

Dr. Filak was selected to receive a 2011 Pfizer Junior Investigator Award ($40,000) for her research.

Catherine Gallagher, PhD Associate Professor
Criminology, Law and Society

Dr. Gallagher’s research focuses on improving the intersection between health care and justice agencies to better meet the needs of high-risk populations and the public health of their larger communities.

Dr. Gallagher develops, monitors and analyzes national statistical programs and provides federal agencies with policy guidance, routinely working iwth the Office of Juvenile Justice and Delinquency Prevention, the CDC, the Agency for Health Care Research and Quality, the Office of the Surgeon General, and the U.S. Bureau of the Census.
Andrew Guccione, PhD Chair, Department of Rehabilitation Science
Department of Rehabilitation Science

Dr. Guccione’s research interests are in geriatrics, health status measurement, and functional outcomes after rehabilitation. He has received grant funding from the Arthritis Foundation and was the recipient of a Special Emphasis Research Career Award from the National Institute on Aging. His clinical practice has centered mainly on geriatrics and musculoskeletal impairment in older adults

Dr. Guccione’s article “Can ‘Severity-Intensity’ be the conception basis of an alternative payment model for therapy services provided under Medicare?” appeared in Physical Therapy,Journal of the American Physical Therapy Association, in October 2011.

Jack Hadley, PhD Professor and Senior Health Services Researcher Associate Dean, Finance and Planning
The College of Health and Human Services

Building on this research, he plans to focus his teaching activities around policy and research issues in the Medicare and Medicaid programs. Possible future studies include the effects of practice and market characteristic son the cost of care received by high-cost Medicare patients, who account for a substantial share of Medicare’s total spending, and the effects of physicians’ financial incentives on treatments and outcomes of Medicare patients with back/spine disorders.

Dr. Hadley’s article “Medical spending and the health of the elderly” appeared in Health Services Research 2011.

Lorens Helmchen, PhD Associate Professor
Health Administration and Policy

Dr. Helmchen researches the potential of provider-issued outcome warranties, which would insure policyholders against easily verifiable adverse treatment outcomes, such as remission after cancer therapy or 30-day survival after undergoing heart bypass surgery. In a related project, he is exploring how negative co-payments might improve existing insurance benefits, instead of paying more for more costly treatment; beneficiaries would get paid for choosing less costly treatment.

Dr. Helmchen studies mechanisms that improve quality transparency in health care and patients’ incentives to choose effective medical treatment. Dr. Helmchen is a co-investigator on a $3 million grant from the Agency for Healthcare Research and Quality (AHRQ) that aims to evaluate how the disclosure of medical errors affects patients’ likelihood to sue and receive compensation, and their assessment of the quality of care.

Thomas (Tim) Henderson M.A.M.C., M.P.H. Assistant Professor
Health Administration and Policy

Mr. Henderson identifies and analyzes state financing mechanisms and public policies for supporting health professions education. He assesses and evaluates the policy approaches for understanding and addressing shortages in the health care workforce.

Emily Ihara, PhD Assistant Professor
Department of Social Work

Dr. Ihara’s research explores the social contexts of health and well-being for older adults. She is particularly interested in the role of race/ethnicity, immigration, and socioeconomic position on health status, health and social services, and policy.

Dr. Ihara spent four years as a research associate at the Center on an Aging Society at Georgetown University’s Health Policy Institute where she focused on access to health and long-term care services, particularly for under-served and low-income populations. Specific projects included national surveys of Medicaid home and community-based services, personal care services, and enrollment simplification; issue briefs on health literacy, cultural competence, and chronic conditions; and incremental reform of long-term care financing and organization.
Gary Kreps, PhD Director, Center for Health and Risk Communication Chair, Communication
Communication, a department within The College of Humanities and Social Sciences

Dr. Kreps developed national health communication research initiatives to promote cancer prevention and control. His areas of expertise include health and organizational communication, health promotion, e-health, multi-media edutainment, multicultural relations, and applied research methods.

He is the Director of the Center for Health and Risk Communication, serves on the Governing Board of the Center for Social Science Research, and is a faculty affiliate of the National Center for Bio-defenseand Infectious Diseases, the Center for Health Policy & Ethics, the Center for the Study of International Medical Policies and Practices, the Climate Change Communication Center, the Center for Consciousness & Transformation, and the Center for Health Information Technology, at George Mason.
Lisa Lindley, Dr.P.H. Associate Professor
Global and Community Health

Dr. Lindley’s research interests include sexual health promotion and the prevention of HIV/STI and unintended pregnancy among under-served populations to included adolescents/young adults, racial/ethnic and sexual minority populations.

Connie McNeely, PhD Professor of Public Policy; Co-Director, Center for Science and Technology Policy
Center for Science and Technology Policy a Center within the School of Public Policy

Dr. McNeely’s research interests in Health Systems/Policy include: comparative health systems and disparities in health care access and delivery.

Dr. McNeely also serves on the advisory board for the journal World Medical and Health Policy.

Mark Meiners , PhD Professor
Health Administration and Policy

Dr. Meiners’ research focuses on aging and health with and emphasis on financing and reimbursement issues, and financing and program development in long term care.

Among his noteworthy accomplishments is his leadership of the Robert Wood Johnson Foundation (RWJF) Medicare/Medicaid Integration Program, an initiative designed to help states develop new systems of care that better coordinate acute and long-term care. In addition he has led the RWJF Partnership for Long-Term Care, an innovative state-based long-term care insurance program, since its beginning in 1987. His path-breaking research on long-term care insurance has been a major catalyst to the current interest in this topic and his work on Medicare/Medicaid integration has helped advance chronic care improvement strategies for all aged and disabled populations.

Arnauld Nicogossian, M.D. Distinguished Research Professor; Director, Center for the Study of International Medical Policies and Practices
School of Public Policy

Dr. Nicogossian’s research specializes in bio-defense and health policy as well as Global Public Health and Preventative Medicine, Internal Medicine, Aerospace Medicine, and Strategic Planning and Execution of Research and Development.

Arnauld Nicogossian is a Distinguished Research Professor and Director of the Center for Study of International Medical Policies and Practices, at the School of Public Policy, George Mason University (SPP/GMU). He conducts research in biodefense and health policy, and teaches the concentration and certificate “Global Challenges and Threats and Medical Policy” graduate courses that he helped create for GMU. He is also the Director of Public Policy for the International Society of Microbial Resistance (ISMR). He is a member of the National American Red Cross Advisory Committee.

Todd Olmstead, PhD Assistant Professor of Public Policy
School of Public Policy

Dr. Olmstead conducts health services research and economic analysis in the field of addiction. His current research interests include: the impact of substance abuse treatment on health services utilization, estimating the elasticities of demand for illicit drugs, and the cost-effectiveness of using computer-based therapies to treat drug addiction.

In addition to his recent work in the field of addiction, Professor Olmstead has published in the areas of intelligent transportation systems, highway safety, and administrative rule-making.

Lisa Pawloski, PhD Associate Professor Chair, Nutrition and Food Studies
Department of Nutrition and Food Studies

Dr. Pawloski’s current research interests involve exploring the bio-cultural, geographic, and social determinants of obesity in transitional countries. Dr. Pawloski has most recently worked and conducted research in Nicaragua, Thailand, Chile, Iraq, and Costa Rica.

As a Fulbright Scholar in 1997, she examined the nutritional status of adolescent girls from the Segou Region in Mali, West Africa to explore factors impacting malnutrition in that region.
Cathy Tompkins, PhD Associate Professor Director, Undergraduate Social Work Program
Department of Social Work

Dr. Tompkins is particularly interested in the caregivers of older adults suffering from Alzheimer’s disease or other chronic illnesses, as well as in older adults who take on the caregiving responsibilities of their grandchildren.

This past year, Dr. Tompkins conducted a classical Glaserian Grounded Theory study developing theoretical models to explain the care giving relationship between grandparents and grandchildren residing within grandparent-headed households for her Hartford Faculty Scholars Program research project.
Lisa Vandemark, PhD. Assistant Professor
School of Nursing

Dr. Vandemark works with communities to identify the physical and social factors that influence health and well-being, especially among disadvantages groups.

Dr. Vandemark’s research is used for decision, support, and to communicate a community’s priorities to policy makers.

Janusz Wojtusiak, PhD Assistant Professor, Department of Health Administration and Policy, Director, Machine Learning and Inference Laboratory, Director, Center for Discovery Science and Health Informatics
Health Administration and Policy, Machine Learning and Inference Laboratory, and the Center for Discovery Science and Health Informatics

Dr. Wojtusiak’s research include: knowledge discovery, artificial intelligence, machine learning, decision support, and application of these areas in healthcare and health services research.

Dr. Wojtusiak performs theoretical and applied research in health informatics, using clinical, administrative and financial healthcare data, existing published studies, and expert knowledge.
Tony Yang Sc.D Assistant Professor
Health Administration and Policy

Dr. Yang’s research includes: policy issues at the intersection of the legal and public health/healthcare systems, especially quality of care, and patient safety.

Dr. Yang was selected to be an editorial board member of the Beijing Law Review, and English language law journal based in China. He’ll recommend health care law papers for publication and review submissions.