According to new information, a provision in the Affordable Care Act has helped 2.5 million young adults gain health insurance since the law took effect.

It was previously estimated that about 1 million young adults under the age of 26 were affected by President Obama’s health care reform law, but new reports suggest it was more than twice that number.

The Associated Press reports:

Under the health overhaul, children can remain on their parents’ health insurance plans until they turn 26, and families have flocked to sign up young adults making the transition to work in a challenging economic environment. But the fate of President Barack Obama’s signature domestic accomplishment remains uncertain, with the Supreme Court scheduled to hear a constitutional challenge next year, and Republican presidential candidates vowing to repeal it.

“The increase in coverage among 19- to 25-year-olds can be directly attributed to the Affordable Care Act’s new dependent coverage provision,” said a draft report from the Health and Human Services Department. “Initial gains from this policy have continued to grow as … students graduate from high school and college.” A copy of the report was obtained by The Associated Press.

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Using unpublished quarterly statistics from the government’s ongoing National Health Interview Survey, analysts in Sebelius’ policy office determined that nearly 36 percent of those age 19-25 were uninsured in the third calendar quarter of 2010, before the law’s provision took effect.

That translates to more than 10.5 million people.

By the second calendar quarter of 2011, the proportion of uninsured young adults had dropped to a little over 27 percent, or about 8 million people.

The difference — nearly 2.5 million getting coverage — can only be the result of the health care law, administration officials said, because the number covered by public programs like Medicaid went down slightly.

While most of the health care reform law does not go into effect until 2014, the provision in question went into effect last fall and most employer health insurance plans started following through with this change on Jan. 1, the AP reports.

Via The Hill:

The Department of Health and Human Services said Indiana and Louisiana do not need an adjustment from the health law’s medical loss ratio. That provision requires insurers to spend at least 80 percent of premiums on medical care or offer rebates to their customers starting next year.

HHS can grant a temporary waiver if regulators determine that the requirement looks likely to destabilize a state’s individual health insurance market.

The agency determined that the health plans of Indiana and Louisiana can meet the threshold and that consumers will get better value without an adjustment, said Gary Cohen, acting director of oversight at the HHS Center for Consumer Information and Insurance Oversight.

The federal government announced two weeks ago that Florida would not hear a decision from Health and Human Services about its own waiver of the medical loss ratio (MLR) waiver until around Dec. 16, 30 days later than originally planned.

MLRs are used to set a standard on the amount of money collected by premiums that health insurance companies must spend on actual services, as well as a limit on how much goes to administration. In this case, insurance companies in Florida will be required by federal law to spend 80 percent of the money they collect on health services and 20 percent on administration.

Florida asked the federal government for permission to phase in the MLR over three years, as opposed to meeting the requirements as soon as they kick in.

Advocacy groups such as Florida CHAIN (the Community Health Action Information Network) have asked the U.S. Department of Health and Human Services “to reject a request by Florida’s Insurance Commissioner to grant insurance companies a reprieve from new Affordable Care Act requirements intended to ensure that consumers get value for the health insurance premiums they pay.”

GOP state legislators have longed disliked federal mandates requiring companies to spend a certain amount of their premiums on services. One legislator claimed the MLR was an example of the state “commandeering” Florida’s budget.

The legislation passed the Michigan Senate — which has a supermajority of Republicans — last week. Gov. Rick Snyder, also a Republican, has called on the legislature to pass the bills by the end of the year.

The Supreme Court will hear arguments on the case brought by states — including Michigan — about the constitutionality of the law passed nearly two years ago. A ruling is expected in the summer of 2012, in the heat of the race for president.

According to a recent poll of opinion leaders in health policy and innovators in health care delivery and finance, almost 90 percent of respondents believe state lawmakers should be implementing the health care reform law.

Parts of the Commonwealth Fund/Modern Healthcare Opinion Leaders Survey results released today show that an overwhelming majority of experts would disagree with Florida’s efforts to stall and block the Affordable Care Act in the state.

According to Modern Healthcare:

A full 89 percent of respondents said it is very important or important that federal and state policymakers continue to move forward to implement the Patient Protection and Affordable Care Act, according to the final Commonwealth Fund/Modern Healthcare Opinion Leaders Survey.

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Survey respondents liked several cost-cutting proposals for Medicare and Medicaid put forth by President Barack Obama in his framework for reducing the federal budget deficit. Among them are adjusting payments to encourage efficient post-acute care, aligning Medicare and Medicaid drug payment policies, and introducing financial incentives to encourage Medicare beneficiaries to use high-value services.

Health care advocates across the state, as well as federal officials, have criticized state lawmakers for stalling the implementation of the health care reform law in the state. Advocates and residents have particularly taken issue with the state turning away millions of federal funds that would have gone to public health programs.

The state of Florida currently has one of the highest rate of uninsured residents in the country. Policymakers in the state are also leading the legal challenge against the health care reform law. It was announced today that the Supreme Court will hear the legal arguments in March 2012.

Labeling lawsuits launched against the landmark health care reform as “politically-motivated,” Harkin said in statement that he was sure the U.S. Supreme Court would find the law constitutional.

Here’s Harkin’s full statement:

“I’m pleased that the Supreme Court has decided to promptly resolve conflicting lower court decisions concerning the Affordable Care Act. These politically-motivated lawsuits are a waste of judicial resources, and an unnecessary distraction from the important work of moving ahead with implementing the health reform law.

“I am confident that the Court will uphold the Act’s constitutionality, affirming the common sense notion that, as a Republican-appointed D.C. Circuit judge wrote last week, the Constitution gives Congress the power to ‘forge national solutions to national problems.’ Virtually all Americans will use health care, whether or not they choose to purchase insurance. Thus, the Constitution gives Congress the power to make that marketplace fairer and more affordable. The Affordable Care Act does just that.

“I look forward to the Court ending this period of legal uncertainty, allowing us to focus on expanding coverage and improving health care quality for all Americans.”

Gov. Terry Branstad is among Republican officials from 26 states and a small business advocacy group that asked the U.S. Supreme Court to strike down the entire law. SCOTUS announced Monday that it would hear the case.

The U.S. Supreme Court announced today (.pdf) that it will review the constitutionality of President Obama’s health care reform law. Twenty-six states, led by Florida, challenged the law — claiming it was an over-reach of federal power.

President Barack Obama aboard Air Force One (Pic by The White House, via Flickr)

The court will hear the legal arguments in March, before the presidential election.

Bloomberg reports that “the justices today said they will consider whether Congress exceeded its authority by requiring all Americans to either acquire insurance by 2014 or pay a penalty.”

Florida has argued that the alleged unconstitutionality of the individual mandate is grounds for striking the bill in its entirety.

However, as the Los Angeles Times reports, this argument has not been upheld by lower courts:

Only three of the 12 appellate judges who have reviewed the law have decided it is unconstitutional to require all Americans to have health insurance. Not a single appeals court judge has said the entire law must be tossed out, the position advocated by Florida and 25 other Republican states leading the legal assault.

While the legal battle has loomed, Florida legislators have actively stopped or impeded the implementation of the health care reform law in the state as much as they have been able to. Florida is currently one of the only states without any plans to start a state exchange as is required by law. Florida also has one of the highest rates of uninsured residents in the country.

President Barack Obama aboard Air Force One (Pic by The White House, via Flickr)

North Dakota is on its way to becoming the first state in the country to have an operating health insurance exchange program. Each state is required by the Affordable Care Act to have some infrastructure in place by January 2013 for an exchange. Florida remains one of the lone states dragging its feet.

The Grand Forks Herald reports that North Dakota is on track to pass legislation that would set up its state exchange.

According to the Herald:

House Bill 1474, drafted by the Health Care Reform Review Committee after the regular legislative session ended this spring, would create a North Dakota health insurance benefit exchange system.

Under the federal legislation, all states must have an operational health benefit exchange by Jan. 1, 2014 or the secretary of Health and Human Services must create one.

Pam Sharp, director of the North Dakota Office of Management and Budget, said the key component of the exchange would be a new website that would allow residents to compare costs and benefits of affordable health insurance plans.

The Center on Budget and Policy Priorities released a report (.pdf) that said as of “August 17, 2011, 39 states and the District of Columbia have introduced some form of legislation promoting exchange implementation.”

“Among the 34 states where the legislation would fully establish a state exchange program, ten states enacted such bills into law,” the group reports.

Only 11 states, Florida among them, have not introduced any legislation to establish a state exchange program.

Florida is among only five states not using federal grants meant to help the state plan and research for an exchange. The Center on Budget and Policy Priorities says that “Florida, Kansas, Louisiana, New Hampshire and Oklahoma reportedly will return exchange grant funds.”

This week, health advocates touring the state warned that Florida had done “virtually nothing” to follow the law’s mandates. The groups also warned that the state would cede their authority to the federal government if the state did not meet the deadlines.

The Associated Press reports:

Some doctors, crisis pregnancy centers and women who say they’ve had abortions want to help defend a new North Carolina law that would set more ultrasound requirements before an abortion.

The potential defendants filed a motion Tuesday in Greensboro federal court with the help of legal groups opposed to abortion. They want to intervene in the case to present evidence on why the law should be enforced in its entirety.

Last month, U.S. District Judge Catherine Eagles put implementation of the law on hold “until she can hear more arguments.” The American Civil Liberties Union, the ACLU of North Carolina Legal Foundation, Planned Parenthood Health Systems, Planned Parenthood of Central North Carolina and the Center for Reproductive Rights filed a lawsuit against the state in October alleging that “the new law violates the rights of health care providers and women seeking abortions.”

This week, anti-abortion groups Jubilee Campaign’s Law of Life Project and the Alliance Defense Fund have filed a motion to intervene in the ruling to defend the law.

Crisis pregnancy centers have been created to attract women facing an unplanned or unwanted pregnancy in order to convince them to keep the pregnancy. NARAL Pro-Choice North Carolina recently released an undercover investigation into crisis pregnancy centers. The report said the centers were “a threat to public health.“

The news signals the state has cleared one of the two major hurdles it has faced in expanding its Medicaid privatization plans statewide.

According to the Current:

The lone obstacle between the state and federal government in Medicaid 1115 waiver negotiations appears to have been settled as state officials announced on Tuesday that Florida will continue to receive $1 billion to fund health care for the poor, uninsured and underinsured.

Medicaid Deputy Director of Finance Phil Williams told a hospital panel on Tuesday that the state will continue to receive $1 billion in Low Income Pool money for three years. But the news wasn’t all good as Williams discussed with the hospital-dominated board some of the new reporting requirements and benchmarks for primary-care funding.

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The Medicaid 1115 waiver makes possible a mandatory managed-care program in five Florida counties. But Florida has been negotiating to extend the program for more than a year. The fate of the low income pool has been one of the bigger stumbling blocks.

The waiver is important because to launch its new statewide mandatory Medicaid managed-care program the state needs the waiver. Because the existing five-county pilot program and the new statewide program are not identical, the 1115 waiver will need to be amended. Florida already has sent the amendments to the federal government to consider even though the underlying waiver still is pending.

The federal government has also expressed concerns over an absent medical loss ratio in Florida’s Medicaid Reform Pilot. The Centers for Medicare and Medicaid Services have asked for a medical loss ratio in the state’s plans to expand the pilots statewide. This “85/15″ requirement mandates that providers spend 85 percent on services and 15 percent on administration. The standard is one of the provisions in the federal health care reform law setting new rules for state Medicaid plans. The federal government plans to fund the expansion of state Medicaid plans to include more people who are currently uninsured.

When this issue came up a couple years ago, Gregg Mellowe of the Florida Center for Fiscal and Economic Policy said medical loss ratio rules were a good way to provide accountability, WFSU reported:

There have been concerns over the lack of accountability in the pilot project throughout its five years. And the concerns that they’ve had have not been resolved. I think that’s universally recognized. [The federal Centers for Medicare and Medicaid Services] has said look, you’re getting a waiver, all these federal rules relaxed, so in exchange for that we need some basic assurance that the power given to managed care plans is not going to be abused.

A.M. Best Company reports that “Florida wants to continue existing state MLR rules that enforce a 65 percent standard for health insurers and 70 percent for health maintenance organizations until 2014.”

Florida CHAIN (Community Health Action Information Network), a patient advocacy group, recently asked the feds to not grant insurance companies in Florida exemption from profit caps mandated by federal law. In a letter, the group asked the U.S. Department of Health and Human Services “to reject a request by Florida’s Insurance Commissioner to grant insurance companies a reprieve from new Affordable Care Act requirements intended to ensure that consumers get value for the health insurance premiums they pay.”

“The comment period for Florida’s application expired Oct. 27. CMS is due to make a determination within 30 days, a period regulations allow U.S. Health and Human Services Secretary Kathleen Sebelius to extend by up to another 30 days,” Best Company reports.

A spokesperson for the Florida Department of Health tells The Florida Independent that budget authority was denied for a competitive grant “awarded to Florida beginning October 2010 for $175,000 yearly.”

The DP10-1017 “Demonstrating the Capacity of Comprehensive Cancer Control Programs to Implement Policy and Environmental Cancer Control Interventions” grant was a “five-year grant built on strengths of existing statewide Cancer Control and Research Advisory Council (C-CRAB) working with four regional cancer collaboratives to reduce the burden of cancer,” according to the Department of Health. The grant did not require any contributions from the state.

The grant was just one of many that has been rejected by the state. This week, health advocates in Broward County expressed their frustration with the millions of dollars Florida has turned away since the passage of the federal health care reform law.

According to a recent report by the American Cancer Society Cancer Action Network, Florida is among many states that have “missed opportunities to enact laws and policies that could not only save money and generate revenue, but also save lives.” In the report, Florida was listed as one of the seven states that fell short in all “five priority areas.” Alabama, Idaho, Mississippi, Oklahoma, South Carolina and Tennessee are the other states that are also falling short in every category.

Two of the priority areas the report focused on had to do with the funding of prevention and detection programs in the state.

According to a Department of Health spokesperson, the state’s joint advisory councils had recently “completed the revised 2010 Florida Cancer Plan and developed an accompanying Implementation Guide.” The plans would have built “on the cancer councils’ combined agenda of identified priorities” and the rejected grant would have “accelerated prevention and risk reduction policies and efforts.”

The department says the plans for the grant included:

• Assisting Moffitt Cancer Center to convene the four goal committees to implement strategies for cancer control.
• Assessing and implement initiatives to reduce tobacco use statewide.
• Promoting national food guidelines and other measures to reduce obesity in school aged populations.
• Developing and support community health workers to improve access to care for underserved populations.
• Creating a forum to enhance the continuum of care for cancer patients through improved medical record keeping including electronic medical systems.

The Department of Health spokesperson tells the Independent that “the work of these initiatives is being continued by other programs in the Bureau of Chronic Disease Prevention and Health Promotion, but in a smaller scope.”