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Health Care Bill Passes With Sunshine Provisions
Volume 697
March 23, 2010

After extensive floor debate and committee compromises in Congress, President Obama has now signed a sweeping health care reform bill that will affect every American, from the uninsured to the wealthy business owner. Besides eventually offering nearly universal health care, providing subsidies to certain families and awarding tax credits to small businesses, the bill includes provisions requiring drug and device companies to publicly report payments they make to doctors. A companion bill, which is likely to be passed in the U.S. Senate, will force the public reporting of any payment or gift given to a doctor that is $5 or greater in value.

The provisions, originally part of the highly controversial Physician Payments Sunshine Act, would take effect in 2011. It appears the current $5 per payment threshold will trump earlier proposals that instead required reporting after a $100 aggregate was reached. The Reconciliation Act, the official name of the companion bill, contains only limited preemption from local action, meaning states may impose additional requirements as well.

While the entirety of the legislation won’t be felt for another four years, many of the nation’s 30 million small business owners will have difficult choices to make. For example, by 2014, employers who have more than 50 workers must offer health insurance benefits or pay penalties, possibly prompting some to cut staff. Business owners will have the opportunity, though, to take part in state-run insurance exchange pools, which could make coverage costs more manageable. In addition, companies with 25 or fewer employees who meet certain wage requirements will be able to earn credits toward health insurance purchases. However, opponents of the legislation argue any credits will be countered by higher premiums, as insurance providers try to make as much money as possible before 2014.

Because the bill would require cash-strapped states to help pay for expanded services, like Medicaid, a joint lawsuit that may even reach the U.S. Supreme Court is expected to be filed at any time. So far, attorney generals in 10 states, including Florida, Pennsylvania and Texas, have announced they will join the suit, which will challenge the constitutionality of the legislation. Opponents believe health care reform that mandates citizens to buy insurance violates the 10th Amendment. 

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