This Week in Health Care Reform: March 14, 2012   Final rules are released regarding the implementation of exchanges, while a Medicare payment board moves closer to being repealed, and the road to the GOP nomination goes through the south. We encourage you to stay involved with the implementation efforts surrounding health care reform by voicing your perspective to Members of Congress and by visiting the Health Action Network. Polling Still Unpopular: It’s been nearly two years since the Affordable Care Act (ACA) was passed, but time has done little to soften public perception of the sweeping health care reform law.  After its initial passage, 39 percent of Americans polled supported the ACA, while 50 percent opposed it.  The latest AP-GfK poll found that 47 percent of those surveyed now oppose the law, while just 35 percent support it.  Additionally, just three in ten respondents say they understand the law with just as many saying they don’t Time Capsule: Similarly, on the eve of the ACA’s two-year anniversary, it appears that public opinion is pretty much where it was when the law was first passed in 2010, at least according to the latest Kaiser Health Tracking Poll.  Today, 41 percent of Americans hold a favorable view of the law, compared to the 40 percent who are opposed to it – remarkably in line with the 46 percent for it and 40 percent against back in 2010.  Ahead of the challenge to the ACA before the Supreme Court, 51 percent believe the individual mandate to be unconstitutional, with a similar percentage (53 percent) expecting the justices to rule it as such. Health Care Reform Sticker Shock: According to the new Congressional Budget Office (CBO) projections released yesterday, the full cost of the ACA through 2022 is pegged at $1.76 trillion.  While weaker economic projections contributed to the higher gross costs, the newly revised numbers are still considerably more than the $940 billion price tag originally advertised. Exchange Rules Released: As expected, the Department of Health and Human Services (HHS) released their final rules on health insurance exchanges this week.  Spanning more than 600 pages, the regulations have already been met with support from various stakeholder groups for allowing, amongst other things, broader flexibility to the states in designing and implementing their exchanges, a necessity, as many have struggled to establish the mandated marketplaces ahead of next year’s 2013 deadline. Broker Accommodations: Also embedded in the final exchange rules, allowances for brokers to direct consumers to the newly-created state health exchange marketplace.  Specifically, fee determinations and compensation structures for brokers and agents directing business to the exchanges would be left up to the states. IPAB Repeal Moving Along: Following on the heels of their colleagues in the Energy & Commerce Committee, members of the Ways & Means Committee last week voted to repeal the Independent Payment Advisory Board (IPAB), the panel tasked with finding cost savings in Medicare.  Surprisingly, the repeal effort has enjoyed bipartisan support, with 19 Democrats co-sponsoring the bill.  That comity may prove to be short-lived, however, as House Republicans have put forth a medical malpractice reform measure to cover the projected $3 billion cost of doing away with the IPAB, threatening to undo any support from across the aisle. Supreme Court Update Roundup: Ahead of this month’s oral arguments, opinions and analysis on key issues in the challenge to the ACA before the Supreme Court continue to proliferate. GOTV Southern Exposure: Coming off his win in Kansas last Saturday, Rick Santorum swept through yesterday’s southern primaries, notching wins in both Alabama and Mississippi.  However, despite the former Pennsylvania Senator’s newfound momentum, Mitt Romney still leads the overall delegate count after picking up wins in Wyoming and the Virgin Islands over the weekend, in addition to his victory in Hawaii last night.  The machinery now moves on to Saturday’s caucus in Missouri, before heading into next Tuesday’s Illinois primary. Congressional Attrition: Last week, Rep. Jay Inslee (D-Washington) announced his resignation from Congress to focus on his gubernatorial campaign.  The 8-term Congressman adds his name to the growing list of members not running for re-election in the fall. Looking Ahead Efforts to offset IPAB repeal costs through malpractice reforms threaten to undermine bipartisan support, while Supreme Court oral arguments are less than a fortnight away, and the GOP presidential nomination process sets its sights on the Show-Me-State, kind of. See something you’d like covered in the next newsletter?  Let us know.     Click here to unsubscribe.