por Loren Bonner
, DOTmed News Online Editor | October 03, 2013
Although one of the major components of President Obama's health care law went into effect on Oct. 1, another central part of the law is still on the table.
The controversial medical device tax took center stage in the budget debate that was supposed to fund the government through the next fiscal year. The republican led House insisted that the tax be repealed and the Affordable Care Act be delayed one year as part of the deal to keep federal agencies open. But Senate democrats did not budge.
Going forward, there might be bigger picture policy issues concerning the Affordable Care Act that democrats will prioritize in coming to any resolution, which means the medical device tax could very well be up for negotiation.
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"I don't know if anyone is particularly wedded to the device tax. Politically they could get the votes to overturn it or repeal it," Caroline Pearson, vice president of the health care consulting firm Avalere Health, told DOTmed News.
On CNN Tuesday, Illinois Senator Dick Durbin implied that democrats would be willing to negotiate on the device tax in order to end the government shutdown.
The medical device tax
was included in the Affordable Care Act to help raise roughly $30 billion over 10 years to offset the cost of reform. If it were repealed, republicans would have to come up with revenue streams to make up for it.
Meanwhile, the health insurance marketplace opened for business as expected on Tuesday. Consumers who are not eligible for Medicaid or who are not covered by their employers will likely find coverage through their state-based exchange, or the federal marketplace that's operating the exchange for 34 states. The Department of Health and Human Services reported 4.7 million visitors to the federal site in the first 24 hours. But according to many reports, shoppers experienced technical glitches including error messages coupled with long wait times.
"I think they are still having some pretty significant challenges, particularly the federal site — it's completely crippled and experiencing high volume," said Pearson. "I'm not convinced it's working at all."
She said her team has not been able to get past the 'creating an account' phase. However, she noted that many of the state marketplaces — including California, Kentucky, Connecticut, and Colorado — were doing better on Wednesday than they were on Tuesday.
While several federal agencies have furloughed employees while Congress tries to work out a budget plan, HHS said the Centers for Medicare and Medicaid Services would "continue large portions of the Affordable Care Act activities, including coordination between Medicaid and the Marketplace, as well as insurance rate reviews, and assessment of a portion of insurance premiums that are used on medical services." It said the Medicare program would also continue despite disruption during this lapse in appropriations.
Over the past several days, President Obama has said repeatedly that he would not agree to delay or repeal the Affordable Care Act to keep the government funded.
In the meantime, Congress is working to pass measures that would fund certain parts of the government, like veterans benefits, that are not operating during the shutdown.