Progress, obstacles and lawsuits affecting health law implementation

Roadblocks confront federal officials implementing parts of the health law including insurance exchanges, a free contraception coverage rule and the board designed to slow Medicare spending growth.

CQ HealthBeat: On Exchanges: CMS Official Sees Progress On State Marketplaces But Final Tally Yet To Come
A Centers for Medicare and Medicaid Services bureaucrat painted a bright picture of brisk action and state-federal cooperation on state exchange implementation at an insurers' meeting on Friday. But an exchange official from Arkansas ... outlined the reality and complications on the ground. In Arkansas, even with a Democratic governor and Democratic legislature, a state-federal partnership will be the most that state officials will be able to muster prior to federal deadlines, given the vocal Republican minority opposed to any exchanges. States face a Nov. 16 deadline for submitting a blueprint application to the Department of Health and Human Services (Norman, 10/5).

CQ HealthBeat: Battle Over Contraception Rule Continues In Appeals Court
The Becket Fund for Religious Liberty on Friday filed an appeal in federal court of a decision dismissing two lawsuits that challenged a federal rule on contraception. Lawyers for the fund said it's the first time the fight over the Department of Health and Human Services birth control coverage requirement has made its way into a federal appeals court. More than 30 suits are pending in federal courts (Norman, 10/5).

The Hill: Obstacles For Obama's Health Panel
Obama and Mitt Romney spent a lot of time during Wednesday's debate talking about the Independent Payment Advisory Board (IPAB), ... Obama described it as a panel of experts leveraging Medicare's purchasing power to bring down health care costs, while Romney cast it as a band of faceless bureaucrats whose decisions will ultimately undermine seniors' access to care. Health policy experts say the IPAB won't turn out to be as sinister as Romney described it, but it also might not be as effective as Obama envisions. In fact, it could be a struggle to even get the board up and running (Baker, 10/6).

Already, a study says that a major part of the health law -- accountable care organizations -- saved little money when applied to providers caring for patients with one health condition -- diabetes:

Medpage Today: Study: No Health Care Savings With ACOs
Accountable care organizations (ACOs) that improved diabetes outcomes by as much as 10 percent achieved minimal or no cost savings, results of a published simulation showed. The simulation found that a 10 percent clinical improvement would create just 1.22 percent in savings for Parts A and B -- well below the level needed to trigger savings sharing, results published online in Health Affairs showed. ... the savings must exceed 2 percent in a given year (Pittman, 10/7).