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CHLPI - Health Care Reform

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[Photo credit: Patient Care Technician]This guide is intended to support the students and staff of the Center for Health Law & Policy Innovation at Harvard Law School as they research and report on health care reform initiatives at both state and federal levels.  Given the promised repeal of the Affordable Care Act, in whole or in part, it will be important to track both formal and informal proposals.  

This guide begins first with current awareness and tracking tools that will enable users to research policy changes and proposals even before they enter the regulatory or legislative channels, as well as guidance materials that may not be codified in official sources.

Additionally, this guide will help users follow regulations from proposal, to comment period, and into final form.  There are several different sites that provide the same information about proposed regulations, and it can be difficult to follow the regulatory path.  This guide attempts to "zero in" on the most useful sites for tracking regulations related to the implementation of health care payment and access models.

Lastly, this guide provides guidance for legislative tracking, including legislative history, to provide access to contextual materials, such as hearing transcripts and floor debates, for legislative action on health care reform.

You may find additional information, including more substantive legal research strategy and a broader range of sources in these additional guides: 

Current Awareness & Tracking

There are many tools available for tracking health care reform proposals, especially at the Federal level.  In most cases you can set up individual alerts for areas of interest or specific search terms.

PoliticoPro LogoPoliticoPro provides subject-based issue and policy tracking tools in multiple areas including Health Care.  It also prepares issue pages for major policy areas with news updates, calendar function, whiteboard updates, charts and graphs, glossaries, and other useful information all in easy to navigate practice centers. PoliticoPro content relies on policy experts in the field, writing in real time. The site also stores all primary source documents in a "document drawer" for easy access.

 

LegiStorm Logo


LegiStorm offers several current awareness tools to help you stay informed.  They are all listed under the "News and Reports" tab.  The In The News section curates news from Capitol Hill.  The StormFeed function provides updates from press releases, twitter accounts from members of congress, and relevant trending hashtags.  To request a personal account, which will enable you to set up alerts, contact the librarians at the Harvard Kennedy School of Government

LegiStorm has a feature called Lightning Alerts which allows you to set up regular alerts for a search.  Once you craft your search you can save it and receive regular updates by email daily, weekly, or monthly, if new results appear.  You can manage your alerts on your profile page.

Screencap of the LegiStorm StormFeed page which allows users to add Lightning Alerts.  It provides fields for searching text, time period, branch of government, congressional house, party affiliation, committee, leadership office, and state.

BNA publications cover a wide range of legal and business topics and include news and analysis as well as access to relevant laws, regulations, cases and other materials. Use Bloomberg Law's Health Practice Center to search all or selected BNA publications related to health care. You can register for email updates to keep current with a BNA publication.

Publications include the Health Care Daily Report, Health Care Policy Report, Health Insurance Report, Health Law Resource Center, Health Law Reporter, and Federal and State Health Care Regulatory Alerts.

 

Cheetah provides access to Wolters Kluwer business and finance, health and medical, and federal, state and international tax law publications and products.

The Health Care library includes several Daily Documents and Newsletters, as well as CMS manuals and guidance, and State Health Care information.  In the older Wolters Kluwer platform - IntelliConnect - Click on Tracker News to receive e-mail trackers including the Healthcare Compliance Tracker, State Health Laws, Regulations & Manuals, and Medicare/Medicaid Tracker, which can each be tailored by topic, document type, and keyword.

Regulatory Research

The regulatory process can be complex and difficult to follow, especially in the field of health care where multiple agencies can be involved in promulgating regulations. This visual overview can be helpful, but may be overwhelming for those unfamiliar with regulatory affairs:

As a general rule, it is easier start with a particular regulation by number or agency by name before diving in to search by topics or keywords. Secondary sources such as current awareness/news sources, scholarly articles, or advocacy communications are extremely helpful in getting started.  

There are multiple websites, all published by different departments within the U.S. Government, where you can find information about proposed regulations and track them through the regulatory process.  

FederalRegister.gov is managed by the Office of the Federal Register and the U.S. Government Printing Office with the goal of making it easier to understand the regulatory process and the broader context surrounding rulemaking.  Each day Federal agencies publish documents in the Federal Register, including proposed rules, final rules, public notices, and Presidential actions. The print-based, official format of the Federal Register displays information in a dense format (3-column PDF). This unofficial, HTML (XML-based) format demonstrates how an alternate format can effectively convey regulatory information to the public.The site connects the same material printed in the federal register with related material from the Code of Federal Regulations and the US Code. 

By setting up an account, you can subscribe to the results of any search, to public inspection documents, via any agency page, and on many other pages of FederalRegister.gov. Look for the envelope icon with the words 'Subscribe' (on the right hand side of many pages) to get started.

Regulations.gov was established as the public facing website for the eRulemaking Program, and allows users to search regulatory materials, submit comments, and sign up for email alerts.  In the past, if members of the public were interested in commenting on a regulation, they would need to know the sponsoring agency, when it would be published, review it in a reading room, and then adhere to the comment process specific to each agency. Regulations.gov removed the logistical barriers that made it difficult for a citizen to participate in the complex regulatory process. Some agencies still require that comments be submitted through their own individual platforms, but this site serves as a clearinghouse for the majority of publicly available material.

Reginfo.gov is produced by the Office of Management and Budget (OMB) and the General Services Administration (GSA).  OMB's Office of Information and Regulatory Affairs (OIRA) is responsible for reviewing Federal regulations and information collections.  The site provides reliable, transparent information about regulations under development to enable the public to participate effectively in the regulatory process.

​OIRA recently released a mobile app that includes many of the helpful tools available on Reginfo.gov in a mobile format, as well as the ability to subscribe to updates about a particular regulation via the RIN number. The app is available for download from the Apple Store or Google Play Store.

Legislative Research

While much of the legislative process is exposed through current awareness tools like Politico and LegiStorm, it is important to connect back to official legislative sources when conducting research.  ProQuest Congressional is a great source for legislative material including committee materials (hearings, prints, reports), Congressional Research Service publications, House and Senate publications, legislative materials, and news from Congressional Quarterly.

In many cases, the best place to look for information about legislation that has already passed is to consult a compiled legislative history.  There are many sources of legislative histories - you can visit this guide for more information - but in many cases you can turn from ProQuest Congressional right into ProQuest Legislative Insight.  For either platform it is best to search by number to take you directly into the primary source.

Legislative Insight includes a complete Legislative History of the Affordable Care Act, and by linking over to ProQuest Regulatory Insight, you can also see all of the regulations that have been promulgated as a result of the ACA. 

Advocacy Organizations

The Kaiser Family Foundation is a non-profit organization focusing on national health issues, providing policy analysis, journalism, and communication for the general public.  Kaiser Health News includes a morning briefing and updates via email or RSS feed as well as an active social media presence.  Their most recent posts are included here:

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Of special interest is Kaiser's Repeal & Replace Watch, which tracks President Trump's plans to revamp America's health care system. Readers can follow via the Kaiser siteTwitter (@Repeal_Replace) and Facebook.

Families USA is a consumer advocacy group that focuses on Health Care.  You can subscribe to their research publications, blogs, press releases via email or RSS feed.  The most recent posts are included here:

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Community Catalyst is a non-profit dedicated to consumer health advocacy, working in 40 states across the country.  Their Dual Agenda Newsletter includes state highlights on health care reform, and their ACA Implementation Fund has partnered with state-based advocacy groups to tackle issues related to the implementation of health care reform at the state level, including the impact of potential repeal.  Their Health Policy Hub Blog allows for email subscription as well. The latest posts from their feed are included below: 

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The Center for Medicare Advocacy is a national nonprofit, nonpartisan law organization that provides education, advocacy, and legal assistance to help people obtain fair access to Medicare.  In addition to their policy blog and podcast, you can sign up for CMA Alerts via email.  The latest alerts are included below:

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