Las Vegas Sun, By Steve Green -

January 23, 2012: Catholic Healthcare West, a big hospital operator in Southern Nevada and the fifth-largest health system in the nation, announced Monday it had changed its name to Dignity Health.

Dignity Health in the Las Vegas and Henderson areas owns the St. Rose Dominican Hospitals system, including the Rose de Lima, Siena and San Martin campuses. Those facilities opened in 1947, 2000 and 2006, respectively.

San Francisco-based Dignity Health said it adopted the new name as part of a governance restructuring in which it will be a not-for-profit organization, rooted in the Catholic tradition.

But it will not be an official ministry of the Catholic Church, a major change.

The system was founded in 1986 when two congregations of the Sisters of Mercy merged their 10 hospitals. In 1988, the Adrian Dominican Sisters joined the system with their St. Rose Dominican Hospital in Henderson — now called the Rose de Lima campus — and Dominican Hospital in Santa Cruz, Calif.

"The new structure and name enable the organization to grow nationally, while preserving the identity and integrity of both its Catholic and non-Catholic hospitals," the company said in a statement.

Dignity Health operates 25 Catholic hospitals and 15 non-Catholic hospitals in California, Nevada and Arizona and it said the restructuring will position the group to grow through partnerships involving both Catholic and non-Catholic organizations.

In the Las Vegas area, the St. Rose hospitals said in a statement Monday: "Our mission, vision and values remain the same, as does our commitment to providing the Henderson and Las Vegas communities with excellent care."

The statement also said: "These changes will have no impact on the operations, policies, or mission of St. Rose Dominican Hospitals. We will remain a Catholic hospital, sponsored by the Adrian Dominican Sisters, following the 'Ethical and Religious Directives for Catholic Health Care Services,' and committed to the overall health of the communities we are so privileged to serve."

Dignity Health said that while its Catholic hospitals would continue to operate under the Catholic Health Care Services religious directives, its non-Catholic hospitals would continue to be non-Catholic and would adhere to a "statement of common values. "

Kaiser Health News, By Phil Galewitz -

January 18, 2012: Half the states last year made it easier for children and their parents to enroll in Medicaid by streamlining enrollment and using technology advances to verify citizenship requirements, according to a report released Wednesday.

Medicaid is the state-federal health insurance program for the poor and disabled that covers about 60 million Americans. Starting in 2014, an additional 16 million Americans will become eligible for Medicaid as a result of the 2010 federal health overhaul.

The survey by the Kaiser Family Foundation¡¯s Commission on Medicaid and the Uninsured also found that eight states expanded eligibility rules so more children would qualify for Medicaid or the Children¡¯s Health Insurance Program, CHIP (KHN is an editorially-independent program of the foundation). Three of the states¡ªIllinois, Texas and Vermont¨C began covering lawfully residing immigrant children without first having them wait five years. CHIP helps more than 5 million children from low-income families whose incomes make them ineligible for Medicaid.

¡°States have made significant strides in covering children, but coverage options for low income adults remain limited,¡± said Samantha Artiga, co-author of the report and associate director of the commission. Only 18 states provide full Medicaid benefits to parents with incomes at or above the federal poverty level, $18,530 for a family of three, the report said.

The annual 50©\state survey of Medicaid programs, conducted with the Georgetown University Center for Children and Families, found only two states reduced eligibility for Medicaid and CHIP. Arizona, which froze enrollment in its CHIP program in 2009, before the health law passed, continued the freeze; 129,000 children are on a waiting list for coverage. Last year, the state also froze enrollment in a temporary Medicaid program for adults without dependent children. Nevada ended a Medicaid expansion program that helped several hundred pregnant women and parents of children on Medicaid.

The federal health law prohibits states from cutting Medicaid and CHIP eligibility. Nevada¡¯s cut was allowed because it was only a temporary program.

Among the ways states made it easier to sign up for Medicaid were using clients¡¯ Social Security information to verify citizenship, enhancing online application tools and eliminating a face-to-face interview requirement, the survey found. Several states also began enrolling children in CHIP based on their eligibility for other government assistance programs such as food stamps.

Federal bonus payments helped spur states to simplify Medicaid enrollment and renewal. Last year, the federal government paid $300 million to 23 states.

The Las Vegas Sun, By Karoun Demirjian -

January 18, 2012:The White House released a progress report on the state of health insurance exchanges across the country today, highlighting Nevada as one of 10 states on the road to establishing a standardized system of providing health care.

Health care exchanges, which states are required to implement under the new health care law, have been a flashpoint on the campaign trail for the last several months. They are at the heart of the Republican complaint that the government is trying to impose its will over the health care marketplace, and at the center of the lawsuit that will come before the Supreme Court on the health care bill this spring.

Nonetheless, 28 states -- including Nevada -- are already “on their way toward establishing their own Affordable Insurance Exchange,” according to the government report.

Last spring, Nevada received a partial, temporary waiver for implementing certain exchange requirements of the health care law. But the state’s still moving ahead toward the original 2014 deadline to establish the basic insurance exchange.

The state Legislature adopted a bill to set up the Silver State Health Insurance Exchange last June, a seven-member board was appointed in September, and Jon Hager, former CFO of the state public employee benefits plan, stepped in as executive director in December.

Nevada received a $4 million establishment grant from the federal government last summer to assist with the set-up and planning of the operation.

That Nevada was profiled is not any sort of endorsement by the Obama administration of its efforts thus far as a national model; the White House pointed out in the report that they only “illustrate the diversity of approaches and progress being made.”

The first major task of the appointed chairman and board will be to select a minimum, benchmark standard against which health plans participating in the system will be compared, and around which the exchange will function. In December, the federal Department of Health and Human services outlined the proposed guidelines for setting such a benchmark, from which states are allowed to pick a governing standard:

• one of the three largest small-group plans in the state

• one of the three largest state employee health plans

• one of the three largest federal employee health plan options

• the largest HMO plan offered in the state’s commercial market.

Nevada has not yet made any decisions on that front.

The Hill, By Julian Pecquet -

January 22, 2012: President Obama, who offered to work with Republicans last year to revamp the healthcare reform law, is expected to adopt a much different tone in Tuesday’s State of the Union address.

Bruised from the huge GOP electoral gains in 2010, Obama said he wanted to work in a bipartisan fashion on healthcare in last year’s speech. Republicans scoffed at what was called an olive branch, and worked to repeal the entire law. While the GOP-led House passed such a measure, the legislation was defeated in the Democratic-controlled Senate.

The battle lines this year are even more sharply drawn ahead of the Supreme Court’s ruling on the law’s constitutionality, which is expected months before the election. Both sides are dug in, hoping the high court’s ruling will give them momentum this fall.

It is unclear how much Obama will address healthcare reform in what Republicans hope will be his last State of the Union. Polls show that the health law is unpopular, and Democrats have acknowledged that the GOP has beat them on the intense message war over the merits of the reforms enacted in 2010.

A year ago, Obama used humor to broach the sensitive topic that helped Republicans win back the House.

“I have heard rumors that a few of you still have concerns about our new healthcare law,” the president told Congress last year, a line that attracted bipartisan laughs. “So let me be the first to say that anything can be improved. If you have ideas about how to improve this law by making care better or more affordable, I am eager to work with you."

Rep. Michael Burgess (R-Texas), a member of the powerful Energy and Commerce Committee, says he remembers the speech like it was yesterday. When the president called for action on medical malpractice reform, he said, he grabbed his neighbor, Rep. Al Green (D-Texas), to join him in standing applause.

“I fired off a letter the next day,” Burgess said Friday. “I'm still waiting for an answer.”

Democrats, meanwhile, point to some bipartisan actions.

After several aborted attempts, Congress in 2011 finally repealed the law’s so-called “1099” tax reporting requirement. And the two parties got together to tighten the eligibility standards for people to qualify for the law’s massive Medicaid expansion in 2014.

The White House at the time said it “look[ed] forward to working with the House to ensure the bill achieves the intended result.”

Beyond that, though, the two parties mostly fired shots at each other.
House Republicans in their first major legislative action of the year unanimously voted to repeal the law in its entirety, defying an Obama veto threat. The legislation subsequently died in the upper chamber.

For the most part, congressional Democrats have stayed united in their defense of the law’s long-term CLASS Act even though the administration will not implement, claiming it is unworkable.

The White House is opposed to repealing the provision, a position Burgess points to as proof that Obama wasn’t serious when he offered to improve the law.

“Just the presence of the CLASS Act harms the overall legislation,” he said. “If [Democrats] were really serious about [working with us], they wouldn’t be fighting against the CLASS Act repeal.”

He said he didn't expect any further bipartisan fixes to the law in 2012.
“It's almost impossible to get the Senate to consider anything the House does,” he said.

Yet, House Republicans plan on using the CLASS Act as an election-year weapon. The CLASS repeal measure, and another bill that would eradicate a controversial payment advisory board stipulated in healthcare reform, are expected to pass the House this year.

An administration official declined to discuss the contents of Obama’s speech on Tuesday, but said, “We’ve worked diligently to implement the Affordable Care Act and we’re making incredible progress. Thanks to the new law, 2.5 million more young adults have health insurance, millions of seniors have cheaper prescription drugs and we’ve ended the worst insurance company abuses….We always welcome good ideas from anyone about how to make health care better and more affordable.”

PR Newswire -

January 19, 2012: The S&P Healthcare Economic Composite Index indicates that the average per capita cost of healthcare services covered by commercial insurance and Medicare programs increased by 5.13% over the 12-months ending November 2011. This is a decline from the +5.29% annual growth rate posted for October 2011.

As measured by the S&P Healthcare Economic Commercial Index, healthcare costs covered by commercial insurance plans increased by 6.96% over the year ending November 2011, down from the +7.10% reported for October. Growth rates in Medicare claim costs rose by 2.37%, as measured by the S&P Healthcare Economic Medicare Index, down from the 2.55% reported for October. The S&P Healthcare Economic Professional Services Medicare Index also dropped from +4.15% in the year ending October 2011 to +3.62% in November. The S&P Healthcare Economic Hospital Medicare Index increased slightly to +1.33% in November from its +1.28% October value.

The Hospital and Professional Services Indices annual growth rates also posted decreases from their October 2011 rates; they increased 5.05% and 4.97%, respectively, from their November 2010 levels. These are below the +5.14% and +5.21% respective annual rates posted in October 2011.

"After seeing a few months of increasing annual growth rates, particularly across commercial insurance plans, November's data presented us with some moderation in health care costs," says David M. Blitzer, Chairman of the Index Committee at S&P Indices. "In November, the Composite Index posted an annual rate of +5.13%, the Commercial Index +6.96% and the Medicare Index +2.37%. All three were down from October's annual growth rates.

"November's moderation in healthcare costs was more attributable to Professional Service practices than to Hospitals. The Professional Services Index's annual rate of change fell from +5.21% in October to +4.97% in November. Looking more closely at the Professional Services Indices, you can see that most of the change was driven by further declines in growth rates in costs covered by Medicare insurance plans, which has been the trend over the past year.

"With the exception of the Hospital Medicare Index, all the Indices saw decreases in their annual growth rates in November 2011. The highest decrease, 0.53 percentage points, was in the Professional Services Medicare Index. The only increase, 0.05 percentage points, was in the Hospital Medicare Index. As we near the end of 2011, the main characteristic in healthcare costs was a trend toward increasing annual rates in the latter half of the year, after a prior 12 month's general trend of deceleration. This was particularly true for costs covered by commercial plans; whereas costs covered by Medicare have been averaging about 2.5% over those same 18 months."

The S&P Healthcare Economic Indices estimate the per capita change in revenues accrued each month by hospital and professional services facilities for services provided to patients covered under traditional Medicare and commercial health insurance programs in the U.S. The annual growth rates are determined by calculating a percent change of the 12-month moving averages of the monthly index levels versus the same month of the prior year.

The S&P Healthcare Economic Composite Index is a weighted average of the S&P Healthcare Economic Commercial Index and the S&P Healthcare Economic Medicare Index. Alternatively, it is a weighted average of the S&P Healthcare Economic Hospital Index and the S&P Healthcare Economic Professional Services Index, as each of these indices has the analogous Commercial and Medicare component.

The table below summarizes the year-over-year change in the S&P Healthcare Economic Indices for the 12-month period ending November 2011. With each monthly release, the index levels, including the 12-month moving averages, are recalculated for the full history of the indices, whenever there are revisions to underlying data used in the models. The entire revised history, as well as full results for the underlying S&P Healthcare Economic Indices, is available from S&P Indices as a subscription service.

S&P Healthcare Economic Indices
(12-Month Moving Average)
Index 1-Year Change (%)
S&P Healthcare Economic Composite Index 5.13%
S&P Healthcare Economic Medicare Index 2.37%
S&P Healthcare Economic Commercial Index 6.96%
S&P Healthcare Economic Hospital Index 5.05%
S&P Healthcare Economic Hospital Medicare Index 1.33%
S&P Healthcare Economic Hospital Commercial Index 8.22%
S&P Healthcare Economic Professional Services Index 4.97%
S&P Healthcare Economic Professional Services Medicare Index 3.62%
S&P Healthcare Economic Professional Services Commercial Index 5.59%
Source: S&P Indices
Data through November 2011

FoxNews.com, By Shannon Bream -

January 19, 2012: A new poll from the US Chamber of Commerce reveals an increasingly frustrated small business community worried about the impact President Obama’s health care law may have on their bottom line.

Nearly three-quarters, or 74 percent, say the new law is causing an impediment to job creation.

Brad Close, vice president of Public Policy for the National Federation of Independent Business, said: "What they know so far scares them; worries them very much."

Close said the businesses he represents are in favor of health care reform, but his clients ultimately could not support what President Obama has crafted.
"They look at this bill as more of a tax bill wrapped up and packaged as a health care reform bill," Close says, adding, "It really puts most of the cost and burden on small business owners."

Administration officials, including Health and Human Services Secretary Kathleen Sebelius, say small businesses will actually benefit from the new law.

"We have millions of small business owners that are taking advantage of the current tax credit, and I can tell you looking forward to a new market where they will have the same affordable coverage as their large competitors have," Sebelius said Thursday.

Close said those businesses are far from convinced. "I think if there had been great benefits when it was written you would have seen a groundswell of support from small businesses to pass this law, but, in fact, you saw the exact opposite."

Speaking at the Families USA Health Action Conference, Sebelius said there is a wealth of misinformation being spread about the law and predicted that the "attacks" will continue.

"In fact, I believe over the next few months we'll see the biggest barrage of attacks and misinformation about the law that we've ever seen." Sebelius also mentioned the upcoming legal fight set for March 26 to 28 at the Supreme Court, saying the law will be upheld and that businesses will then be able to move forward with that certainty.

NFIB is one of the plaintiffs challenging the law, and Close is feeling equally confident about victory.

Next up in the case, a brief from the administration on the issue of severability. The brief, due Jan. 27, will argue that even if the individual mandate is struck down the rest of the health care law can survive on its own.

The Hill, By Sam Baker -

January 18, 2012: Programs designed to cut Medicare spending and improve the quality of healthcare have mostly failed, according to the Congressional Budget Office.

The findings are a blow to existing Medicare projects as well as a key goal of the healthcare reform law.

There is widespread support, in Congress and among economists, for the broad ideal that Medicare would save money if it paid for better outcomes instead of more procedures. But 20 years of trying to shift the program in that direction have yielded little to no progress, CBO said Wednesday.
CBO analyzed six programs designed to improve care coordination for patients with chronic diseases. They either made no difference or were actually more expensive than the traditional payment system.

The CBO report also looks at four “value-based purchasing” demonstrations, in which doctors received financial incentives to improve quality. One of those programs successfully saved money; the others had no effect.

“Demonstrations aimed at reducing spending and increasing quality of care face significant challenges in overcoming the incentives inherent in Medicare’s fee-for-service payment system, which rewards providers for delivering more care but does not pay them for coordinating with other providers,” CBO said.

The healthcare law includes several programs designed to improve care coordination and improve quality, including a new type of integrated health system known as accountable care organizations. Like many of the programs assessed in the CBO study, the heathcare reform initiatives either offer bonus payments to participating doctors or give them a share of any savings to the Medicare program.

Federal News Bulletin for AHIP -

January 23, 2012: On January 18, by a vote of 23 to 13, the House Ways and Means Committee approved legislation, H.R. 1173, that would repeal the Community Living Assistance Services and Supports (CLASS) Program. The bill was approved with support from 22 Republicans and one Democrat, Rep. Ron Kind (D-WI). The committee did not consider any amendments during this markup.

The bill approved by the House Ways and Means Committee is very similar to a version of H.R. 1173 that was approved by the House Energy and Commerce Committee on November 30, 2011. One notable difference between the two bills is that the Ways and Means bill does not allow funding for the National Clearinghouse for Long Term Care Information – because the committee does not have jurisdiction over this issue. By contrast, the Energy and Commerce version of H.R. 1173 includes language that would authorize $3 million in discretionary funding for the National Clearinghouse in fiscal years 2013-2015. We anticipate that this funding will be included in the version of H.R. 1173 that will be considered on the House floor in the near future.

During the January 18 markup, members of both parties expressed interest in advancing alternatives to the CLASS program. Rep. Charles Boustany (R-LA) indicated that he is preparing to introduce legislation addressing the affordability of long-term care insurance. It is our understanding that his bill, as currently envisioned, would provide tax incentives for private long-term care insurance and also focus on educating consumers about issues relating to long-term care. Rep. Lloyd Doggett (D-TX) noted that he has introduced legislation (H.R. 63) that would establish new consumer protections for private long-term care insurance. Other Democratic members of the committee expressed interest in fixing or modifying the existing CLASS program.

Associated Press, By Ricardo Alonso-Zaldivar -

January 19, 2012: President Barack Obama's health care overhaul is on track in many states, the White House asserted Wednesday. But officials said the administration is preparing a federal backstop anyway for states in which opposition to the new law has blocked planning.

The law calls for states to build new health insurance markets called exchanges, so that millions of middle-class people who are currently uninsured can buy taxpayer-subsidized private coverage. It also expands eligibility for Medicaid so low-income adults who have no dependent children can get government insurance. Putting the two approaches together, more than 30 million Americans are expected to gain coverage starting in 2014.

But 26 states are asking the Supreme Court to overturn the health care law, and many of those have made little progress in planning their exchanges, even though the deadline clock is ticking. The law says state plans must be approved by Jan. 1, 2013 — a year in advance of the program's launch — or the federal government will step in and run things.

"No matter where you live, on Jan. 1, 2014, an exchange will be up and running," deputy chief of staff Nancy-Ann DeParle said on the White House blog.

An accompanying progress report said 28 states and Washington, D.C., are "on their way" toward establish exchanges, widely considered the operational linchpin of the health care law.

With a presidential election and Supreme Court decision on the fate the health care law coming first this year, 2014 seems like a long way off even if Obama's signature domestic accomplishment is upheld. But to federal and state officials planning for exchanges, time is short. A totally new marketplace must be created, along with systems for verifying and safeguarding confidential personal information used to determine eligibility.

"Exchanges will offer consumers the same kinds of health insurance choices that members of Congress now have," DeParle said.

But the White House report put a rosy outlook on the progress in some states.

For example, Idaho was among the states highlighted as advancing. Republican Gov. Butch Otter originally supported a state-run exchange, and his administration received a $20 million federal grant to start work. But the legislature has to approve the actual spending of the money, and Republican foes of the federal overhaul are trying to block the state from moving ahead. Faced with a standoff, Otter now says he is leaving it in the hands of the legislature.

"It seems that the White House is desperate to show progress and is selectively searching for any evidence that states are taking action," said Mike Schrimpf, spokesman for the Republican Governors Association. "Many of the states that have started action are doing so primarily as a defensive maneuver to keep the federal government from having even greater control over their health care markets."

Financial Advisor News -

January 17, 2012: More than one in five older Americans skimp on health care to save money, says the Employee Benefit Research Group.

A significant number of Americans over the age of 50 skip medication or postpone doctors’ appointments to save money, according to a recent report by the EBRI, a private, nonprofit research institute based in Washington.

According to the study, 21.5% cut down on their prescription drugs, switched to cheaper drugs or got free samples, and 19.4% skipped or postponed doctor appointments. An even larger number, 27.5 %, reported having difficulty paying their monthly bills.

“We know that consumption tends to fall with age, but it’s difficult to measure whether falling consumption is voluntary,” says Sudipto Banerjee, EBRI author of the study.

“However, we found evidence that a significant segment of the older population may be making spending adjustments to their health care in order to save money,” Banerjee adds.

One in 10 people in excellent health reported skipping or postponing doctors’ appointments to save money, while 36.5% of those in poor health reported doing the same. Similarly, 29.9% of those in poor health reported making prescription drug changes to save money.

Single women and blacks made the most changes to save money. For single women, 22.8% changed their prescription drug allowances and 24.8% postponed doctors’ appointment, while for blacks the respective figures were even higher at 25.9% and 27.3% respectively.

Employee Benefit Research Institute -

January 12, 2012: Account-based health plans continued to grow in 2011, increasing to $12.4 billion in assets among 8.4 million accounts, according to the latest survey by the nonpartisan Employee Benefit Research Institute (EBRI) and Mathew Greenwald & Associates (MGA). That’s up more than 55 percent in the number of accounts and almost 70 percent in assets since 2010.

This growth comes after a leveling-off of account balances during the recession years of 2008 and 2009, and a slight decline in 2010. The average health account balance was $1,490 in 2011, up 9 percent from 2010.

“As the number of people with account-based plans grows, total assets in these plans can be expected to grow as well,” said Paul Fronstin, director of EBRI’s Health Research and Education Program and author of the report.

These and other findings are based on the results of the 2011 EBRI/MGA Consumer Engagement in Health Care Survey, published in the January 2012 EBRI Issue Brief, “Health Savings Accounts and Health Reimbursement Arrangements: Assets, Account Balances, and Rollovers, 2006–2011,” online at www.ebri.org

Reuters, By David Lawder -

January 20, 2012: Republicans in the House of Representatives will put forward a budget plan this year that will seek substantial reforms to health benefits for the elderly and make aggressive strides toward reducing deficits, a senior lawmaker said on Friday.

House Budget Committee Chairman Paul Ryan said he wanted his budget plan to offer voters an alternative vision to the "cradle-to-grave welfare state" that he says Democratic President Barack Obama is promoting.

The House Republican budget resolution will contain reforms to Medicare, the healthcare program for Americans 62 and over, such as providing subsidies to help recipients pay for private insurance, based on their wealth and medical needs.

"We haven't written it yet, but we're not backing off on the kinds of reforms we've advocated," Ryan told reporters at a retreat for House Republicans in Baltimore.

Ryan said there was emerging bipartisan support for such "premium support" plans as the best way to save Medicare, which he said was going broke.

The Wisconsin congressman caused an uproar last year by proposing a plan effectively to privatize Medicare by turning the popular $525 billion fee-for-service program into a system of vouchers to be used by recipients to buy private insurance.

The plan was enough to rattle elderly voters and was cited as a key factor in the defeat of a Republican candidate in a normally conservative New York state congressional district last year.

In December, Ryan and Democratic Senator Ron Wyden unveiled a new approach to cut Medicare costs through a "premium support" model that allowed seniors to buy insurance through a regulated exchange while retaining Medicare's traditional fee-for-service model. The plan was viewed by critics as a ploy to soften opposition to future reforms.

The Obama administration has steadfastly opposed reforms that would end Medicare for seniors or amount to what it calls "radical privatization" of the program.

Representative Tom Price, who heads the House Republican Policy Committee, said there was a lot of enthusiasm at the Baltimore retreat to tackle fundamental reform of "automatic spending programs" such as Medicare and Social Security.

BUDGET RERFORM PLANS

Ryan said his budget plan would aggressively shrink deficits.

to put U.S. debt on a downward path, adding the United States would be in a situation similar to some debt-stricken European countries in a few years if no action was taken. He did not specify an amount for planned cuts.

"We feel we have an obligation to show the country our plan to pre-empt a debt crisis in this country. What matters most as is that we get the trajectory right," he said.

Despite the controversy raised about the House's last budget plan, Ryan insisted that Americans be offered an alternative as a vision of what the Republicans would accomplish if elected.

"People want to be bolder on the budget. People feel good about our budget experience and the budget we passed, even the Northeasterners, the people from the tough seats, they feel we did the right thing on the budget and they want to keep doing it."

Ryan also said he hoped to reform the budgetary process, which he said was outdated and broken, noting the Senate had not passed a budget resolution in nearly three years.

The House Budget Committee is working on 10 bills to reform the annual budget process, including a provision that would force the two houses of Congress, along with the White House, to work on a joint budget resolution early in the year, for votes later in the year.

In the process in place since 1974, the House and Senate work on separate budget bills and then work out the differences later.

Ryan said the panel would begin to refine some of the proposals in coming weeks, but the process would be halted for the committee's work on the fiscal 2013 budget plan, which will be unveiled in March. The reforms will resume later in the year once the budget plan is passed, he said.