September 21, 2017
Senate will vote on Graham-Cassidy next week
Next week, the Senate will hold a vote on the Graham-Cassidy bill to repeal and replace the ACA. The bill reduces federal spending on health care and converts funding for ACA programs to block grants for states to use on health programs as they see fit. The bill would also end Medicaid expansion and allow states to waive protections for pre-existing conditions and essential health benefits. The CBO has not issued a score and, due to the short timeframe, predicts it will only be able to assess the budgetary impact and not the coverage impacts of the bill.
Numerous senators have refused to publicly commit to supporting the plan and Sens. Lisa Murkowski (R-AK), Susan Collins (R-ME) and John McCain (R-AZ) have expressed deep skepticism about the bill and legislative process. Sen. Rand Paul (R-KY) will oppose the bill. President Trump and Speaker Ryan have endorsed the bill, and the White House has dispatched Vice President Mike Pence to lobby for its passage. A bipartisan group of governors has released a letter opposing the bill, and Gov. Chris Christie (R-NJ), an ally of President Trump, is also opposed. Almost all major health care organizations have come out against the bill, including the AMA, American Hospital Association, American Heart Association, AHIP, and Blue Cross Blue Shield. ACHP has also sent a letter to Senate leadership noting opposition to the bill.
ACA repeal push could endanger CHIP funding
The latest ACA repeal effort could jeopardize federal funding for the Children’s Health Insurance Program. Several congressmen brokered a deal last week to reauthorize the program, but the Republican repeal bill is complicating the lawmakers’ ability to get the CHIP deal across the finish line before it is set to expire on September 30. CHIP provides coverage for nearly 9 million children in low-income families who do not qualify for Medicaid.
State regulators set to increase insurance premiums for 2018
The CMS deadline to finalize premium rates was yesterday, but insurers have until September 27 to sign contracts with healthcare.gov, locking them into selling plans on the federal exchange. Many state regulators are approving sharp rate increases in response to uncertainty around CSR payments. The nonpartisan Congressional Budget Office has estimated that the loss of CSRs would result in premiums increasing an average of 20 percent for ACA “silver” plans. Kentucky, Mississippi and Connecticut are approving average rate increases that are at least 25 percent higher than 2017 rates. The Graham-Cassidy bill does not include the funding and previous Senate efforts to guarantee CSRs funding has stalled.
Overhauls planned for Centers for Medicare and Medicaid Innovation
HHS Secretary Tom Price and CMS Administrator Seema Verma plan to overhaul the Center for Medicare and Medicaid Innovation to move the agency toward more market-driven policy ideas, which could lead to radical changes to Medicare and Medicaid. The agency was created within the ACA to conduct small-scale experiments with different payment models and health care delivery strategies. CMS has requested input from providers and patient advocacy groups.
Anthem will buy Florida Medicare Advantage plan
Anthem will acquire HealthSun, a 40,000-member Medicare Advantage plan and network of clinics in Florida. Anthem will now have about 650,000 Medicare and Medicaid members across the state of Florida. HealthSun, which is based in the Miami area, serves Medicare Advantage and duel-eligible enrollees. HealthSun was rated a 4.5 star plan in 2016 and 2017.
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