ACHP Media Monitoring Report: April 19, 2017

Want to subscribe to the Media Monitoring Report? Sign up by emailing us at

Verma hints Congress will need to act on CSR subsidies
In a meeting with CMS Administrator Seema Verma, health insurance representatives urged the Administration to fund cost-sharing reduction subsidies. Verma did not commit to funding the subsidies and suggested Congressional appropriations would be necessary for the program to continue. Insurers have been pressuring the Administration to commit to funding the subsidies as the deadline for filing rates rapidly approaches.

White House continues push for ACA repeal, possible market impact
Vice President Mike Pence reiterated the White House’s commitment to repealing and replacing the ACA. Pence believes Republican lawmakers will be able to work out a compromise soon, although he did not provide a timeframe. Conservative and moderate lawmakers have been attempting to negotiate a plan, but remain divided over preserving coverage and benefit requirements.

Negative signals from the Administration about the future of the exchanges may cause more insurers to leave the marketplace, leaving consumers with fewer options. If no insurers choose to sell plans in a given region, consumers could find themselves uninsured. The bare-market problem could potentially affect a substantial portion of the more than 10 million Americans enrolled in coverage through the exchanges.

Grassley demands answers on Medicare Advantage overcharges
Senate Judiciary Chair Chuck Grassley (R-IA) is urging federal regulators to more closely scrutinize Medicare Advantage health plans. Grassley sent a letter to CMS Administrator Seema Verma demanding that the agency explain why it failed to recoup hundreds of millions of dollars that may have been overcharged to the government by Medicare Advantage plans, which allegedly inflated risk scores. Grassley also asked how CMS plans to ensure risks scores are accurate in the future.

Indiana Medicaid design draws praise from providers
HIP 2.0, Indiana’s conservative version of Medicaid, is drawing praise from many health care providers, suggesting it could be a model for Medicaid expansion in other conservative states. Providers note HIP 2.0’s coverage expansion has prevented them from absorbing costs from uninsured patients, and believe the program offers a robust benefits package. State officials attribute the program’s success to a higher reimbursement rate for providers, which encourages participation and creates a wider network. Unlike traditional Medicaid, the plan requires minor contributions from beneficiaries.