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Modified Senate health care bill to be released today
Senate Republican leaders will unveil their latest draft today and hope to vote on the bill next week, but the caucus remains divided. Reports indicate the Senate bill will have only minor changes, including additional funds for opioid treatment, an expansion on how health saving accounts can be used, and the retention of two ACA taxes. The bill may include the Cruz amendment, which would allow health plans to sell cheaper plans with fewer protections as long they also sell an ACA-compliant plan in the same exchange. The changes do little to address moderate lawmakers’ concerns about deep cuts to Medicaid or changes to provisions protecting essential health benefits. Republicans can only afford three defections, and Sens. Rand Paul (R-KY) and Susan Collins (R-ME) have both indicated they plan to vote against the bill.
Behind closed doors, Senators take bipartisan approach to health reform
Republican Senators outside party leadership have begun informal talks with Democratic colleagues about potential bipartisan fixes to the ACA. No formal partnerships have emerged, but Sen. Lindsey Graham (R-SC) hopes to introduce an amendment that could gather support from centrist Democrats. Democratic Senators have indicated they are open to working on a solution, but are unwilling to talk until efforts to fully repeal the ACA are off the table.
Health insurers oppose Cruz amendment
The health insurance lobby is concerned about Sen. Ted Cruz’s amendment to allow the sale of health plans that don’t meet ACA mandates. Lobbying groups representing insurers are warning the amendment could destabilize the individual market by causing the exchanges to act as high-risk pools.
Alaska’s Section 1332 waiver request provides model for other states
Alaska’s state-funded reinsurance program for the individual market helped contain insurance rate increases to just 7.3 percent in 2017, despite predictions they would jump by 40 percent or more. Alaska submitted a 1332 waiver to HHS to recoup some of these savings to fund additional individual market stabilization. The Alaska model is gaining attention from other states as the Trump Administration encourages 1332 waiver requests. The waiver was approved this week, and the state will receive more than $300 million from 2018 through 2022 to cover people with high medical claims.
Early Congressional health budget includes more funds for NIH
The House health appropriations subcommittee has proposed a budget that includes a $1.1 billion funding boost for the NIH. The White House had asked Congress to cut funding for the NIH by almost $6 billion. Support for NIH funding has been bipartisan, and Congress had indicated they were unwilling to make cuts to the program.
Nursing homes start selling Medicare plans
Several nursing home companies have started selling private Medicare insurance policies, which place a nurse in the retirement village to assess patient conditions and coordinate with staff. The nursing homes aim to provide health plans that give doctors greater ability to choose what treatments are covered for patients. However, some patients say this model allows the company to hold an unfair advantage over beneficiaries. Since staff often work for the insurance provider, they are less likely to challenge coverage decisions, according to patients. Consultants also note that when a nursing home is responsible for the cost of hospitalization, the company would be more likely to prevent hospital stays.
Cotiviti purchases Rowdmap as market shifts to value-based care
Cotiviti Holdings, Inc., a provider of analytics-driven payment accuracy solutions, has acquired the payer-provider analytics company RowdMap, Inc. The acquisition broadens Cotiviti’s data analytics capabilities and expands its portfolio of solutions in value-based care. Cotiviti CEO Doug Williams said RowdMap will help provide solutions to payment accuracy to target over $600 billion in waste and abuse in healthcare expenditures.