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ACHP in the News: The constantly shifting effort to repeal and replace the ACA is not the only factor driving uncertainty in the health care marketplace. President Trump’s frequent threats to cut cost-sharing reduction subsidies has also created instability. ACHP President and CEO Ceci Connolly stressed the importance of CSR subsidies to maintain a stable market.
Administration pays July CSRs but won’t commit to future payments
The White House will not block cost-sharing subsidies scheduled to be paid to insurers today but will not commit to future payments. President Trump threatened to halt subsidy payments in the past. Experts believe ending the subsidies could cause the individual market to collapse, as insurers would be forced to raise rates or withdraw from markets entirely.
Senate mulling health care reform again
Senate Republicans are revisiting health care reform, days after a bill handcrafted by party leadership was pulled due to lack of support. Majority Leader Mitch McConnell (R-KY) is urging Senators to vote yes on a motion that would open the floor for debate and allow Senators to offer amendments to the existing bill. Senators met with the President yesterday and worked late into the night trying to find a compromise. Hardline conservatives have indicated recess should be delayed until the Senate can reach a deal.
The Senate is still divided over key provisions, including steep cuts to Medicaid. Party leaders have offered $200 billion in additional assistance to expansion states. It’s unclear if the concession is enough to secure moderate votes, and the move may anger conservative lawmakers committed to rolling back Medicaid.
McConnell had previously planned to bring a straight repeal bill to the floor for a vote. A CBO score of that plan released yesterday found that a clean repeal without replacement would lead to 32 million more uninsured, double premium costs and leave three quarters of the country uncovered by an insurer in the individual market.
Optimistic score of Cruz amendment draws ire of outside analysts
Independent policy experts are panning an HHS score of the Cruz amendment, which would allow insurers to sell less generous benefit packages as long as they also offered one ACA-compliant plan. The score projects lower premiums for all plans and an expansion of coverage, but assumes deductibles would reach $12,000. Policy experts have criticized the lack of transparency in the scoring process as well as the score for including unreasonable comparisons between different plan types.
Fraudulent payments cost Medicare roughly $16 billion in 2016
The Government Accountability Office (GAO) found that Medicare Advantage overpaid health plans by 10 percent in 2016, totaling more than $16 billion. CMS believes most of the overpayments come from plans and providers who approved medically necessary treatments, but failed to keep documentation and records validating those treatment decisions. The GAO is recommending an overhaul of CMS procedures because the agency did not implement processes necessary to prevent fraud.
Hospitals criticize cuts to Medicare drug subsidy
The American Hospital Association (AHA) is urging the Administration to reconsider its decision to cut a Medicare subsidy for pharmaceuticals. The subsidy was designed to help hospitals provide expensive treatments for uninsured patients. The AHA argues the cut will threaten rural and cancer hospitals.
Social Interaction May Lead to Improved Outcomes for Cancer Patients
Researchers from the National Human Genome Research Institute recently published a study that found cancer patients were more likely to survive for five years or more after undergoing chemotherapy if they interacted with other patients who also survived for five or more years after treatment. The study’s author attributes part of the findings to patients following healthy behavior modeled by previous survivors. Data for the study was collected from electronic medical records from two major hospitals in the United Kingdom.