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Senate bill moving swiftly, but faces opposition
Senate Majority Leader Mitch McConnell plans to release a draft version of the Senate health care bill by Thursday and a CBO score Monday. McConnell said that senators will have adequate time to review the bill before a vote, yet there are continuing disagreements on issues like Medicaid and tax credits, and several senators are unsure of who has written the bill.
Sens. Rob Portman (R-OH), Shelley Moore Capito (R-WV) and Susan Collins (R-ME) have opposed the bill if the proposed Medicaid cuts affect funding for addiction services. Substance abuse experts warn that current proposals may worsen the opioid crisis and fail to address the complicated health issues of addiction. If the GOP Medicaid cuts are enacted, states may have to choose between scaling back coverage or cutting substance abuse-related government programs.
Republicans say that the Senate version of the bill diverges from the House bill, but risk further division if it strays too far. According to a Morning Consult/POLITICO survey, disapproval to the House GOP health care bill has nearly doubled within Republican voters since April.
Several counties lack insurers prior to rate-filing deadline
Today is the rate-filing deadline for insurers to file 2018 HealthCare.gov rates. Although insurer participation will not be finalized until fall 2017, there are currently 44 U.S. counties at risk of having no insurers to choose from on the ACA exchanges. Without any insurers, consumers will be unable to access federal subsidies for coverage. The health care reform debate has left the exchange market in flux but if insurers miss the Wednesday deadline, regulators may choose to accept last-minute applications.
Other states will have trouble adapting Alaska premium fix
Alaska’s reinsurance program kept premium increases to single digits for 2017 even as other states saw rate hikes of up to 50 percent. But convincing Alaska’s legislature to authorize the program was an arduous task, and the plan relied on an existing funding pool. Erin Mershon of CQ explores how Alaska’s insurance commissioner was able to convince Alaska to implement the program and the challenges other states will face in emulating Alaska’s success (subscriber’s content).
CMS exempts more small practices from MACRA compliance
Physician practices with less than $90,000 in Medicare revenue or fewer than 200 unique Medicare patients per year would be exempt from MACRA under a new draft rule released by CMS. Previously, the threshold was $30,000 or fewer than 100 Medicare patients. Administrator Seema Verma said CMS is taking a “hard look at reducing burdens” after hearing concerns about the number of quality programs, technology requirements and measures. Comments on the proposed rule are due Aug. 30.
MedPAC report recommends changes to MIPS
MedPAC is advising Congress that the Merit-based Incentive Payment System (MIPS) under MACRA should be redesigned. In its June 2017 report, MedPAC said that MIPS is not likely to help consumers select clinicians or help doctors improve practice patterns. MedPAC recommends an alternate structure for MIPS, which would withhold a portion of payments from clinicians.
Consumers show interest in telehealth
Most patients in the U.S. are open to telehealth appointments, however only a small number of people receive care virtually. According to an Advisory Board survey, more than three-quarters of participants said they would use telehealth services, yet less than 20 percent have seen a doctor virtually. The researchers said the results signal that the health care industry is still working to meet consumer interest in telehealth.