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Member news: The New York Times examines Capital District Physician’s Health Plan’s program that hires former pharmaceutical reps to help educate doctors on drug costs and encourage them to prescribe lower cost alternatives – saving the plan and members money in the long run.
Still divided, Senate Republicans plan for vote on health care
Today, Senate GOP leaders will present Senate Republicans options for the major policy decisions shaping their health care bill. Senators are considering a gradual phase-out of the ACA’s Medicaid expansion and tools to help stabilize the market. Republican Senators are also weighing a separate bill designed to address market instability in the short-term. Senate Republicans still disagree about exactly how to proceed with the bill and aren’t certain they have enough votes in the Senate to pass the House legislation – but plan to vote on in June, regardless. The White House will meet with House and Senate leadership regarding the future of health care this afternoon and claims a bill will be passed by the August recess.
Insurers exiting did not significantly change the marketplace
The New York Times analyzed insurer data from the Robert Wood Johnson Foundation and found that despite insurer exits, the market size hasn’t declined much. The total number of insurance companies now selling plans in the individual market is not that different from when the ACA took effect in 2014. The biggest drop in participation was among plans who sell exclusively in ACA marketplaces, and a third of plans are choosing to sell outside of marketplaces where customers are not eligible for federal subsidies.
KFF analyzes impact of AHCA’s focus on states’ role in health care
The House health care bill includes provisions designed to downplay the federal government’s role in health care and provide greater flexibility to the states. The Kaiser Family Foundation has released an analysis exploring the potential benefits and drawbacks of different provisions, including the Patient and State Stability Fund and State Waiver Options.
SCOTUS determines faith-based hospitals eligible for ERISA exemption
The U.S. Supreme Court unanimously ruled that the pension plans of faith-based hospitals qualify for exemption from the Employee Retirement Income Security Act (ERISA). Faith-based health systems will not be required to pay premiums to the Pension Benefit Guaranty Corporation or fund pensions to meet ERISA standards.
Nevada passes “Medicaid for all” bill
The Nevada legislature passed a bill opening Medicaid enrollment to all state residents who lack health care coverage, regardless of income or health status. The plan would sell under the name Nevada Care Plan and would be almost identical to traditional state Medicaid coverage. Under this bill, people who qualify for tax credits under the ACA would be able to use those credits to buy Medicaid coverage instead. People who don’t qualify for anything would be able to use their own money to do the same. The plan would likely sell on Nevada’s health insurance marketplace, making it a public option to compete against the private health insurance plans also selling there. There are significant hurdles to implementing the plan if it passes. The bill shouldn’t raise federal costs, but the Trump administration still may object to the plan.
Opinion: Painting Medicaid per capita funding model as cut is misrepresentation
Manhattan Institute senior fellow Chris Pope pushes back against criticism of the Medicaid per capita funding model in the House health care bill. Pope disputes allegations that the shift cuts funding, noting the change would curb spending increases but would not affect existing services. Pope also argues the model also helps correct currently existing funding inequalities between states.