ACHP Media Monitoring Report: June 7, 2017

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Senate GOP bill could keep some ACA protections, reduce Medicaid funds
Senate Majority Leader Mitch McConnell presented a policy on state waivers to Senate members on Tuesday indicating that states will not be able to opt out of protections for people with pre-existing conditions. Waivers will be allowed for essential health benefits, regulation on how much of insurers’ premium revenue must be spent on claims and limits on how much more older individuals can be charged. McConnell also said the Senate may vote on legislation by July 4.

Unless the Senate drastically changes the Medicaid provisions in the House-passed GOP bill, Medicaid managed-care plans could go out of business. The bill that passed the House would lock baseline spending at 2016 rates, which would increase the likelihood that states would cut payment rates to managed-care plans, according to analysts. Some insurers are worried about the financial viability of managed-care plans under the system.

Rural areas hit hardest by Medicaid cuts
Proposed Medicaid funding cuts would disproportionately affect rural populations. A recent Georgetown University Center for Children and Families report found that Medicaid covered 45 percent of children and 16 percent of adults in rural areas in 2015. In states that expanded Medicaid under the ACA, the rate of uninsured people in rural areas dropped by 11 percentage points.

Anthem pulling out of Ohio ACA market
Anthem will withdraw from the Ohio exchanges next year, a move that leaves around 10,500 Ohioans without an insurer. Anthem cited uncertainty caused by the protracted political debate over health care as the primary cause for withdrawing. The company will offer a catastrophic coverage plan outside of the exchanges, which will allow them to bypass a rule requiring them to wait five years to reenter the marketplace. Anthem has not decided whether it will offer plans in other exchanges.

Providers begin to consider cost when assigning procedures
Health systems are encouraging health care providers to consider the price of a procedure or test before suggesting it to patients. Systems have begun investing in health record systems that will remind physicians about the cost of high-priced recommendations and are exploring other options for minimizing costs. Some advocates worry the shift could lead to clinicians focusing on cost-saving instead of the patient’s health, but others believe front-line staff play a vital role in helping patients control costs.

Medicare announces fee waiver for mistaken ACA enrollees
Medicare is waiving penalties for individuals who missed deadlines or did not enroll in Medicare Part B due to confusion caused by the ACA. Many Medicare enrollees are not aware they are not eligible for ACA subsidies and mistakenly believed an exchange plan would be less expensive than enrolling in Part B. As a result, a number of Medicare enrollees purchased ACA plans, only to find their rates jump when they became eligible for Medicare.

Francis Collins will continue to lead NIH
The White House announced that Francis Collins will continue as director of the National Institutes of Health. Collins has been director since 2009 and may provide the NIH with stability as it faces proposed budget cuts by the Trump Administration.