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Member news: Priority Health Senior Vice President Marti Lolli has been named one of Managed Health Care Executives’ Top 10 Emerging Industry Leaders. Learn more about Lolli’s work and read a quick Q&A here.
Administration divided on market stabilization
The Trump Administration is divided on whether to let the ACA deteriorate or help insurers if the GOP bill does not pass. President Trump is working to demonstrate the problems with the ACA and encourage support for reform. Meanwhile, HHS Secretary Tom Price has indicated he supports federal assistance for insurers. The split among officials is contributing to continued uncertainty in the market, which insurers say is one of the main reasons they are posting higher rates.
Steps to stabilize the market are being discussed as part of broader health care reform, but may be left out of the final package due to cost. It is unlikely Congress will make a decision about CSRs before insurers’ deadline to commit to the ACA exchanges next year. The deterioration of some states’ health insurance markets has added pressure on lawmakers to act.
Senate bridging gap on Medicaid in health care reform
Senate Republicans are nearing a consensus on the Medicaid provisions of their health care reform bill. GOP leaders have proposed a plan that would gradually roll back the Medicaid expansion to allow states to adapt. The program would then shift to a per capita funding model with a yet to be determined annual growth rate to offset rising costs. Republican leaders are pushing for a three year rollback, but moderate Senators Rob Portman (R-OH) and Shelly Moore Capito (R-WV) are pushing for a seven year phase-out.
Wisconsin applies for Medicaid drug test requirement
Wisconsin submitted a federal waiver that would allow the state to drug test able-bodied, childless adults applying for Medicaid. Wisconsin Gov. Scott Walker has proposed drug testing not be required for applicants if they are willing to enter substance-abuse treatment, but critics claim that the drug testing proposal is another hurdle for low-income patients.
California and New York weigh single payer systems as potential path to universal coverage
In reaction to efforts to repeal and replace the ACA, California and New York state legislatures are considering state-run, single-payer health care systems. Experts are skeptical proponents will be able to pass the bills due to their reliance on large, unpopular tax increases, but argue the push represents public support in those states for universal coverage. If either state were to enact a single-payer system, it would be the first in the country to do so.