Alexander-Murray could find vehicle for passage
The bipartisan ACA stabilization bill from Sens. Lamar Alexander (R-TX) and Patty Murray (D-WA) could be attached to the upcoming funding package
. Sen. Cornyn (R-TX) hinted that the Alexander-Murray proposal, which would restore CSR payments to insurers for two years, is likely to be included in the end-of-the-year package. Some Democratic Senators have said they would move to block the Alexander-Murray bill if the GOP tax plan includes a provision to repeal the individual mandate.States with their own ACA exchanges see low uninsured rate
In the first six months of 2017, the average uninsured rate in states that use the federal HealthCare.gov
exchange was nearly double (16 percent) that of states that set up their own exchanges (8 percent), according to data released by the CDC. Medicaid expansion partially explains the difference in coverage. Nearly all of the 12 states that run their own exchanges have expanded Medicaid, while the 17 states that use Healthcare.gov or partner with the federal exchange opted to not expand the program. States that expanded Medicaid tend to have lower uninsured rates and healthier individual marketplaces overall.
HHS issues warning about long-term viability of Medicare
HHS is warning that Medicare needs to increase its revenue or reduce program benefits in order to balance its budget. The agency believes that a diminishing taxpayer base, higher beneficiary numbers and increasing costs are threatening the long-term viability of Medicare. HHS projects that the ratio of workers paying taxes to beneficiaries eligible will decrease from 3:1 in 2016 down to 2:1 by 2091. The deficiency in funds is expected to amount to more than $3 billion over the next 75 years, so many providers may find it financially difficult to continue to serve Medicare beneficiaries.
Massachusetts hopes to pilot new Medicaid drug coverage test
Massachusetts’ Medicaid program is taking an experimental route to tackle high drug prices. The state is requesting a waiver to be able to negotiate discounts on drugs purchased through Medicaid. State Medicaid programs are currently required to cover almost all FDA-approved drugs, with manufacturers offering drugs at a discount. However, as drug prices continue to increase, the rebates are no longer enough to offset costs. Massachusetts is requesting a Section 1115 waiver to be able to choose which drugs it covers based on beneficiaries’ medical needs and cost effectiveness. If CMS approves the waivers, experts believe other states will submit similar proposals.
Uncertainty around renewed funding for community health centers
Community health centers are struggling to make contingency plans as they wait to see if Congress will renew billions of dollars of federal funding that expired on September 30. Community health centers are required to take any patient that seeks care, regardless of ability to pay. In 2015, Congress renewed the funds for more than $7 billion over two years, but let the reauthorization lapse this past September. If funding is not renewed, health centers will have to scale back services or cut programs, including opioid treatment programs and pediatric dental services. Community health centers provide care for about 26 million people and are the nation’s largest source of primary care for underserved communities.
States continue to face CHIP funding uncertainty
Two months since federal funding for CHIP lapsed, states officials are still uncertain when they will run out of money and if Congress will renew the funds. Colorado plans to send informational notices about the potential end of the program as early as November 27, and California anticipates federal funds will run out in late December or early January 2018. CMS recently sent nearly $607 million dollars to 14 states and territories to provide temporary funds, and has about $3 billion— including the $607 million it already distributed—available for states while they wait for Congress to reauthorize funds.