November 9, 2017
CBO releases updated analysis on elimination of individual mandate
The nonpartisan Congressional Budget Office (CBO) has released an updated analysis on the impacts of repealing the individual mandate. The CBO now projects repealing the mandate would save $338 billion over a decade (instead of $416 billion) and result in 13 million more uninsured Americans by 2027. CBO also said abolishing the requirement would cause premiums to rise because healthier people would be less likely to purchase insurance. It found that the resulting increases would cause more people to forego insurance. Some lawmakers hope to include the mandate’s repeal in the tax reform bill currently being debated in Congress or in a year-end package that would extend government funding.
Healthcare top issue for voters
Recent elections suggest health care–and particularly Medicaid—remains a key political issue for many voters. This week, voters in Maine passed a ballot initiative to expand Medicaid and exit polling suggests Democrat Ralph Northam’s positions won the Virginia governor’s race partially due to his health care plan, which also calls for Medicaid expansion. Groups in Idaho, Nebraska, Utah, and other states are pushing for ballot initiatives to expand Medicaid, and many expect health care to be a central topic in the 2018 midterms.
Maine Medicaid expansion faces difficulty
On Tuesday, Mainers voted to expand Medicaid, but Governor Paul LePage will not implement Medicaid expansion until the state legislature finds a way to fund the program that does not rely on tax increases or pull from the state’s rainy day fund. Legal analysts believe that LePage could face lawsuits if he has not expanded the program by August of next year. The program could provide health coverage to an additional 89,000 people. Governor LePage had previously vetoed expansion five times.
Ron Johnson to introduce employer mandate bill
Senator Ron Johnson (R-WI) will introduce a bill today that prevents the IRS from collecting penalties from employers who failed to meet the employer mandate in 2015. The IRS is still in the process of collecting penalties for that year from employers that did not offer health insurance to their full time workers. The bill is just two pages long and its only purpose would be to bar that collection.
Ex-Pharma Exec Alex Azar is Trump’s top choice to run HHS
Sources suggest that President Trump is leaning toward naming Alex Azar as HHS secretary. Azar was a senior executive at Eli Lilly for a decade including five years as president of its U.S. unit. He also served as general counsel and deputy secretary for HHS under President George W. Bush.
Commercial insurers eye Medicare Advantage as new growth market
Insurers who traditionally focused on commercial markets are expanding into Medicare Advantage (MA). Many health insurers believe MA provides opportunities for growth due to aging baby boomers; insurers also believe the MA market will remain more stable, as the program has been mostly ignored during health care reform discussions on Capitol Hill. Moves by insurers like Anthem and Aetna have forced companies already in the sphere—especially Humana—to consider new strategies for holding off additional competition.
Providers say government assistance would help in transition to value-based care
Physician groups say they need more support from the government to boost participation in alternative payment models. During a House Energy & Commerce Health Subcommittee hearing, experts said smaller, rural providers may lack the resources to move toward value-based payment and providers could benefit from the opportunity to test out their alternative payment models on a small scale before implementing the programs. Despite the challenges, many physicians are moving toward alternative payment models, and CMS expects close to 360,000 clinicians to enter into one of four of models offered by the agency in 2017.
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