October 19, 2017
Wavering support for Alexander-Murray
Republican opposition to the bipartisan deal from Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) is growing. President Trump has backed away from an endorsement and Speaker Paul Ryan (R-WI) has said he will not support the legislation and remains focused on repeal and replace. Senator Ron Johnson (R-WI) is proposing changes to the deal hoping to shore up support from conservative House members. Johnson’s proposed changes include increasing the duration of short-term health plans to a 364-day limit, expanding health savings accounts, not enforcing the employer mandate and waiving the individual insurance mandate penalty for 2017.
In a letter, a bipartisan group of governors urged Congress to “quickly pass legislation to stabilize our private health insurance markets and make quality health insurance more available and affordable.” If the bill passes, it would signal to insurers that it is safe to remain in the ACA marketplaces long term. While the bill’s fate is uncertain, experts expect legislation will not pass soon but instead be included in the year-end spending bill.
Attorneys General fight to keep CSRs
On Wednesday, 19 Democratic attorneys general asked a federal judge in California to force the Trump Administration to continue CSRs. The states, led by California Attorney General Xavier Becerra, asked a judge in San Francisco for an emergency court order by 4 p.m. on Thursday requiring CSRs be paid on time. The coalition is also seeking an order preserving the status quo until the issue can be more fully argued in court. U.S. District Judge Vince Chhabria said he’d like to hold a hearing early next week so he can issue a ruling soon after.
Fact check: CSRs are not a bailout
A fact check from the Washington Post refutes President Trump’s claim that CSRs are a bailout for insurers. In the report, the Post explains that insurers do not make any profit off of the subsidies. The payments were implemented to cover costs incurred by insurers due to ACA provisions requiring plans to provide discounts to low-income Americans. Ending CSRs would lead to increases in premiums and higher federal spending, as insurers will be forced to compensate for higher costs.
States expand Medicare benefits despite GOP efforts to curb funding
While some politicians have been seeking major cuts to Medicaid, 26 states this year expanded or enhanced benefits and at least 17 plan to do so next year, according to a report released by the Kaiser Family Foundation and the National Association of Medicaid Directors. The expanded benefits were largely for mental health and substance abuse treatment, but some states also added coverage of telemedicine and dental care. The number of states recently adding benefits was the highest in at least a decade, according to the 50-state survey.
Delays in state health insurance waiver approvals
Open enrollment begins in two weeks, and patients are uncertain as to how the ACA will function during the six-week sign up period. Many consumers are hearing rumors about changes in health care and do not have a source for information on how they will be impacted. The Trump Administration’s push to allow skimpier insurance plans and uncertainty around CSR payments is contributing to the confusion. Additionally, some states are seeking last-minute changes. Iowa is asking for federal approval to revamp its insurance market, which is adding to the uncertainty in that state.
Eight other states have applied for waivers to strengthen their health insurance markets with only two having been granted in full. Applications have also faced delays and partial approvals.
National health care organizations join forces to better serve communities
A national organization of regional healthcare improvement collaboratives and a national trade association representing health information exchanges have joined forces to improve patient care and promote population health while reducing costs. The Network for Regional Healthcare Improvement (NRHI) and the Strategic Health Information Exchange Collaborative (SHIEC) are collaborating to advance policies that support regional data sharing, identify regional partnership opportunities, as well as share best practices across members of both organizations.
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