October 24, 2017
Negotiations on Alexander-Murray continue
A nonpartisan Congressional Budget Office score on the Alexander-Murray bill is likely to be released early this week. The report will indicate whether restoring CSRs now will cost the government money. On Monday, the White House put out a one-pager on the bill outlining additional requests, including ending the individual mandate and halting penalties on large employers who don’t provide health coverage. The Administration would also like to see expanded use of health savings accounts and increased access to short-term insurance plans. Many lawmakers are pressing for the bill to go to the floor in its current form, but the bill may be on hold until December when it could get attached to a larger spending bill.
CSR ruling expected today
A federal judge is expected to rule today on a request from 18 states to reinstate CSR payments. U.S. District Judge Vince Chhabria is skeptical of the states’ push for CSRs to continue while the lawsuit over the payments makes its way through the courts. The judge suggested that California and other states had anticipated the end of CSR payments and worked with insurers to make sure most consumers would not be harmed. Either side could appeal Chhabria’s ruling, with any further appeal going to the U.S. Supreme Court.
Disagreements on CHIP extension
A House bill to extend CHIP could go to the floor as soon as this week. The proposed legislation includes several cuts to other health programs in order to pay for the extension and would phase out a funding increase to CHIP under the ACA. The bill would also extend funding for community health centers for two years and provide $1 billion to help with Puerto Rico’s Medicaid crisis. House Democrats oppose the funding offsets in the bill. Some lawmakers believe the bill could take until December to pass, as the House is still debating the substance of the bill and floor time in the Senate is limited.
1.1 million fewer people could sign up for coverage
Funding cuts to the ACA’s advertising and outreach budget could result in 1.1 million fewer people signing up for coverage this year, according to an analysis released by Get America Covered. Advocates for the ACA are worried that funding cuts will mean less people will be aware of open enrollment and the financial assistance that is still available. Many people are already confused about the open enrollment period, with talk of halting CSR payments and confusion on the latest health care bill.
Two states withdraw waiver requests from CMS
Iowa and Oklahoma have both withdrawn 1332 waiver requests after the government failed to respond in time for states to adjust for open enrollment. Both waivers were to establish reinsurance programs. Additionally, Iowa’s waiver would have altered the structure of ACA subsidies and who is eligible for support as well as allowed consumers to use subsidies on off-exchange plans.
Health insurance competition shrinking
According to an analysis by the American Medical Association (AMA), a single health insurance company dominates the commercial insurance market in more than 4 in 10 of the nation’s metropolitan areas. The study shows that competition among health insurers continues to shrink, despite several proposed mergers falling through earlier this year. The findings are part of the AMA’s annual review of insurance market competition, which found that nearly 7 out of 10 commercial markets have a significant lack of competition.
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