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Fight over health care intensifies as Congress returns
The Senate’s window for passing health care reform with a simple majority is closing, according to a ruling from the Senate parliamentarian. If the Senate has not passed a bill by September 30, the end of the fiscal year, the Senate will have to craft a bill that can gather the 60 votes necessary to override a filibuster. Republicans were hoping to pass health care legislation using budget rules that allow them to avoid a filibuster, but have been unable to draft legislation that satisfies enough lawmakers.
Tomorrow, the Senate HELP Committee will begin hearings on market stabilization. Five state insurance commissioners are slated to testify Wednesday, followed by five governors on Thursday. Insurers in federally-run marketplaces are scheduled to finalize their 2018 rates and sign final contracts by September 27. Premiums will be an estimated 20 percent higher if insurers don’t get extra subsidies (CSRs) to help cover discounts they must give to the lowest-income enrollees. Funding the subsidies is top of mind for some prominent Republicans, and many Democrats.
The Senate Finance Committee will hold a hearing on the Children’s Health Insurance Program (CHIP) this Thursday. CHIP has strong bipartisan support; providing insurance for millions of children in families with modest incomes that might be too high to qualify for Medicaid. With that funding deadline approaching on September 30, lawmakers and lobbyists are already eyeing a CHIP reauthorization bill as a potential vehicle for other priorities. Republicans could try to add language to repeal elements of Obamacare, Democrats might try to boost funding to stabilize the insurance markets.
Administration cuts spending on ACA promotion
The Trump Administration is cutting spending on the promotion of the ACA and has previously released materials, like videos, infographics and tweets, critical of the law. Experts are concerned that the promotion of negative materials on an existing law could contribute to instability in the market. There will also be less funding for navigators – those who help consumers across the country enroll in ACA plans. The program is being cut from $62.5 million in 2017 to about $36 million for next year.
Outpatient status can lead to higher costs for consumers
Patients can spend days in the hospital receiving tests and drugs without officially being admitted, which can lead to financial troubles as Medicare beneficiaries classified as outpatients face higher costs for drugs, coinsurance and subsequent nursing home care. Medicare covers the full cost of skilled nursing for the first 20 days after a hospital discharge, but only for patients who spent three consecutive days as inpatients. While patients can appeal all other Medicare claims, they cannot appeal observation status. Currently a lawsuit is aiming to change this. A trial is expected next year to determine if patients will be able to appeal observation status.
Telemedicine provides care to displaced Texans in the wake of Harvey
Responding to the devastation of Hurricane Harvey, national health companies are meeting the demand for essential medical care through telemedicine. American Well, Doctor on Demand, MDLive and Teledoc are among companies providing virtual health services to individuals affected by the storm free of charge through September 8. Conditions commonly diagnosed and treated include sinus problems, respiratory infection, allergies, cold and flu symptoms and many other non-emergency illnesses. Texas firms and providers are also filling in with virtual health delivery – the Children’s Health System of Texas is providing telehealth services through a temporary clinic set up in a convention center in Dallas, and company Star ER is using a free app that can be downloaded by anyone in the area for teleconsultations with a physician.