Administration pays CSRs for September, rate deadline for 2018 exchanges
The White House will make September CSR payments
to ACA health insurers, reimbursing them for reducing copayments and deductibles for millions of low-income customers. Today is also the final deadline for insurers
to file rates for plans they are selling on the 2018 ACA exchanges. This is the last chance for insurers to raise premiums to offset the potential loss of CSR funding as the future of CSR payments still remains uncertain.
Graham-Cassidy bill faces opposition
The Graham-Cassidy bill is gaining momentum as the deadline for using a procedural vote to pass an ACA repeal bill in the Senate approaches. The bill would lump together the money spent under ACA on subsidies for private insurance and Medicaid program expansion and redistribute it as block grants to states, who could use it to fashion their own health systems. All of the bill’s health spending would end in 2027 and need to be reauthorized by Congress. The bill also makes structural changes to Medicaid by capping how much federal money states can get. According to an analysis from Avalere, the bill could shrink federal health spending by more than $4 trillion by 2036.
Vice President Mike Pence appeared at the Capitol yesterday to declare that the Trump administration was “all-in” on the repeal effort. However, several key senators remain undecided, and Senate Majority Leader Mitch McConnell (R-KY) said he will not bring the bill to the floor next week unless he has 50 votes for passage. Hospital groups, health organizations and state governors are coming out against the Graham-Cassidy repeal bill. Yesterday the American Hospital Association and AARP sent letters urging senators to reject the bill. A group of 11 governors also submitted a letter to the Senate indicating preference for the bipartisan push to stabilize insurance marketplaces by Senators Lamar Alexander (R-TN) and Patty Murray (D-WA ).
Cost of employer-based plans remains stable
Though health insurance premiums are rising for some ACA plans, the cost for individuals with health coverage through an employer is remaining steady. According to a Kaiser survey, total premium increase for family coverage was about 3 percent. This is the fifth straight year that employer-provided policies have increased at a rate below 5 percent. About 151 million people are covered by an employer, which means the majority of Americans are not seeing their premiums rise significantly.
Hospitals may begin to see reimbursement issues with ACA
The ACA expanded the number of insured, curbing hospital debt from bills left unpaid by uninsured patients. But the hospital reimbursement rates for services covered through Medicare were setup to be adjusted for productivity, or what a hospital employee produces in a typical hour. Under that system, reimbursement payments decrease as productivity grows. CBO estimates project that these economic adjustments could cause reimbursement rates to grow at an annual rate of 2.2 percent, instead of the previously expected 3 percent. The slower growth could have negative effects on the bottom line of many hospitals.
Role of social determinants of health in treatment
Clinicians are seeing increasing evidence that a holistic view of patients and non-clinical information can improve health. To address the underlying factors that affect health, many providers are factoring social determinants of health into patient assessments. Sharing non-clinical information is new to providers, but electronic health record systems are helping to combine data on social determinants with medical information. Many experts believe additional patient-specific information will help improve overall treatment and achieve cost-effective health outcomes.