September 25, 2017
Graham-Cassidy bill gets makeover
Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) have rewritten their health care reform plan in an attempt to convince reluctant Senators to vote for the bill. The latest draft has softened funding cuts for Alaska, Arizona, Kentucky, and Maine, states home to Senators who have expressed reservations. In an attempt to appease conservatives, the bill would also allow states to opt out of additional ACA regulations. The Senate Finance Committee will hold a hearing on the bill this afternoon.
It’s unclear if the new plan will be able to garner enough support for passage. Sen. John McCain has stated his opposition to the bill and Sen. Susan Collins (R-ME), who has criticized the bill, has also expressed frustration with process. The CBO has yet to score either version of the Graham-Cassidy legislation, but does have plans to release a partial analysis of the first iteration of the bill. CBO does not have time to fully score the bill, so it will only release an assessment of the budgetary effects, not the impacts on coverage or premium costs. An analysis from the Brookings Institute estimates 21 million Americans would lose coverage by 2026 if the Graham-Cassidy bill is passed.
The bill has drawn strong industry opposition due to steep spending cuts and erosion of protections for pre-existing conditions. The bill has also come under fire for its sweeping changes to Medicaid, a popular program that provides coverage to 74 million Americans.
Healthcare.gov will face downtime
Healthcare.gov will experience large downtimes for maintenance during the next open enrollment period, set to begin November 1. The site will be taken offline after midnight the first day of open enrollment and may be down from midnight to noon every Sunday thereafter for the duration of the enrollment period. The move has prompted criticism that the Administration is attempting to sabotage the individual market for political reasons, particularly after shortening the enrollment period from three months to six weeks. The Trump Administration claims downtimes for maintenance are typical for a site as complicated as Healthcare.gov and that the proposed downtimes are worst case scenarios.
Children’s health care coverage funding cuts
The Children’s Health Insurance Program (CHIP) and Medicaid provide health care coverage to an estimated 46 million children. Federal funding for CHIP expires at the end of September and if the Graham-Cassidy bill were to pass, Medicaid funds will be cut by billions. With both funding for CHIP uncertain and potentially drastic reductions in funding for Medicaid possible, pediatric providers worry that that they will face challenges in coverage and health care access for patients and cuts to payments for providers. Medicaid and CHIP are responsible for dropping the percentage of uninsured U.S. children from 15% in 1996—the year before CHIP was enacted—to around 4% in 2016.
Fact Check: Medicare versus private plan operating costs
Lawmakers advocating for single-payer often suggest Medicare is much more efficient than private insurance and will save billions in annual administrative costs. The suggestion is that expanding a Medicare-type system to the entire health-care market would result in huge savings. Some health experts say administrative costs for Medicare are artificially low, as some of these costs are paid for by other agencies and Medicare patients are unhealthier, and operating costs for private health plans are artificially high, as they typically include state and federal taxes. Other analyses of administrative costs per patient indicate that Medicare is actually less efficient than private insurance.
Opinion: Social determinants is key to effective health care reform
In a column for Modern Healthcare, former HHS Secretary Mike Leavitt and former assistant secretary Karen Desalvo, assert addressing social determinants is critical to improving health care, driving down costs, and effectively implementing value based care. Leavitt and DeSalvo believe a focus on social determinants can help revolutionize the medical industry and unify communities in addressing the roots of public and private health issues.
Hospitals invest more in outpatient services as patients seek cheaper care
Large hospital operators like Tenet Healthcare Group and HCA Healthcare are investing heavily in outpatient emergency rooms, surgery centers and urgent care clinics. The move is an attempt to meet increased patient demand for outpatient care, and offer more affordable and convenient care. By investing in outpatient centers, these large hospital groups hope to regain patients they’ve lost to competitors offering outpatient services.
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