Healthcare Reform News Update for July 31, 2017
Bipartisan Leaders Unite to Fix Obamacare
The Problem Solvers caucus, a group of about 40 House Republicans and Democrats, have created a set of Obamacare fixes. The caucus plans to announce its potential solutions Monday and hope the suggestions will gain support after the recent failures to repeal and replace Obamacare.
The Obamacare fixes focus on:
- Stabilizing the marketplace as quickly as possible
- Funding cost-sharing reduction subsidies (CSRs)
- Altering the employer mandate to include only companies with more than 500 employees (rather than the current 50)
- Creating a federal stability fund to help states reduce healthcare costs for those with extremely high medical charges
- Eliminating the medical-device tax
- Creating greater flexibility for state innovation with stricter guidance on how states can use waivers
The Problem Solvers caucus is led by Tom Reed (R-NY) and Josh Gottheimer (D-NJ). Legislators from the New Democrat Coalition and the Republican moderate Tuesday Group are also involved with the caucus.
Trump Threatens to End CSR Payments if Reform Bill Fails
President Donald Trump threatened Saturday over Twitter to end cost-sharing reduction (CSR) payments if Congress doesn’t pass a healthcare reform bill. He also threatened to end funding for Congress’ healthcare. Trump’s tweet reads, “If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!”
What Could Happen if CSR Payments Are Eliminated?
If cost-sharing reduction (CSR) payments are no longer funded by the government, here are some likely effects.
Assuming states remain in ACA marketplaces:
- The cost of a silver plan’s premium will increase by 19 percent.
- 15 percent in states that expanded Medicaid
- 21 percent in states that did not expand Medicaid
- The increase in the benchmark silver plan would increase the amount of premium tax credits.
- The expense of increased tax credits would cost the federal government 23 percent more than it would save from eliminating CSRs.
- That is a cost of $2.3 billion for fiscal year 2018 and $31 billion over the next decade.
The change in price of silver plans may influence consumers to look for lower-cost plans, and enrollment could shift to other metal level plans. Some consumers might be encouraged to use subsidies they have not previously applied for.
Lawsuits Could Push Government to Pay ACA Insurers
Health insurance companies have filed almost two dozen lawsuits against the government over risk corridor funding. The companies claim that the government owes them $8 billion in payments from a program meant “to blunt their losses in the Obamacare marketplaces.”
Minuteman Health CEO Tom Policelli said, “[The Obama administration] repeatedly assured us it was there, and it would be a clear obligation of the government. Even the federal government is subject to the rules.”
HHS Secretary Promises to Uphold Obamacare
During an interview on “Meet the Press,” U.S. Health and Human Services Secretary Tom Price told NBC he would implement Obamacare as it was intended. “Our job is to follow the law of the land,” Price said, despite the fact he believes “the law … is failing the American people.”
Continued Marketplace Uncertainty Puts Hundreds at Risk
The four top health insurance companies that provide ACA coverage—Anthem Inc, Cigna Corp, Health Care Service Corp, and Molina Healthcare—continue to weigh whether or not to pull out of 2018 marketplaces.
There are currently 40 counties that could be left without a marketplace insurance option, but that could increase to hundreds of counties if insurance companies continue leaving the marketplace. Presently, more than 1,300 counties—primarily in 15 states—have only one insurer participating in 2018. Anthem and HCSC are the remaining insurers in one-third of those counties and states, leaving those areas at risk.
Healthcare Reform News Update for July 28, 2017
Senate Votes Down ‘Skinny’ Obamacare Repeal
A Republican Senate bill (nicknamed the “skinny repeal”) that would repeal the individual mandate, the employer mandate, and the medical excise tax was voted down Thursday night. Senators Susan Collins (R-ME), John McCain (R-AZ), and Lisa Murkowski (R-AK) joined their Democratic colleagues in voting against the measure.
Following to vote, Senate Majority Leader Mitch McConnell (R-KY) said it was time for the Senate to move on from healthcare reform. Other senators suggested attempting a bipartisan approach to stabilizing health insurance marketplaces, but the next steps in healthcare reform are unclear.
Healthcare Reform News Update for July 27, 2017
Senate Votes Down Two Healthcare Reform Proposals
Two healthcare reform proposals were put to a vote Wednesday on the Senate floor. First, the repeal and delay bill was voted down 45-55. The proposed legislation included an amendment from Senator Rand Paul (R-KY) that would ban the use of subsidies to buy plans that cover abortion. Seven Republicans and all Democrats voted against the measure. Next, a vote to return healthcare reform to a committee process was voted down 48-52. All Republicans voted against the measure, and all Democrats voted for it.
Senate Republicans Unite Behind ‘Skinny Repeal;’ House Is Wary
After a full repeal bill was rejected Wednesday, Senate Republicans are moving on to their back-up plan: a “skinny repeal.” The proposal would eliminate the individual mandate, the employer mandate, and one ACA tax. It would also allow Republicans to succeed in passing a healthcare reform bill.
However, House conservatives seem to disagree with a small repeal. On Wednesday, Representative Mark Meadows (R-NC) told reporters that a skinny repeal delivered to the House would be “dead on arrival.” Speaking on the idea of a scaled-back repeal, Representative Mark Walker (R-NC) said, “I don’t think it’s going to be very well received.”
What Could a ‘Skinny Repeal’ Mean for Individual Marketplaces?
Health insurance companies have warned that a “skinny repeal” of the ACA’s mandates could hurt the individual health insurance market. CareFirst BlueCross and BlueShield President and CEO Chet Burrell said that eliminating the individual mandate would dismantle the individual market. “It is hard to think of anything more devastating, especially if nothing else is done to stabilize the health insurance market,” Burrell said. “The significant coverage gains we have made for Americans in recent years would be wiped away with this damaging blow.”
The Congressional Budget Office (CBO) determined that a “skinny repeal” would cause 16 million more Americans to become uninsured by 2021. Additionally, premiums would increase by around 20 percent annually.
Anthem May Exit More Marketplaces
Anthem CEO Joe Swedish said Wednesday that the company needs “certainty quickly” on whether Congress will move to fund cost-sharing subsidies, which low-income Americans who buy ACA plans use to pay their out-of-pocket costs. Swedish said, “There are still many areas of marketplace uncertainty—principally, cost-sharing reduction subsidy funding—that make it challenging to be comfortable with the level of predictability of a sustainable marketplace. If we aren’t able to gain certainty on some of these items quickly, we do expect that we will need to revise our rate filings to further narrow our level of participation.”
The company has already announced its intentions to stop selling individual coverage on public exchanges in three states next year