Healthcare Reform News Update for May 17, 2017
Senator John Thune Working to Improve AHCA’s Subsidies
Senate Republicans largely agree that subsidies laid out in the American Health Care Act (AHCA) need to be altered. Tennessee Senator Bob Corker has said, “The way the subsidies were in the House bill, it really wasn’t enough to help people who were on the lower end of the economic spectrum to be able to actually purchase it.”
South Dakota Senator John Thune, who said, “We clearly want to drive more of the benefit of the tax credit to people on the lower-income part of the scale and the elderly,” is crafting a proposal with others that would:
- Tie subsidies to income
- Lower the income-based eligibility limit currently listed in the AHCA
- Increase tax credits for those still eligible
- Provide more support for older Americans
Healthcare Reform News Update for May 16, 2017
Bipartisan Group of Senators Meets for Healthcare Reform Talk
Monday night, a group of Democratic and Republican Senators met to “discuss whether there is a bipartisan way forward on healthcare reform.” The preliminary meeting, organized by Republican Senators Susan Collins and Bill Cassidy, was attended by around 10 Senators.
Bipartisan Lawmakers Re-Introducing Fair Drug Pricing Act
Lawmakers plan to re-introduce a drug-pricing transparency bill Tuesday. The bill requires drug manufacturers to justify price increases and detail their expenses before raising the cost of certain medications. “Under the Fair Drug Pricing Act, companies will have to notify the U.S. Department of Health and Human Services and submit a report 30 days before they increase the price of certain drugs that cost at least $100 by more than 10 percent in one year, or 25 percent over three years.”
CMS Plans to Close Online SHOP Enrollment, Offer Small Business Health Care Tax Credits
In a press release published on Monday, the Centers for Medicare and Medicaid Services (CMS) announced a plan to alter the Federally-Facilitated Small Business Health Options Program (SHOP). Currently through SHOP, small businesses could apply for a determination of SHOP eligibility. After receiving the designation, small businesses could purchase health insurance coverage for their employees through the SHOP online marketplace and received a Small Business Health Care Tax Credit.
In CMS’s planned change, SHOP would discontinue online enrollment through HealthCare.gov. Small businesses could still receive a SHOP eligibility determination and receive the Small Business Health Care Tax Credit. However, small businesses would “access coverage through an agent or broker, or an issuer of their choice, for plan years beginning on or after January 1, 2018.”
Healthcare Reform News Update for May 15, 2017
An Update on Senate’s Healthcare Bill Progress
The Senate is currently debating healthcare reform, mostly on a partisan basis. While no proposal has been released (the Senate will wait for a CBO score on the AHCA), here is an update on their progress:
- It has been difficult for conservative and centralist Republicans to come to a consensus. After the 13-member Senate working group negotiated on Medicaid and Obamacare regulations last week, a Republican aid felt “much less optimistic that something will get done.”
- Centralist Senators Bill Cassidy and Susan Collins have been reaching out to Democrats, hoping for bipartisan healthcare reform. Collins said in a recent interview, “I really want us to have a bipartisan bill. I just think [it] will be so much better. And we have better ideas. So that’s my goal. You end up with a better bill, you end up with better acceptance by the public.” The two Senators are also working on their own healthcare bill.
Legislative Conversations on Drug Pricing Continue
A prior proposal to allow drug-importation from Canada was dismissed by the Senate last week. However, legislators are still working to find ways to lower drug prices. All ideologies seem interested in speeding up the generic drug approval process and increasing transparency in drug pricing.
Department of Health and Human Services Secretary Tom Price is holding listening sessions with patient groups, insurance companies, pharmacy groups, and hospital groups. Proposals from these organizations “include boosting competition through generic drug development, price transparency, and more communication between regulators and government payers.”
Mick Mulvaney, the White House budget director, also suggested changing Medicare drug pricing negotiations during a conference at Stanford University. During the conference, Mulvaney drew a direct comparison between drug price negotiations in Medicaid (which includes mandatory rebates) and Medicare (in which drug companies and insurance companies negotiate to win rebates).
Trump Releases Supportive Statement in Celebration of Women’s Health Week
“Ensuring affordable, accessible, and quality health care is critical to improving women’s health and ensuring that it fits their priorities at any stage of life,” Trump said in a statement released on Mother’s Day, during Women’s Health Week.
The statement continues: “The number of women dying from heart disease and cancer—the top two killers of women in America—has been decreasing for decades. Thanks to new breast cancer treatments, our health care professionals have saved lives and improved the quality of life for millions of women. We must continue to foster an environment that rewards these needed advances in research.”
Trump added that “he is committed to working with Congress on behalf of paid family leave for mothers and fathers, and to ‘invest in the comprehensive care that women receive at community health centers.’”
Healthcare Reform News Update for May 12, 2017
Conservative Senators Begin Outlining Healthcare Reform Ideals
Conservative Republicans have several ideals for the healthcare bill they are currently drafting and negotiating with other members of the Senate:
- Change the AHCA’s refundable tax credits to non-refundable tax credits
- Remove Medicaid expansion eligibility for “able-bodied” adults
- Repeal insurance regulations put in place by the ACA — “such as the requirement that plans don’t charge higher premiums to people with pre-existing conditions — or make states opt in.”
Senate Assures Women’s Involvement in Healthcare Reform
The Republican Senate has recently faced criticism pointing at the lack of women in the 13-member healthcare reform working group, despite the number of women’s health issues at play. Senate Majority Leader Mitch McConnell has assured his colleagues, and the public, that women will not be (and haven’t been) excluded. According to a member of the GOP, “The leader has assured us that at least one of the
Healthcare Reform News Update for May 10, 2017
Republican Senators Take Different Sides on Medicaid Expansion
Ohio Senator Rob Portman and West Virginia Senator Shelley Moore Capito want two very different things for Medicaid. Portman “supports rolling back the Medicaid expansion by ending the extra federal money for it, as long as there is a ‘soft landing.’” On the other hand, Capito “wants the expansion of coverage to remain, though she said it did not have to be in the same form.”
Healthcare Reform News Update for May 9, 2017
Health Insurance Companies Raise Premiums as Marketplace Uncertainty Continues
Three states—Connecticut, Maryland, and Virginia—are the first to make their health insurance premium rates public. In each state, premiums will increase by more than the anticipated.
- Connecticut, with 2 marketplace insurance companies, will have an average rate increase of 24.
- Maryland, with 4 marketplace insurance companies, will have an average rate increase of 45.
- Virginia, with 6 marketplace insurance companies, will have an average rate increase of 31.
Moderate Senators’ Concerns May Reshape Healthcare Bill
With a slim margin needed to pass the bill (Republicans can lose only two votes), the Senate’s Republicans will have to negotiate and appease both sides (conservative and moderate) of their party. Because of this, moderate Republicans have the leverage to alter several more controversial aspects of the AHCA. Moderate Republicans’ concerns with the current healthcare reform bill are predominantly about:
- Changes to Medicaid
- Early CBO estimates that the AHCA would result in 24 million people losing coverage
- Coverage for pre-existing conditions
- Planned Parenthood Funding and abortion language
Healthcare Reform News Update for May 8, 2017
Senate Healthcare Vote Will Likely Be a Simple Majority
Republican Senate Majority Leader Mitch McConnell told the Associated Press that he didn’t expect Democratic support on healthcare legislation. “We don’t anticipate any Democratic help at all, so it will be a simple majority vote situation.”
More Senators Suggest Rewriting, Not Refining, GOP Healthcare Bill
Rather than revising the American Health Care Act of 2017 (AHCA), more members of the Senate have said that a completely new bill will be written. Moderate Republican Senator Susan Collins stated, “The Senate is starting from scratch. We’re going to draft our own bill, and I’m convinced that we’re going to take the time to do it right.”
Senator Collins and Senator Bill Cassidy have already introduced a bill called the Patient Freedom Act. Their bill “keeps some of the consumer protections within Obamacare for people with pre-existing conditions while seeking to solve some of the flaws within the healthcare law.”
Democrats Criticize Lack of Women in Republican Group Working on Healthcare Reform
Republicans have created a group of 13 Senators to “craft a plan to pass legislation to repeal and replace Obamacare.” Democratic Senators questioned why the group included no women, despite the number of women’s health issues involved in healthcare reform.
- Democratic Senator Dianne Feinstein: “Women’s health is a big part of this and women are a majority of the population, and their health interests deserve to be contemplated in any reform.”
- Democratic Senator Patty Murray: “It matters to have women at the table—and it matters when they aren’t.”
- Democratic Senator Kamala Harris: “The GOP is crafting policy on an issue that directly impacts women without including a single woman in the process. It’s wrong.”
Trump Relying on Senate to Improve Healthcare Bill
White House chief of staff Reince Priebus told reporters that President Trump expects Senate Republicans to improve the healthcare reform bill. “Everyone is committed to getting this thing done and getting it done as soon as possible,” Priebus told Fox News. Trump also tweeted, adding pressure to the Senate, “Republican senators will not let the American people down!”
Former President Obama Pressures Senate to Preserve ACA
On Sunday night, Former President Barack Obama urged Congress to maintain the ACA (or Obamacare) and its patient protections. “I hope they understand that courage means not simply doing what’s politically expedient, but doing what, deep in our hearts, we know is right,” Obama said. Obama also expressed his hope that Congress members “recognize it takes little courage to aid those who are already powerful, already comfortable, already influential—but it takes some courage to champion the vulnerable and the sick and the infirm, those who often have no access to the corridors of power.”
Healthcare Reform News Update for May 5, 2017
Senators Likely to Alter House-Approved AHCA
Senator Roy Blunt (R-MO) has already indicated that the AHCA will be altered in the Senate. “We’re going to look at what the House has done and see how much of that we can incorporate in a product that works for us with reconciliation.”
Senator Lamar Alexander (R-TN) supported his colleague’s statement, saying, “We’re writing a Senate bill and not passing the House bill. We’ll take whatever good ideas we find there that meet our goals.” Alexander also gave no hints about when a Senate bill would be ready. “There will be no artificial deadlines in the Senate. We’ll move with a sense of urgency but we won’t stop until we think we have it right.”
Senator Lindsey Graham (R-SC) gave a harsher statement against the House’s passage of the AHCA, noting the lack of a score from the Congressional Budget Office. “Like y’all, I’m still waiting to see if it’s a boy or a girl. Any bill that has been posted less than 24 hours, going to be debated three or four hours, not scored? Needs to be viewed with suspicion.”
House Passes Bill Removing AHCA Coverage Exemptions
Shortly after passing the AHCA, the House voted on a separate piece of legislation. This separate bill nullifies exemption language in the AHCA (which allows lawmakers and their staff to maintain coverage regardless of their states’ coverage changes). The bill is now with the Senate.
What’s Next for the American Health Care Act Bill?
Now that the AHCA has been approved by the House, it will go straight to the Senate. In order for the Senate to pass the bill by a simple majority (51 votes), the bill must follow the “Byrd Rule.” The rule dictates that, as a reconciliation bill, the AHCA can only alter budget-related provisions of the Affordable Care Act. Additionally, the bill cannot increase the federal deficit in the long term. Any provisions in the bill that are not budget-related can be rejected, and the Senate has the authority to completely alter the bill.
After the Senate has reviewed and potentially changed the bill, they will vote on it. If the bill passes, the House must review the Senate’s altered bill. The House can approve the Senate’s bill, or they can try to reconcile the differences between the two. In the latter case, the two chambers of Congress will create a bill that meets the needs of both chambers, and each will vote again on the final bill.
When a final bill has been approved by the House and the Senate, the bill goes to the President. Trump can accept the bill and sign it into law, or he can veto the bill.
Healthcare Reform News Update for May 4, 2017
House Passes the American Health Care Act (H.R 1628)
This afternoon at 2:19 p.m. EST, the House passed the amended American Health Care Act of 2017 (AHCA). The bill passed by a slim margin (217 to 213). As with any bill, the AHCA will be sent to the Senate. The Senate might amend different parts of the bill or write its own bill. If the Senate passes a different version of the bill, then the House and Senate will hold a conference committee to resolve the differences between the two bills. Once a new bill has been created, it must then pass unchanged through both the House and Senate, and be signed by the President, in order to become a law.
Under the AHCA, the following will be repealed:
- The individual mandate
- The employer mandate
- Cost-sharing reduction subsidies
- Certain ACA taxes
The following will be changed:
- Medicaid expansion
- Pre-existing condition policies
- Essential health benefit policies
- Restrictions on increased costs for older Americans (age band rating)
- Premium subsidies
- Health savings accounts
The following will not change:
- Dependent coverage until the age of 26
- Prohibitions on annual and lifetime limits
GOP Healthcare Plan Still Includes Congressional Exemption
Language in the GOP healthcare plan still exempts Congress and their aids from being subject to state waiver provisions. This protects Congress and their staff from “losing the [ACA’s] popular provisions.” According to Rep. Tom MacArthur’s office, separate legislation will eliminate this controversial exemption.
Aetna to Exit Virginia ACA Marketplace
Aetna will no longer offer individual health insurance plans, on- and off-exchange, in Virginia. The company cited $200 million in anticipated losses and market uncertainty as its reason to exit Virginia’s individual market. Including Iowa, this marks the second state where Aetna has withdrawn individual plans.
News Update for May 3, 2017
Can Moderate Republicans Draft a Winning Proposal?
After moderate Republican Reps. Fred Upton (MI) and Billy Long (MO) announced their opposition to the current healthcare reform bill, they drafted a proposal addressing their concerns. Upton’s and Long’s proposal “would provide $8 billion over five years to help some people with pre-existing medical conditions afford coverage.” Upton and Long “said Wednesday they were now backing the high-profile [healthcare reform bill] after winning President Donald Trump’s support for their proposal.”
News Update for May 2, 2017
Will Republicans Have Enough Support for a Healthcare Reform Vote?
Concern over pre-existing conditions isn’t helping the GOP pass healthcare reform legislation. In addition to moderates withholding their support, a Republican legislator—and Trump supporter—has decided to vote against the amended American Health Care Act (AHCA). Rep. Billy Long (MO-R), in explaining his decision to vote no, said this: “I have always stated that one of the few good things about Obamacare is that people with pre-existing conditions would be covered. The MacArthur amendment strips away any guarantee that pre-existing conditions would be covered and affordable.”
The New York Times has created a report of the number of “no” votes, collecting and updating numbers from 4 additional news organizations. To see how many “no” votes there currently are, and who is voting “no,” read their article here.
Trump Talks Pre-existing Conditions With Bloomberg News
During an interview with Bloomberg News, President Trump said, “I want it to be good for sick people. It’s not in its final form right now. It will be every bit as good on pre-existing conditions as Obamacare.”
By “final form,” it is not clear if the President is saying that the current, amended healthcare bill is still being negotiated or if he is commenting on future Senate revisions after the bill is passed in the House.
10 Patient Advocacy Groups Speak Out Against Revised AHCA
Patient advocacy groups, including the American Cancer Society Cancer Action Network and the American Heart Association, have spoken out in opposition to the most recent Republican healthcare reform proposal. In the group’s statement, they wrote: “As introduced, the bill would profoundly reduce coverage for millions of Americans—including many low-income and disabled individuals who rely on Medicaid—and increase out-of-pocket costs for the sickest and oldest among us. We are alarmed by recent harmful changes to the AHCA, including provisions that will weaken key consumer protections.”
News Update for May 1, 2017
Will GOP Try for Another Healthcare Vote Before One-Week Recess?
The House will leave for a one-week recess on Thursday. This gives Republicans four days to shore up enough votes before going back home to their constituents. Some lawmakers have hinted at a vote this week, but publically GOP leaders have said they have until the end of May to pass healthcare legislation.
President Trump Comments on New Healthcare Bill, Pre-existing Conditions
Trump told CBS, during an interview Sunday on “Face the Nation,” that the Republican healthcare bill has “evolved” and will protect those with pre-existing conditions. While he mentioned that the proposed bill would set up high-risk pools, he “also repeatedly seemed to suggest continuing the current mandate.” Trump said, at different points in the interview:
- “Pre-existing conditions are in the bill—and I mandate it. I said, ‘Has to be,’ Trump said, later adding that the proposal has ‘a clause that guarantees’ protection for those with preexisting conditions.”
- “Pre-existing is going to be in there, and we’re also going to create pools, and pools are going to take care of the pre-existing.”
Trump Vows Not to Alter the ‘Concept of Medicare’
President Trump, during an interview Sunday with “Face the Nation” on CBS, said he had no intentions of altering Medicare. Trump said, “I’m not going to touch it, because I said it. Now, waste, fraud and abuse, I’m going to touch. If there’s something in Medicare that’s been abused, I will touch that. There are certain provisions in Medicare that are horrible and abusive and there’s been terrible things happening. So that kind of stuff, I will absolutely touch … But the concept of Medicare, I’m not touching.”
NIH Gets Funding Increase
Rather than the proposed cut of $1.2 billion, the National Institutes of Health (NIH) will receive $2 billion in increased funding through the next five months.
New Kaiser Family Foundation Poll on Prescription Drug Prices
In a new poll, the Kaiser Family Foundation found that 60% of Americans think that lowering prescription drug costs is a “top priority.” Most of those polled supported the following actions to lower drug prices:
- Allowing the government to negotiate Medicare drug prices (92 in favor)
- Making it easier for generic medications to enter the market (87 in favor)
- Requiring drug companies to release how they set their prices (86 in favor)
- Limiting how much companies can charge for high-cost medications (78 in favor)
- Allowing Americans to purchase imported Canadian prescriptions (72 in favor)
- Creating an independent group to oversee the pricing of drugs (72 in favor)
- Allowing Americans to purchase prescriptions from online Canadian pharmacies in favor)
- Eliminating prescription advertisements (56 in favor)
- Encouraging consumers to purchase lower-cost drugs by increasing responsibility for higher-cost drugs (52 in favor)