Healthcare Reform News Update for May 30, 2017
The Senate Parliamentarian’s Role in Healthcare Reform
Elizabeth MacDonough, the Senate parliamentarian, will soon decide if the American Health Care Act (AHCA) meets the reconciliation requirements that allow a bill to pass in the House and Senate with a simple majority vote. MacDonough will sit down with 8 lawyers (4 Democrats and 4 Republicans), listen to both sides’ arguments, and make an unbiased decision on each piece of the AHCA.
Healthcare Reform News Update for May 26, 2017
Senate to Begin Drafting Healthcare Bill During Weeklong Recess
Now that the CBO score for the American Health Care Act has been published, the Senate can begin drafting its own bill. Thursday, Senator Ron Johnson said, “Over the break, initial legislation will be drafted and then we’ll have more time, actually have a basis to discuss” policies. While there are no final agreements on critical reform points, the initial draft will be a step forward for the Senate.
FDA Steps Into Efforts to Lower Drug Prices
Scott Gottlieb, the new FDA Commissioner, informed a congressional panel that the FDA is creating a “drug competition action plan.” This plan would speed up the approval process for generic medications (specifically generic versions of brand-name drugs with no competition).
Blue Cross and Blue Shield of North Carolina Hikes Premiums over CSR Payment Uncertainty
Blue Cross and Blue Shield of North Carolina has asked state regulators to approve a 23% premium rate increase for 2018. The company did say it could afford a 9% increase with the assurance of CSR payments, but it is currently planning on the high rate increase “because it doesn’t expect [the] crucial payments from the federal government to continue.”
“Blue Cross and Blue Shield of North Carolina sells coverage in all 100 North Carolina counties, and it is the lone option in 95. It said Thursday that its participation for next year is not guaranteed.”
Wisconsin Proposes Drug Screenings for Medicaid Applicants
Wisconsin has proposed a drug-testing requirement for Medicaid applicants, as well as time limits for recipients who do not work or train for employment. Florida and Michigan, states that previously tried to implement drug-testing requirements, “faced lawsuits and court rulings that held that the requirement was unconstitutional.” The proposal “has won approval from the Legislature’s budget-writing committee.”
Healthcare Reform News Update for May 25, 2017
Key Findings From the CBO’s AHCA Report
Yesterday, the CBO published a report on the American Health Care Act, estimating its effect on healthcare costs and the insurance market. Here are the main findings:
- The uninsured rate will increase by 14 million after one year.
- The uninsured rate will increase by 23 million after 10 years.
- By 2026, the uninsured rate is estimated to reach 51 million (28 million under the Affordable Care Act).
- Medicaid funding would be cut by $834 billion and insure 14 million fewer people.
- Premiums would increase in 2018 and 2019. Then they will vary on the states’ decision to opt in or out of essential benefit rules.
- States that opt out of some essential benefit rules will see an estimated premium decline of 20% in the next 10 years.
- In 2020, 17% of Americans will experience an unstable insurance market in which sick people have difficulty getting coverage. Everyone else will experience fairly stable insurance markets.
- Low-income, older Americans will see higher premiums (about 9 times more).
- The federal deficit would reduce by $119 billion over the next 10 years, and $664 billion in taxes and fees would be repealed.
The report also gave the following predictions for coverage:
- “Less healthy people would face extremely high premiums, despite the additional funding that would be available.”
- In states that decided to opt out of coverage requirements, “people who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive nongroup health insurance at premiums comparable to those under current law, if they could purchase it at all.”
Blue Cross and Blue Shield of Kansas City to Exit Marketplace
On Wednesday, Blue Cross and Blue Shield of Kansas announced its decision to exit the ACA Marketplace for 2018. The marketplace exit will affect 67,000 residents in 30 counties in Missouri and Kansas. It was the only marketplace insurance plan for about 25 counties in Missouri. The company cited more than $100 million in losses for its decision.
Healthcare Reform News Update for May 24, 2017
The CBO Has Released Its Score on the Newest Draft of the AHCA
The Congressional Budget Office (CBO) released its estimate of the American Health Care Act of 2017 (AHCA) this afternoon. According to the estimate, the House-approved AHCA would reduce the federal deficit by $119 billion over the next 10 years. It would also increase the number of uninsured people by 23 million in 2026. The bill is confirmed in following reconciliation rules and can now move on to the Senate.
Senate Working Group Meets With BCBS to Discuss Healthcare Reform
On Tuesday, the 13-member Senate group working on healthcare reform met with Blue Cross Blue Shield. Senator John Hoeven spoke on the meeting, intended to get health insurance companies’ perspectives. “We really focused on the insurance aspect — how do we build a plan that works for the insurers in terms of making sure they participate and helping keep premium costs down?”
Senate Interested in Phasing Out Medicaid Expansion
According to Senator John Thune, Republican Senators on the 13-member working group are planning to end Medicaid expansion in their healthcare reform proposal. However, a gentle phase-out is being discussed over a quick termination of the expansion. “There’s an interest among many of our members having a longer phaseout, a smoother glide path. At some point you’re gonna get back to the original [reimbursement rate], it’s just a question of how quickly that happens.”
Administration’s Proposed Budget Draws Concern and Criticism
After the White House proposed steep spending cuts, legislators and analysts have voiced their concerns and criticisms over the effect of certain funding decreases.
- “Lower-income children would have their federal health benefits cut sharply, … which analysts say could reverse gains that have pushed uninsured rates for this vulnerable population below 5 percent.”
- The EVP of the Planned Parenthood Foundation of America, Dawn Laguens, called the budget “the worst budget for women and women’s health in a generation.”
- Senator Bill Cassidy, on Medicaid cuts: “I don’t think the president’s budget is going anywhere … You don’t cut $800 billion over 10 years and keep your same level of coverage. I think that President Trump’s campaign contract with the voters should be fulfilled.”
- Senator Susan Collins: “Obviously I’m concerned about the additional cuts proposed in Medicaid.”
- Tom Cole, on NIH cuts: “I certainly understand wanting to plus up defense, but you have to remember part of defending the American people is protecting them from pandemics,” said Cole, the chairman of the House health appropriations subcommittee. “Part of getting hold of the long-term expenses of the federal government is dealing with things like Alzheimer’s.”
California’s Single-payer Healthcare Plan Expected to cost $400 billion
Legislative analysts estimate that California’s proposed single-payer healthcare bill will cost the state $400 billion and result in payroll tax increases. The cost would be offset by existing spending and payroll tax increases, though individuals may see savings from no longer paying premiums and out-of-pocket costs.
States Passing Bills Aimed to Lower Prescription Drug Pricing
Several states have recently passed, or proposed, bills to curb prescription drug prices.
- New York passed a bill that increases pricing scrutiny to influence drug makers.
- Nevada’s Senate has passed a bill that would require diabetes drug manufacturers to disclose insulin pricing, profit, expense information, aimed to increase transparency.
- California’s Senate has passed a bill that restricts most payments made by drug manufacturers to doctors, citing a study showing such practices increased the use of more expensive medications.
- Ohio is working to pass a bill that “would require state agencies to pay no more for prescription drugs than the lowest price paid by the U.S. Department of Veterans Affairs.” The bill faces heavy opposition from the group called Ohioans Against the Deceptive Rx Ballot Issue.
Healthcare Reform News Update for May 23, 2017
Administration Asks for Third Postponement in CSR Case
On Monday, the Trump administration and House Republicans requested a 90-day extension over the ongoing cost-sharing reductions (CSR) payment case. This is the third requested delay in the case as the House and the administration try to work out CSR payments out of court.
White House’s Proposed Budget Cuts for Medicaid, Biomedical Research, and More
The administration mistakenly posted (and quickly removed) their planned budget for 2018. Significant budget reductions include:
- $610 billion cut from Medicaid, in addition to the $839 billion cut included in the AHCA
- 18% cut from the National Institutes of Health (NIH)
- 19%cut from the National Cancer Institute
- Elimination of the Fogarty International Center (an NIH program “that promotes medical research overseas”)
- 17% cut from the Centers for Disease Control and Prevention
- 17% cut in spending for HIV/AIDS, viral hepatitis, sexually transmitted infections, and tuberculosis prevention
- 18%cut from the CDC’s global health program
- 28%cut in spending for environmental health
- Elimination of the Agency for Healthcare Research and Quality (NIH would absorb many functions)
- 31% cut from the FDA
- $403 million cut from physician training programs