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Healthcare Reform News Update for September 25, 2017

Healthcare Reform News Update for September 25, 2017

Obamacare Website to Go Dark Most Sundays During Enrollment

The Trump administration plans to shut down the Affordable Care Act’s website for 12 hours nearly every Sunday of the upcoming enrollment season. This will affect more than 30 states that use the federal website for their marketplaces.

The site will go down for maintenance every Sunday, except December 10, from midnight until noon. It will also shut down overnight November 1, the first day of open enrollment.

CMS Asks for Public’s Opinion on Healthcare Revamp

The Centers for Medicare & Medicaid Services (CMS) has put out an informal request to hear from the general public about ways to revamp government healthcare programs.

The Centers for Medicare and Medicaid Innovation (CMMI), an idea development lab based inside CMS, has put out an informal request for information and seeks feedback on a new direction that “will promote patient-centered care and test market-driven reforms that empower beneficiaries as consumers, provide price transparency, increase choices and competition to drive quality, reduce costs, and improve outcomes.”

CMMI is interested in testing models in 8 focus areas:

  • Increased participation in advanced alternative payment models (APMs)
  • Consumer-directed care and market-based innovation models
  • Physician specialty models
  • Prescription drug models
  • Medicare Advantage (MA) innovation models
  • State-based and local innovation (includes Medicaid-focused models)
  • Mental and behavioral health models
  • Program integrity

There are 2 ways to submit responses:

  1. Fill out the RFI online submission form.
  2. Send an email to

All comments are due by November 20.

Hurricanes Prompt Request to Extend ACA & Medicare Enrollment Dates

Due to the impacts of hurricanes Harvey and Irma, 2 top House Democrats have asked the Trump administration to extend the upcoming open enrollment season for both Obamacare and Medicare Advantage plans through January 2018.

Representatives Richard Neal (D-MA) and Frank Pallone Jr. (D-NJ) argued in a letter to Health and Human Services Secretary Tom Price that residents affected by the storms should be given more time due to rebuilding efforts.

Healthcare Study: Most Americans in Agreement About Insurance

A majority of Americans agree on major points of health insurance decisions, according to a new study from the Texas Medical Center Health Policy Institute. The findings show:

  • 98 percent consider health insurance important.
  • 28 percent think health insurance systems should include basic coverage for everyone. (This was the most popular answer to the question).
  • 49 percent said they’ve had to cut expenses to pay for healthcare.
  • 55 percent said that cost was the primary reason for their lack of health insurance.

The survey, taken earlier this summer, was given to more than 450 physicians and 9,200 people across 15 states.

Deadline for Waiving Medicare Late Enrollment Penalty Ends This Week

A temporary rule change that enabled people to enroll in Medicare late without paying a lifetime of penalties ends on September 30.

Last week, several health and insurance groups asked Medicare chief Seema Verma to extend the waiver, saying many people were not aware of the waiver.

Typically, if people over 65 do not sign up for Medicare Part B as soon as they are eligible, their monthly premium may go up 10 percent for each year that they could have had Part B.

Health, Insurance Groups Oppose GOP Healthcare Bill

The Graham-Cassidy Obamacare replacement bill has garnered strong opposition from dozens of national health and medical advocacy groups, including the American Cancer Society, Alzheimer’s Association, American Hospital Association, American Diabetes Association, and the American Congress of Obstetricians and Gynecologists. In addition, Blue Cross Blue Shield Association and America’s Health Insurance Plans have also come out against the bill.

Bipartisan Healthcare Bill Halted

Senate Health, Education, Labor and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) says there’s not a path forward for the bipartisan work he and Patty Murray (D-WA) have recently completed in an effort to stabilize the healthcare marketplace.

Democrats call the move a political strategy to bolster the Graham-Cassidy replacement bill. House Speaker Paul Ryan and the Trump Administration announced their opposition to the bipartisan plan last week.

Healthcare Reform News Update for September 20, 2017

Insurance Premiums for Job-Based Coverage Show Modest Rise

Annual premiums for employer-based family plans continued to increase this year, while the share of employers who provide insurance for their workers continued to decline, according to an annual poll of employers by the Kaiser Family Foundation and the Health Research & Educational Trust.

Other findings from the survey include:

  • There was a 3 percent increase for people getting family health insurance through their employers.
  • On average, the total cost of family premiums was $18,764 for this year.
  • Workers are paying, on average, about a third of the total cost for family coverage.
  • Individuals are paying an average of $1,213 for employer-provided coverage. This is a 4 percent increase.
  • Employees at small firms (companies with fewer than 200 workers) pay about $1,550 more each year for family premiums than those at larger firms.

Feds Make September Cost-Sharing Reduction Payments

Health insurers will receive key Obamacare payments this month that help them reduce out-of-pocket costs for millions of low-income enrollees. An effort in Congress to extend the payments, known as cost-sharing reductions (CSR), has failed as the White House and GOP leaders push for another vote to repeal Obamacare.

Ryan, White House Reject Senate Committee ACA Fix

House Speaker Paul Ryan and the White House informed Senate GOP leaders that they oppose a bipartisan pushfrom the Health, Education, Labor and Pensions (HELP) Committee to stabilize the Affordable Care Act exchanges. This move potentially halts negotiations as GOP senators try to build momentum for the Graham-Cassidy repeal bill.

Governors, Healthcare Groups Oppose Graham-Cassidy ACA Repeal Bill

The GOP Senate’s new Obamacare repeal bill, drafted by Senators Lindsey Graham (SC) and Bill Cassidy (LA), was strongly rejected by 11 bipartisan governors on Tuesday. Opposition also came from the AARP and the American Hospital Association, the nation’s largest lobbying group for hospitals and doctors.

Healthcare Reform News Update for September 19, 2017

CBO to Release Limited Analysis of ACA Repeal Bill Next Week

The Congressional Budget Office (CBO) is aiming to provide a “preliminary assessment” of an Obamacare repeal bill sponsored by Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) by early next week.

The analysis will only include basic budgetary estimates. Details on how the bill will affect healthcare coverage or insurance premiums won’t be available for several more weeks, which would be after the September 30 deadline Republicans have to pass the bill using only party-line support.

Private Insurer Launches OEP Ad Campaign

After federal funds for ACA advertising were cut by 90 percent, startup insurance company Oscar Health decided to launch a multimillion dollar ad campaign this week. The campaign is aimed at millennials, in hopes of getting them to sign up on the ACA exchanges during the open enrollment period (OEP).

Oscar Health is the first private company to run its own campaign in lieu of the cuts. “Particularly in this year of uncertainty, it’s really important for us to be in market early and reassure the 22 million folks that are insured that it is really important to get covered,” said Sara Rowghani, the company’s vice president.

Healthcare Reform News Update for September 18, 2017

Anthem Decides to Remain in Virginia ACA Exchange

Anthem, Inc. announced Friday that, in 2018, it will sell Affordable Care Act health plans in 68 Virginia cities and counties that had been at risk of having no individual coverage options. This act is a reversal of the company’s previous decision to not sell insurance in the state.

This move eliminates the risk of bare counties, meaning there are no longer any U.S. counties without at least 1 insurer willing to sell individual market health plans in 2018.

Anthem is still working with other state regulators concerning its market participation for next year.

Healthcare Reform News Update for September 15, 2017

ACA Stabilization Committee to Craft Bill Next Week

The Senate Health, Education, Labor and Pensions (HELP) Committee on Thursday held its fourth and final hearing on stabilizing the insurance market. Chairman Lamar Alexander (R-TN) says the panel intends to produce a new bipartisan bill by early next week that would stabilize the market. The panel hopes to pass it by the end of the month.

Alexander summarized the ideas that were heard in the 3 previous hearings:

  • Funding cost-sharing reduction (CSR) payments
  • Expanding copper plans to those 30 and over
  • Granting states more flexibility to approve health insurance plans and prices

The committee has posted a package of hearing materials, including a video recording and written versions of the witnesses’ testimony.

ACA Navigator Enrollment Programs Face 92%Cut

Department of Health and Human Services (HHS) officials have informed navigators, groups who assist with Affordable Care Act enrollment, that their funding will be reduced by up to 92 percent.

The groups have braced for the cuts since the Trump administration announced two weeks ago that it would shrink overall program funding from $62.5 million to $36.8 million for the 2017 enrollment season and cut the ACA advertising budget by $90 million.

Grant funds for the navigator programs ran out at the beginning of September, and the groups will not be paid retroactively for the first 2 weeks of September.

CBO Projects 15 Percent Hike in 2018 Premiums

The nonpartisan Congressional Budget Office (CBO) predicts that individual health insurance premiums will rise around 15 percent next year. The projected increase is due to marketplace anxiety about whether the Trump administration will block federal subsidies. Also, more people are living in regions with only one insurer, which creates less competition for companies.

According to the CBO report, the amount of Americans buying insurance on the ACA exchange is expected to rise by 1 million in 2018; however, the increase would be constrained by rising premiums, dissolved outreach programs, and a shortened enrollment

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