Friday, 24 January, 2020

Insurance Policy Health Care Reform News Update for January, 2018

Insurance Policy Health Care Reform News Update for January, 2018. Healthcare Reform News Update for January 30, 2018. The Affordable Care Act advocacy group Save My Care is releasing television ads this week that are critical of Republican efforts to repeal the law. Here is all about Insurance Policy Health Care Reform News Update for January, 2018

Pro-ACA Group Launches Ads Targeting GOP Lawmakers

The ads claim that the failed bills GOP lawmakers proposed would have increased health insurance premiums and left millions of people without coverage. They will run in West Virginia, where Congressional Republicans are holding a retreat, in addition to Washington D.C., Maine, and Alaska.

Leslie Dach, Save My Care’s campaign chairman, hopes the ads will remind lawmakers to act. “It’s time to listen to what Americans demand, move on from repeal and sabotage, and work on bipartisan solutions that keep and improve on the Affordable Care Act,” he said in a press release.

Azar Sworn in as HHS Secretary

Alex Azar was sworn in Monday to lead the Department of Health and Human Services.

“As our new secretary, Alex will continue to implement the administrative and regulatory changes needed to ensure that our citizens get the affordable high-quality care that they deserve,” President Donald Trump said at a White House ceremony honoring Azar.

Azar was confirmed last week in a 55-43 Senate vote.

Open Enrollment Period Ends Tomorrow for 3 Exchanges

California, New York, and Washington D.C. will end their Open Enrollment Periods at midnight January 31.

California’s state exchange has signed up about 1.2 million residents renewing their policies and 342,000 new enrollees. New York will enroll 2.1 million people. And the Washington D.C. exchange says its poised to match last year’s numbers.

Healthcare Reform News Update for January 29, 2018

Trump Administration Sued Over Cuts to ACA Plans

The attorneys general for New York and Minnesota have sued the Trump administration for cutting off more than $1 billion in annual federal funding for state Affordable Care Act plans that cover almost 1 million low-income residents.

The Department of Health and Human Services (HHS) announced December 21 that it would not pay the $266 million to New York or $32 million to Minnesota for their Basic Health Program plans in the first quarter. The cuts represent more than 25 percent of the overall funding to the programs and $1.2 billion over one year.

The states are the only two that participate in the Basic Health Program, which provides low out-of-pocket plans with premiums of $0 to $80 per month. New York has 700,000 enrollees.

“The abrupt decision to cut these vital funds is a cruel and reckless assault on New York’s families,” said New York Attorney General Eric Schneiderman.

Healthcare Reform News Update for January 26, 2018

Two Reinsurance Bills Vie for Congressional Support

Two rival reinsurance bills — one with only GOP support in the House, the other with bipartisan support in the Senate — are complicating ACA stabilization efforts.

The House version, sponsored by Representatives Ryan Costello (R-PA) and Collin Peterson (D-MN), will cost $30 billion over three years at the discretion of the secretary of Health and Human Services. It consolidates a federal reinsurance program and includes retroactive funding of cost-sharing reduction (CSR) payments for 2017 and funding for 2019.

The Senate bipartisan version, sponsored by Senators Susan Collins (R-ME) and Bill Nelson (D-FL), uses 1332 wavers to give states a $2.25 billion pool every two years to fund their own reinsurance programs.

Costello says his approach has the advantage of “speed, efficiency, and certainty,” because obtaining waivers can be uncertain. Collins says the waivers will ultimately benefit states more.

Costello and Collins have discussed the proposals, and talks are ongoing. It’s unclear which proposal has more support from lawmakers.

Warren Calls for ACA Supporters to ‘Go on Offense’

Senator Elizabeth Warren (D-MA) in a Thursday speech called for supporters of the Affordable Care Act to be more aggressive over healthcare issues in response to Republican efforts to repeal the law.

“We need to do more than play defense,” she said at a conference held by Families USA, a liberal healthcare advocacy group. “I believe it is time for us to go on offense.”

Warren spoke about building on the ACA’s fundamentals, including creating a public health insurance option and expanding Medicare eligibility. She also criticized insurance carriers and said the government needs to “hold America’s insurance companies accountable.”

Healthcare Not Priority for Battleground Voters

Even though healthcare is a top issue for voters nationwide, it lags behind the economy, North Korea, and immigration as a priority for voters in states with competitive political races, according to a recent poll from the Kaiser Family Foundation.

Nationwide, healthcare is the top issue for 29 percent of voters, followed by the economy and immigration. For the 13 states with congressional or gubernatorial races, 21 percent of voters choose healthcare as the priority.

The poll also found that 50 percent of voters were not aware that the ACA’s individual mandate had been repealed. The same percentage said they supported the ACA.

Healthcare Reform News Update for January 25, 2018

Azar Confirmed as Health & Human Services Secretary

Former Eli Lilly executive Alex Azar was confirmed Wednesday as the new secretary for the Department of Health and Human Services (HHS) in a 55-43 Senate vote.

Azar previously served the department as general counsel and then as deputy secretary under former President George W. Bush. “He understands the process, and he knows the levers and how you make it work and where the potential roadblocks are,” said former HHS Secretary Mike Leavitt.

Azar has four main objectives for the department:

  • help contain prescription drug prices
  • make health insurance more affordable and accessible
  • continue working to make Medicare payments based on quality—not quantity
  • tackle the opioid addiction epidemic

Idaho to Allow Sale of Non-ACA-Compliant Health Insurance

Idaho revealed a plan Wednesday that would allow the sale of health insurance that does not meet the consumer protections established under the Affordable Care Act. It’s the first state to do so without prior federal approval.

The director of the Idaho Department of Insurance says the plan is necessary to make cheaper insurance available to more people. But the legality of the measure is being questioned by healthcare experts.

Under Idaho’s guidelines, the new, cheaper plans could:

  • Deny coverage for pre-existing conditions for up to 12 months
  • Exclude pediatric dental coverage and vision care
  • Charge people more based on where they live, health history, and age
  • Charge consumers separate out-of-pocket maximums for different services

Insurers in the state would continue to have ACA-compliant marketplace plans available.

Trump Administration Seeks to Expand Individual Mandate Exemptions

The Affordable Care Act’s individual mandate was repealed last month, but it doesn’t go into effect until 2019. In response, the Trump administration is exploring ways for more consumers to qualify for exemptions on 2018 tax returns.

The Centers for Medicare and Medicaid Services (CMS) is creating guidance to expand hardship exemptions but has yet to finalize or publish the details.

Ted Cruz Continues Fight to Repeal ACA

Senator Ted Cruz (R-TX) on Wednesday said he is still working to repeal the Affordable Care Act this year.

Cruz said he has been “speaking with a wide number of senators” about repeal efforts and is trying to get enough support for an effort to pass.

“I don’t think leadership is interested in going down this road again until we can get 50 votes, and so we need to do the hard work of bringing the rest of the conference together. I think we’re still quite close,” he said.

Healthcare Reform News Update for January 24, 2018

ACA Tax Delays Will Cost $31.3 Billion

The postponement of three Affordable Care Act taxes in the stopgap spending bill, which ended the three-day government shutdown, will reduce federal revenue by $31.3 billion over 10 years, according to the Joint Committee on Taxation.

  • Delaying the medical device tax will cost $3.8 billion.
  • Postponing the Cadillac tax will cost $14.8 billion.
  • Deferring the health insurance tax will cost $12.7 billion.

HHS Nominee Advanced by Senate

Alex Azar, President Donald Trump’s nominee to lead the Department of Health and Human Services (HHS), won Senate approval Tuesday in a 54-43 vote. Final confirmation is expected today. Azar is a former Eli Lilly executive.

Healthcare Reform News Update for January 23, 2018

Stopgap Bill Includes 3 ACA Tax Delay Extensions

The bill that reopened the federal government today includes three measures that affect the Affordable Care Act.

The “Extension of Continuing Appropriations Act, 2018″ (ECAA) bill will delay:

  • the start date of the ACA’s Cadillac tax through 2022.
  • the health insurance tax through 2019.
  • the medical device tax through 2019.

The Congressional Budget Office (CBO) has estimated that the three taxes represent $12.7 billion in federal revenue.

California Marketplace Enrollment Up 7 Percent

Covered California, the state’s ACA marketplace, has signed up about 342,000 healthcare enrollees since Open Enrollment began November 1. That’s a 7 percent increase compared to the same time last year.

“The demand — as well as the need — for health insurance is as strong today as it was when we first began offering coverage five years ago,” said Peter V. Lee, Covered California’s executive director, in a statement.

Enrollment will continue for the state through January 31.

ACA Stabilization Bills Still Alive in Congress

Senator Susan Collins (R-ME) remains optimistic about bipartisan legislation created to help lower premiums and stabilize the Affordable Care Act marketplace.

Collins expects the measures to be included in an omnibus bill due for a vote within the next few weeks.

“Our negotiations with the House are going very, very well. The deadline slipped but the policy is what is important,” she said.

Healthcare Reform News Update for January 18, 2018

Azar Moves to Full Confirmation for HHS Secretary

The Senate Finance Committee voted 15-12 to advance Alex Azar’s nomination to head the Department of Health and Human Services (HHS). All committee Republicans voted for Azar; Tom Carper (DE) was the only Democrat voting in support of the nominee.

Azar was an HHS official during the George W. Bush administration and is a former executive for pharmaceutical company Eli Lilly. Azar has said he intends to cut back the Affordable Care Act through new regulations and help stem the rise of drug prices.

A confirmation date has not been scheduled, but lawmakers expect a vote by the end of the month.

GOP Plans for ACA Taxes Unveiled

Republican lawmakers introduced measures Tuesday to suspend or delay some ACA taxes as part of the efforts to avoid a government shutdown.

The proposals include delaying the health insurance tax (HIT) for one year and a two-year delay on the medical device tax and the Cadillac tax on high-cost insurance plans. It also included a six-year reauthorization of the Children’s Health Insurance Program (CHIP).

Opponents have asked to suspend the HIT tax retroactively for 2018, saying it would lower premium costs. “While we welcome the suspension of the health insurance tax (HIT) in 2019, small businesses need help now. It’s critical that policymakers provide urgent relief and much-needed certainty by suspending the tax immediately for 2018 and 2019,” said Elena Tompkins, executive director of Stop the HIT, a coalition representing small-business owners.

Healthcare Reform News Update for January 16, 2018

Uninsured Americans Grew to 12.2 Percent Last Year

After years of decline due to the Affordable Care Act, the number of Americans who do not have health insurance rose to 12.2 percent in 2017, compared to 10.9 percent at the end of 2016, according to a new national survey from Gallup.

This is the first time in nine years where there was not a year-over-year decrease in the number of uninsured.

About 3.2 million Americans lost coverage in 2017. Especially affected were young adults, blacks, Latinos, and households making less than $36,000 a year. The majority of the newly uninsured had previously purchased individual insurance, rather than receiving group coverage from an employer, Medicare, or Medicaid.

It’s expected that the Trump administration’s efforts to weaken portions of the Affordable Care Act, such as repealing the individual mandate, could continue to impact the number of uninsured. “It seems likely that the uninsured rate will rise further in the years ahead,” according to the report.

Republican Leaders Hope to Eliminate ACA Employer Mandate

House Republicans Devin Nunes (CA) and Mike Kelly (PA) have introduced a bill that would suspend the Affordable Care Act’s mandate that employers offer healthcare to employees, canceling penalties that would be imposed for any year from 2015 to 2018.

“The employer mandate is a job-killer, a wage-killer, and a business-killer,” said Representative Kelly.

Currently, if an employer does not offer minimum essential coverage to full-time employees, the business is subject to a penalty of $2,260 per year for each employee in excess of 30. It’s estimated that businesses will pay $12 billion in penalties in 2018.

Democrats oppose repealing the employer mandate saying that the measure has not harmed businesses since the law’s implementation in 2010.

Healthcare Reform News Update for January 12, 2018

ACA Exchange Carrier Faces Lawsuit

A class-action lawsuit claiming inadequate access to doctors was filed Thursday in a federal court against Centene, one of the largest insurance carriers on the federal healthcare exchange.

Centene sells Ambetter plans in more than 15 states and insures 1.4 million people. In some areas of the country, the company is the only provider available on the exchange.

The lawsuit alleges that Centene falsified its network of doctors and that patients have trouble finding providers who accept the plans. “Centene misrepresents the number, location and existence of purported providers by listing physicians, medical groups and other providers — some of whom have specifically asked to be removed — as participants in their networks and by listing nurses and other non-physicians as primary care providers.”

The company said it was not aware of the lawsuit until Thursday. According to a spokesperson, “We believe our networks are adequate. We work in partnership with our states to ensure our networks are adequate and our members have access to high quality healthcare.”

House Chairman Hopes ACA Cadillac Tax Will Be Eliminated

House Ways and Means Committee Chairman Kevin Brady (R-TX) said there is a chance that a repeal of the Affordable Care Act’s “Cadillac tax” could be included as part of the government funding measure under negotiation in Congress. Currently, the tax will not go into effect until 2020.

The Cadillac tax imposes a 40 percent excise tax on employer-funded health insurance plans that cost more than $10,200 for individuals and $27,500 for families.

Healthcare Reform News Update for January 11, 2018

Internal Document Discloses Trump Administration’s ACA Strategy

An internal Trump administration document recently obtained by Senator Bob Casey (D-PA) outlines 10 actions that Health and Human Services (HHS) planned to implement via executive authority to make changes to the Affordable Care Act.

The March 23, 2017, document says the measures would “improve the individual and small group markets most harmed by Obamacare.”

Casey called the list “sabotage” of the ACA. “The primary problem here is government officials, government agencies, were taking steps that would lead to fewer people having coverage and erecting barriers to people having coverage,” Casey said.

The document was used during a meeting with House GOP lawmakers in March, including House Speaker Paul Ryan (R-WI).

Most of the proposals have since been implemented. The suggested actions include:

  1. Require 100 percent verification for Special Enrollment Periods.
  2. Tighten rules on payment grace periods.
  3. Shorten the Open Enrollment Period to six weeks.
  4. Give oversight authority for network adequacy back to the states.
  5. Give states the authority to select essential health benefit benchmarks.
  6. Set up expedited review and approval of Section 1332 state innovation waivers. (These apply to the individual and small group markets.)
  7. Prevent providers from steering patients to ACA plans instead of Medicaid and Medicare.
  8. Allow alternative enrollment pathways.
  9. Give states the authority to review plan designs and formularies.
  10. Promote states to create “skinny” state exchanges, which cost less and rely on innovation from the private sector.

Healthcare Reform News Update for January 10, 2018

Maryland Lawmakers Propose Replacement for ACA Individual Mandate

Two Maryland Democratic state lawmakers proposed a program Tuesday that will impose a penalty on Maryland residents who don’t buy health insurance. The money would be used as a down payment for a plan on the state exchange.

The measure is the nation’s first response to the recent repeal of the Affordable Care Act’s individual mandate, which imposed a penalty on Americans who did not have health insurance.

Stat Senator Brian J. Feldman and Delegate Joseline A. Peña-Melnyk introduced the proposal, which would start in 2020.

The law would charge uninsured residents a penalty that could be used to help pay for a plan on the state exchange. If the cost of the penalty is equal to or more than the cost of an available plan, the resident can receive coverage at no additional charge. Residents would also have the option of simply paying the penalty.

Supporters of the measure are optimistic that Governor Larry Hogan (R) will support it, but he has not commented.

Alexander: President Supports Stabilization Bill

Senator Lamar Alexander (R-TN) told reporters Tuesday that President Donald Trump voiced his approval of the bipartisan Alexander-Murray bill, which was created to help stabilize the ACA marketplace.

The measure extends cost-sharing reduction (CSR) payments to insurers for two years. Proponents hope to include the bill as part of an upcoming funding package.

Repeal of ACA Takes a Backseat for GOP Leaders

After a meeting with the president last weekend, leading Republicans say that repealing and replacing the Affordable Care Act is no longer a primary issue.

“There’s some work we need to do on the healthcare front, but I would hope we’re in a position to do things on a bipartisan basis,” said Majority Whip Sen. John Cornyn (R-TX). He said they did not discuss ACA repeal during the meeting.

Some lawmakers, including Senator Lindsey Graham (R-SC), want to keep up the effort, but Trump and other GOP leaders have prioritized other issues, such as job training.

Healthcare Reform News Update for January 9, 2018

HHS Nominee Gets Pushback From Pro-ACA Group

As Health and Human Services (HHS) secretary nominee Alex Azar begins his confirmation hearing today, pro-Affordable Care Act group Protect Our Care has released a digital ad urging senators to oppose his nomination.

“President Trump and Republicans in Congress are in search of a new leader for their war effort to captain their repeal and sabotage campaign, and in a former pharmaceutical executive they have found their man,” the ad states.

Despite opposition from the group and several Democratic lawmakers, Azar’s appointment to the position is expected to be confirmed.

HHS Sued by Insurer for Failure to Reimburse CSR Payments

Nonprofit insurer Maine Community Health Options (MCHO) has filed suit against the Trump administration for its failure to pay cost-sharing reduction (CSR) reimbursements of $5.6 million last year.

In October, President Donald Trump signed an executive order that stopped the payments.

In its lawsuit, MCHO says that the failure to provide the CSR payments violated an Affordable Care Act contract between HHS and insurers.

Healthcare Reform News Update for January 8, 2018

Idaho Opens the Door to Skimpier Health Plans

Governor Butch Otter (R) of Idaho signed an executive order Friday allowing state health insurers to sell policies that do not meet Affordable Care Act requirements.

In an attempt to provide lower-cost options for consumers, the new plans would not cover all of the ACA’s 10 essential benefits, which include prescription drugs, emergency care, maternity care, and mental health services. The plans would also not be eligible for government subsidies.

Some officials have questioned the legality of the plans, but Otter said recent actions in Washington helped make way for his order.

“Congress and President Trump have eliminated the individual mandate requiring all Americans to buy Obamacare plans or face financial penalties. That means we will no longer be penalized for buying coverage that doesn’t meet all the Obamacare rules,” Otter said in a statement.

The state will still be required to sell ACA-compliant plans.

Healthcare Reform News Update for January 5, 2018

Labor Department Issues Association Health Plan Proposal

The Trump administration on Thursday proposed new rules allowing small employers and self-employed individuals to form associations to purchase health insurance.

The Department of Labor issued the proposal, which would expand the definition of eligible members and provide health coverage that’s exempt from many of the Affordable Care Act’s essential benefits, including prescription drugs, hospitalization, maternity care, and emergency care.

The proposal also allows associations to form specifically to provide healthcare for its members. “A plan could serve employers in a state, city, county, or a multi-state metro area, or it could serve all the businesses in a particular industry nationwide,” according to the release.

Poponents of the new rules say that it will provide lower-cost health insurance alternatives and give businesses more choices. Critics fear they could increase consumers’ out-of-pocket costs and cause healthier people to drop from ACA individual plans, which could lead to instability.

The proposal is now open for comment from the public for the next 60 days.

Senator Hopes ACA Stabilization Bills Pass This Year

Senator Susan Collins (R-ME) continues to push for passage of both bipartisan ACA stabilization bills despite pushback from the House. She now believes it can happen before 2019.

Collins voted in favor of the tax overhaul legislation that repealed the ACA’s individual mandate under the condition that the stabilization measures become law to prevent rising premium costs.

One of the stabilization bills restores cost-sharing reduction (CSR) payments to insurers for two years; the other allows states to set up reinsurance programs.

“When the mandate is repealed in 2019, we must have other health care reforms in place in order to prevent further increases in the cost of health insurance. Senator Collins believes that averting these price spikes, particularly for low-income families, should be a goal that members of both parties can embrace,” said a statement from the senator’s office.

Healthcare Reform News Update for January 4, 2018

Analysts Predict Stable 2018 ACA Marketplace

Global credit rating organization A.M. Best believes that insurance markets under the Affordable Care Act (ACA) will be relatively stable this year.

According to a briefing released Wednesday: “Negative factors continue to impact the industry, but A.M. Best believes that insurers overall have been able to adapt and as a result, does not expect any significant deterioration in market conditions over the next year.”

However, the firm’s analysts said the forecast could change if Congress succeeds in repealing and replacing the ACA.

Healthcare Reform News Update for January 3, 2018

Conservative Groups Urge President to Promote ACA Repeal

Forty-three conservative advocacy groups sent a letter to President Donald Trump asking for his administration and Congress to prioritize repealing the Affordable Care Act this year.

Signers included Independent Women’s Voice, Heritage Action, Americans for Tax Reform, and Susan B. Anthony List.

An excerpt from the letter: “Health reform must be the focus of the 2019 budget reconciliation instructions. And your administration’s leadership can help the Senate and the House design a bill that can muster the votes needed for passage of true health reform to give Americans more choices of more affordable health coverage and care that meet their needs.”

The White House made no commitments, but a spokesman said that healthcare will be one of the topics discussed in meetings with Congress this week.

Confirmation Hearing for HHS Secretary Scheduled for Next Week

President Donald Trump’s pick to lead the Department of Health and Human Services (HHS) will face his confirmation hearing with the Senate Finance Committee on January 9.

Alex Azar was previously a deputy secretary for HHS and an executive at pharmaceutical company Eli Lilly.

If confirmed by the full Senate, Azar would replace Tom Price, who resigned from the position in September.

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