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Health Exchange Alert Weekly Report - 02/15/2017

  • GOP Sees Price's Takeover Of HHS As Chance To Revise ACA

    Some GOP lawmakers are looking to newly confirmed HHS Secretary Tom Price to administratively get the ball rolling on an Affordable Care Act overhaul following a party-line Senate vote early Friday morning (Feb. 10) that ended a contentious nomination process which included Democratic boycotts of committee votes. Republican lawmakers looking to chart an ACA replacement path expect Price will tap into the law's flexibility to immediately start making changes while also taking steps to shore up the markets, and produce a legislative ACA overhaul plan the president promised would be unveiled when the new CMS chief took over.

    920 words

  • Blues Float Marketplace Stabilization Options In Meeting With White House

    The Blue Cross Blue Shield Association on Monday (Feb. 6) met with White House and HHS officials on ways to stabilize the exchange market, coming as the Office of Management & Budget reviews a draft rule aimed at doing just that.

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  • Brady: Tax Credits To Be Age-Adjusted, Will Offer Less Funding Than ACA

    House Ways & Means Committee Chair Kevin Brady (R-TX) said the Republican alternative to the Affordable Care Act will not provide the same level of funding for beneficiary subsidies as in the current law, but will provide tax credits that are universal and increase by age as is the case in Speaker Paul Ryan’s (R-WI) Better Way proposal.

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  • GOP Weighing Revisions To Medicaid Federal Match System

    House GOP leadership may revise the federal matching system for states' Medicaid programs in the first budget reconciliation that is likely to be voted on in April, an industry executive close to the talks told Inside Health Policy.

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  • ACA's 'Age 26' Provision Not Priority For Insurers

    Republicans have vowed to keep consumer protections in the Affordable Care Act that cover people regardless of their health status and allow children to stay on their parent's plan until age 26, but there has been some chatter that the provision could be stripped or altered in an effort to get more young, healthy adults to enroll in the exchanges.

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  • CMS Chief-Nominee Verma Offers Medicaid Critique From 2013

    CMS Administrator-designate Seema Verma offered her 2013 public-record testimony, "The Need for Medicaid Reform: A State Perspective," as the main policy statement in the completed questionnaire she submitted to the Senate Finance Committee outlining her qualifications for the job. The questionnaire, obtained by Inside Health Policy, is among the documents cabinet and sub-cabinet nominees have to submit to the Senate committees ahead of their confirmation hearings.

    635 words

  • NGA To Price: Make 1115, 1332 Waivers Easier; Let States Share Duals Savings

    Governors are hopeful newly confirmed HHS Secretary Tom Price will let states make successful 1115 Medicaid waivers permanent, simplify 1332 and 1115 waiver processes, and let states collect on some of the federal Medicaid savings accrued when they lower their spending on dual-eligible beneficiaries, a National Governors Association official said.

    406 words

  • Meadows: Republicans Planning Meetings To Discuss HSAs

    House Freedom Caucus Chair Mark Meadows (R-NC) said at a Heritage Foundation event on Wednesday (Feb. 8) that House Majority Whip Steve Scalise (LA) has scheduled meetings to discuss expanding the use of health savings accounts, a policy on which GOP members reportedly are united.

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  • Moda Risk Corridor Ruling Could Spur More Suits, Settlement Talk

    U.S. Court of Claims Judge Thomas Wheeler ruled Thursday (Feb. 9) that the government failed to abide by a promise made to issuers when it didn't provide ACA risk corridor payments and must pay Oregon-based Moda Health $214 million the company was owned for 2015 and 2015. The ruling, the first win on the merits of issuers suing the government to get the payments, could spur other insurers to sue CMS, prod settlement talks with the Department of Justice, and potentially result in a series of appeals to the federal court and potentially the Supreme Court.

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  • Ways & Means Progressing On Reconciliation Package

    The House Ways & Means Committee is still discussing what policies to include in the reconciliation package that would provide relief to individuals hurt by the Affordable Cart Act and allow more flexibility for states and individuals.

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  • Barrasso: Republicans Meeting With Insurance Chiefs On Tax Credits

    Wyoming Senator John Barrasso (R) tells Inside Health Policy that Republican lawmakers are meeting with insurance commissioners to discuss how to approach ACA tax credits in the upcoming reconciliation bill.

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  • Mike Lee: Don't Include CSRs, Tax Credits In Reconciliation Bill

    Sen. Mike Lee (R-UT) said it is a bad idea to include tax credits and cost-sharing reduction payments in the upcoming reconciliation package because he said the Affordable Care Act should be repealed before determining what it is replaced with.

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  • GPhA Changes Name, Launches Pro- Generic Drug Pricing Campaign

    The generic drug trade association is the latest group to launch a campaign touting its industry as the solution to lowering drug prices, but it is also using its new campaign to push back against certain drug pricing proposals it sees as bad for the generic market. The Generic Pharmaceutical Association (GPhA) announced Tuesday (Feb. 14) that it will become the Association for Accessible Medicines (AAM) and will launch an advertising campaign both touting generics as a means to increase access to medicines, and opposing drug pricing proposals that would regulate the generic industry in the same way as the brand industry.

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  • Reps. Meadows & Jordan, Sen. Lee: Repeal/Replace ACA In 2-3 Months

    Conservative Republicans are lighting a fire under their fellow colleagues to repeal the Affordable Care Act within two to three months at the latest and replace the health care law on the same day.

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  • Meadows' Replace For GI: HSAs, High-Risk Pools, Catastrophic Coverage

    House Freedom Caucus Chair Mark Meadows (R-NC) said lawmakers are talking about using health savings accounts, high-risk pools and catastrophic coverage plans to cover those with pre-existing conditions.

    480 words

  • Source: Administration Likely To Extend Grandmothered Noncompliant Plans

    Former advisor to the Trump transition team expects the administration will extend the ability of issuers to sell non-ACA-compliant insurance plans, sometimes referred to as “grandmothered” plans, that would otherwise be phased out after 2017.

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  • Centene To Expand In 2018 As Other Issuers Await Market Fixes

    Centene CEO Michael Neidorff told investors in an earnings call Tuesday (Feb. 7) that the company expects to be profitable with its exchange products, and revealed it aims to expand into at least two counties in 2018.

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  • Employers Ramp Up Opposition To Cap On Employer Benefits

    The expected lobbying against Republicans' proposal to cap the tax exclusion for employer-sponsored benefits is starting to kick into gear: The American Benefits Council released a survey finding opposition to the cap and the industry alliance working to repeal the ACA's Cadillac tax is expanding its mission to beat back attempts to tax workers' health coverage.

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  • AEI's Jim Capretta: Republicans Should Not Repeal All ACA Taxes Upfront

    Jim Capretta from the American Enterprise Institute argued that Republicans should leave a few of the Affordable Care Act's taxes in place during budget reconciliation so they can use them as leverage to get what they want in the second reconciliation package.

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  • Health Policy Wonks Suggest Tightening SEPs, Grace Periods

    Health policy experts say Republicans should tighten the ACA's special enrollment and grace periods, change the age-rating ratio and allow states more flexibility through the use of the Affordable Care Act’s state innovation waivers as a part of their overhaul and replacement of the ACA.

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  • Sanford To Propose Companion To Rand Paul's ACA Repeal Bill

    South Carolina GOP Rep. Mark Sanford will introduce as soon as next week a companion bill to Sen. Rand Paul’s (R-KY) that repeals and replaces the Affordable Care Act.

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  • Health Policy Experts Suggest Ways For GOP To Deal With CSR Payments

    As Republicans discuss ways to stabilize the individual market, health policy wonks recommend appropriating money to temporarily continue cost-sharing reduction payments.

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  • Alexander: GOP Expects Trump Plan Once Price Confirmed

    Senate health Committee Chairman Lamar Alexander (R-TN) said the reason Republicans have not unveiled a replacement plan for the Affordable Care Act yet is partially because President Donald Trump said he would submit his plan after Tom Price is confirmed as HHS secretary.

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  • Kidney Care Advocates, AHIP Bring Spat Over Premium Assistance To Congress

    Kidney care advocates and insurers brought to Congress last week their ongoing policy battle over whether third parties should be allowed to offer patients premium assistance for private insurance, coming as a federal court reviews the issue.

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  • House GOP Promises Medicaid Reform In Reconciliation But No Details Yet

    Reps. Michael Burgess (R-TX) and Brett Guthrie (R-KY) chaired a Feb. 14 meeting with House Republican lawmakers to outline for their Republican colleagues the differences between per-capita caps and block grants as the GOP plans to include Medicaid changes within their first budget reconciliation.

    675 words