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Health Exchange Alert Weekly Report - 06/21/2017

  • 'Discussion Draft' Of AHCA Coming Thursday, Vote Expected Next Week

    Senate GOP leadership will release a working draft of its version of the American Health Care Act on Thursday (June 22) with the goal of a vote next week, Senate Majority Leader Mitch McConnell (R-KY) confirmed Thursday amid mounting frustration among key moderate and conservative lawmakers that they haven't seen the bill and that their asks have not been incorporated.

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  • Gingrich Tells GOP To Hit The Brakes On ACA Repeal Efforts

    Former House Speaker Newt Gingrich (R) penned an op-ed Monday urging his fellow Republicans to slow down their push to repeal and replace the Affordable Care Act because it is being branded as hurting elderly individuals and will hurt the party politically in the midterms. Gingrich, who informally advised Donald Trump during the presidential transition, said GOP lawmakers should stabilize the market and fund the ACA's cost-sharing reduction payments through 2018 before working on a long-term health care overhaul.

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  • Iowa 1332 Waiver Poses Litmus Test On CMS Flexibility

    The Trump administration has stressed state flexibility in its plans for a health care overhaul, but Iowa's 1332 waiver requesting changes to stabilize its insurance market for 2018 will test how far the agency can go given the statutory limits of such waivers. Iowa Insurance Commissioner Doug Ommen tells Inside Health Policy that the state's plan fits into President Donald Trump's executive order granting states flexibility and the ability to waive requirements that are causing fiscal or regulatory burdens.

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  • First Phase Of SEP Pre-Enrollment Verification Process Kicks In June 23

    CMS is set to roll out its new pre-enrollment verification process for special enrollment periods in two phases, with the first slated to start June 23 for two categories -- a permanent move and loss of minimal essential coverage -- and the second phase starting in August for additional categories -- marriage, adoption, birth, and denial of Medicaid or CHIP. The agency has been holding webinars to introduce the process to insurance enrollment assisters, agents and brokers as well as consumers advocates, some of whom tell Inside Health Policy they worry the process will be too confusing for many people.

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  • Cassidy Still Pushes Auto-Enrollment As Senate Health Reform Vote Nears

    Sen. Bill Cassidy (R-LA) is still advocating for passive enrollment and touting his Patient Freedom Act bill with moderate Sen. Susan Collins (R-ME) even as a vote on the emerging Senate health care bill is expected next week.

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  • Bipartisan Coalition Of Governors Urges McConnell To Stabilize Markets

    Seven Republican and Democratic governors are calling on Senate Majority Leader Mitch McConnell (R-KY) to work with them to help stabilize endangered state exchanges, and their priority is making plans affordable.

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  • Schumer Calls For All-Senate Bipartisan Meeting On Health Care

    Senate Minority Leader Charles Schumer (D-NY) on Friday (June 16) called on Majority Leader Mitch McConnell (R-KY) to bring his caucus to an "All-Senators" meeting this week in the old Senate Chamber to discuss health reform.

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  • House GOP Pulls Medical Malpractice Bill Over States' Rights Concerns

    House Republicans postponed a floor vote on medical malpractice legislation because some conservatives are worried about imposing federal standards on states, according to Freedom Caucus Chair Mark Meadows (R-NC). Tort reform is one of many issues that House Republicans had wanted to address in the American Health Care Act but were forced to deal with separately because of budget rules. The president's 2018 budget request also calls for medical malpractice reform.

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  • Nevada Governor Vetoes Medicaid Buy-In Bill

    Gov. Brian Sandoval (R-NV) waited until the deadline day, Friday (June 16), to veto a bill that would have allowed anyone to buy into the state's Medicaid managed care plans, although he praised the "creativity" of Nevada Assemblyman Michael Sprinkle, who wrote the bill, in his three-page veto message. Sandoval's decision comes in a charged moment, as moderate Republicans including the Republican senator from his own state, Dean Heller, face an imminent and difficult vote on the American Health Care Act.

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  • Murray, Grassley Worry Justice Department Restricting Oversight Requests

    HHS Secretary Tom Price said he has instructed his agency to respond to requests for information from all members of Congress, despite what Sen. Patty Murray (D-WA) called a "disturbing" memo from the Justice Department's Office of Legal Counsel that says the executive branch should only consider requests from committee chairs or full committee requests as oversight.

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  • Price Said He Hadn't Seen Senate GOP's Health Bill

    HHS Secretary Tom Price told senators Thursday (June 15) that he had not seen legislative language for the Senate GOP's health care overhaul, though his staff has provided lawmakers with some technical assistance. When pressed by Democrats at a Senate Appropriations subcommittee hearing about the lack of transparency around the upper chamber's health care efforts, Price said it was not his place to critique the legislative process.

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  • Alexander Urges Administration To Continue CSR Payments Through 2018

    Sen. Lamar Alexander (R-TN) on Thursday (June 15) became the second congressional GOP chair to recommended the administration fund cost-sharing reduction payments at least through 2018, and he said it would be preferable for the subsidies to run through 2019. Alexander told HHS Secretary Tom Price at a Senate Appropriations subcommittee hearing that the CSR payments would keep many people from having no options to buy insurance in 2018.

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  • Analysts: Periodic Rebasing Of Per-Capita Caps Could Still Hurt States

    Senate Republicans have mulled the idea of rebasing the formula for Medicaid per-capita caps on a weighted average every three years to woo moderates, a proposal that health care experts say could shield states from some of the risk imposed by per-capita caps but could also lock in deep federal funding cuts for states that reduce their Medicaid spending the most.

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  • Separate Opioid Funding Could Limit Care For Addicts, Experts Warn

    Mental health advocates are blasting a Senate Republican proposal to set up a separate funding pool for the care of opioid addicts currently covered through Medicaid expansion but who under the American Health Care Act would not be allowed to re-enroll in Medicaid once they cycle off.

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  • CMS Actuary Predicts 13 Million More People Uninsured Under AHCA

    The CMS actuary predicted last Tuesday (June 13) that roughly 13 million more people would be uninsured under the House-passed American Health Care Act by 2026, and while the federal government and private business spending is estimated to account for a smaller share of national health spending, state and local governments and households are expected to shoulder more. The Congressional Budget Office estimated that the AHCA would lead to a much higher loss of coverage, 23 million more uninsured, but used a different baseline.

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  • Trump Tells GOP Sens. To Pass Bill Because Exchanges Struggling

    President Donald Trump invited Republican senators to the White House last Tuesday (June 13) to deliver a message that the Senate needs to pass a health care bill because insurers are increasingly dropping out of the exchanges, and Vice President Mike Pence held up a new CMS county-by-county report to paint a picture of fewer consumers buying coverage. Sen. John Thune (R-SD), who attended the meeting, said some lawmakers pitched a short-term stabilization plan that funds cost-sharing reduction payments.

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  • Centene To Expand ACA Individual Market Coverage In 2018

    While a lot of insurers have been dropping out of the ACA's individual market, Centene announced on Tuesday (June 13) that the company plans to expand its presence in Florida, Georgia, Indiana, Ohio, Texas and Washington and enter three new markets. The news comes as CMS released a report citing a lack of insurers participating in the exchanges for 2018 -- insurer filing deadlines are next week -- and as Senate Republicans mull a short-term market stabilization bill.

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  • Executive Order On Rx Prices Could Direct CMS To Test Value-Based Designs

    President Donald Trump could use an executive order to direct the CMS innovation center to waive rules that would make it easier for drug companies and insurance companies to use value-based contracts, said Paul Howard, director and senior fellow at the Manhattan Institute. Drug industry representatives met with administration officials Friday (June 16) to discuss policies aimed at curbing drug price increases, and drug industry lobbyists said news reports about a soon-to-be-released executive order aimed at encouraging value-based contracts are true.

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  • HHS Pays June CSRs But Still Weighs Future Payments; Filing Deadline

    HHS tells Inside Health Policy it has paid insurers the ACA's cost-sharing reduction payments for June, but is still deciding whether to make the payments going forward as the administration urges Congress to pass the American Health Care Act. Insurers have until Wednesday (June 21) to file rates for next year.

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