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Health Exchange Alert Weekly Report - 03/22/2017

  • Updated GOP Bill Blocks New Medicaid Expansion, Repeals ACA Taxes Now

    GOP chairs of key House committees unveiled a much-anticipated managers amendment that revises their health reform legislation in a bid to get the 218 votes needed to pass the bill, which is slated for a floor vote Thursday.

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  • House Freedom Caucus Chair Still Opposed To ACHA Despite Changes

    House Freedom Caucus Chair Mark Meadows (R-NC) said GOP leadership's changes to the American Health Care Act don't satisfy the conservative group's issues with the bill. Chair of the moderate Tuesday Group, Rep. Charlie Dent (R-PA), also said the changes floated to accommodate his concern about the tax credits don't go far enough. Meadows predicted there wouldn't be enough votes to pass the bill when it comes to the floor on Thursday.

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  • Four GOP Govs Push Medicaid Reform Plan With 3 Options

    Four GOP governors whose states expanded Medicaid said the health bill heading to a House vote would cripple state Medicaid programs and urged Republicans to stabilize private insurance before broaching Medicaid -- while floating their own reform plan that lets states choose Medicaid per-capita caps, block grants or the current financing structure, and gives states new flexibility to set program requirements and to control drug costs by not having to cover all FDA-approved drugs.

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  • Manager's Amendment Draws More AHCA Support, Still Some Holdouts

    After a managers amendment and a visit from President Donald Trump and HHS Secretary Tom Price, some moderate Republicans have decided to support the American Health Care Act. But House Freedom Caucus Chair Mark Meadows, who Trump specifically called out during a Republican conference meeting Tuesday (March 21), said there are still enough people in his conservative bloc to prevent the bill's passage on Thursday.

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  • S&P: States May Lose Medicaid Managed Care Plans Under AHCA

    States will need to lean on private Medicaid insurers under the per-capita caps proposed in the GOP's American Health Care Act, but the plans may lose money under the new financing model and have to walk away from their Medicaid contracts with states, Standard & Poor's ratings analysts say.

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  • House Rules Panel Moves AHP, Anti-Trust Exemption Bills To Floor

    The House Rules Committee cleared for a House vote on Tuesday legislation promoting association health plans and repealing the anti-trust exemption for the health insurance industry. The bills are part the GOP's three-phase health reform process that includes passing reconciliation, making regulatory adjustments and passing a series of other bills, including reforming medical malpractice and potentially addressing high drug costs.

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  • AHA Launches TV Ad Urging Congress To Protect Affordable Coverage

    The American Hospital Association (AHA) launched a new television ad in the Washington, DC market that urges members of Congress to protect the coverage the Affordable Care Act (ACA) provided to more than 20 million Americans. The ad comes as the GOP-led House has scheduled a vote on the House GOP health bill Thursday (March 23), the seven-year anniversary of House passage of the ACA, that the Congressional Budget Office (CBO) estimates would result in 24 million fewer people with insurance by 2026.

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  • House Freedom Caucus To Offer Amendments At Rules Markup Of AHCA

    The House Freedom Caucus remains largely opposed to the American Health Care Act as currently drafted and members plan to file amendments at the Rules Committee markup Wednesday (March 22) in a bid to further change the bill before it hits the House floor Thursday. This comes as the White House courts the most conservative bloc in the lower chamber.

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  • Withdrawn Amendment Would Have Stripped Penalties For ACA Market Reforms

    Rep. Ted Yoho (R-FL) introduced, but later withdrew, an amendment that would strip the federal government's ability to penalize issuers for failing to comply with all of the ACA market reforms except requirements they cover children up to age 26 on their parents' plans and bar discrimination for people with preexisting conditions. The amendment, which would be added to legislation repealing the McCarran-Ferguson anti-trust exemption for health issuers slated to go to the Rules Committee Monday (March 20), mirrors Yoho's Holding Health Insurers Harmless Act introduced last week. It was withdrawn because is was deemed not germane to the antitrust bill, his office says.

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  • Employers See Opening For Further Caddy Tax Delay, Full Repeal

    Employer stakeholders, while pleased the GOP health bill would delay implementation of the 40 percent tax on high-cost health plans through 2024, remain hopeful lawmakers will fully repeal the so-called Cadillac tax or at least delay it an additional two-years in the final version of the bill.

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  • HHS Revamps Website To Explain ACA Regulatory Overhaul

    As House Republicans ready themselves to vote on a bill to repeal and replace the Affordable Care Act, HHS updated its website to explain the regulatory changes it is making to undermine the law and stabilize the marketplace.

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  • Energy & Commerce Touts Avalere Report On AHCA Stabilization Fund

    House Energy & Commerce Republicans on Friday (March 17) touted a new Avalere report on the American Health Care Act's patient and state stability fund for 2018, which found states with the fewest insurers in the exchange markets would likely see the most money under the current methodology, as would large states like California and New York.

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  • Massie: GOP Leadership Jeopardizes Lawmakers' Seats By Pushing AHCA

    As Republican leadership whips votes for the American Health Care Act, due on the House floor on Thursday (March 23), members of the conservative Freedom and Liberty Caucuses say they still count 40 lawmakers who continue to oppose the bill. One Liberty Caucus member, Rep. Thomas Massie (R-KY) said that since the bill seems doomed in the Senate, lawmakers may be jeopardizing their seats in 2018 for no reason if they vote for it.

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  • Wyden Questions How Verma's Medicaid Work Fits With Ethics Obligations

    Senate Finance ranking Democrat Ron Wyden (OR) is raising questions about how HHS will make sure that CMS Administrator Seema Verma complies with all necessary ethics rules -- including President Trump's executive order barring administrators from working with former clients for two years -- considering she worked directly with states to help negotiate waivers from CMS through her consulting firm and has announced her intentions to work with governors to revamp Medicaid since taking office.

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  • RSC Chair Backs GOP Health Bill, But Freedom Caucus Still Holds Out

    Republican Study Committee Chair Mark Walker (R-NC) and 16 out of 17 members of the RSC steering committee agreed to support the American Health Care Act after President Donald Trump assured them that there would be an option for states to block grant Medicaid and to implement work requirements for able-bodied Medicaid beneficiaries without dependents, and that the tax credits cannot be used to pay for abortions. But House Freedom Caucus members continue to slam the bill and are not satisfied with the proposed amendments.

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  • Conservatives: HHS 'Phase 2' May Lead To Litigation, Instability

    Vocal members of the Freedom Caucus said after a Friday (March 17) meeting with HHS Secretary Tom Price and CMS Administrator Seema Verma that the promised administrative "phase 2" of the Republican health overhaul doesn't assuage their opposition to the American Health Care Act. They fear that uncertain HHS changes on top of a bill they view as weak will cause further problems for health care.

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  • Roe Said AHCA Tax Credits Could Be Changed During Tax Reform

    Some Republicans have suggested beefing up the tax credits in the American Health Care Act after the scathing Congressional Budget Office scores, but Rep. Phil Roe (R-TN) says tax credits can be handled in a separate tax reform measure down the road. Though Roe did note that House Speaker Paul Ryan (R-WI) told lawmakers that tweaks would be made to the tax credits in AHCA to help older adults and possibly lower-income individuals.

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  • Former CBO Head: GOP Bill Cuts Medicaid Beyond ACA Repeal

    Republicans' plan to repeal and replace the Affordable Care Act would go much further for Medicaid than a mere reversal of ACA policies, former Congressional Budget Office Director Douglas Elmendorf said Thursday (March 16). After the CBO estimated greater-than-expected coverage losses, Republicans began considering changes that would offset some of those losses, including increasing tax credits to buy private exchange coverage, but most of the estimated coverage losses were in Medicaid, and far-right Republicans began pushing policies that would further cut Medicaid enrollment following the CBO score.

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  • Price, Verma Brief House GOP On Administrative Changes To Medicaid

    CMS Administrator Seema Verma accompanied HHS Secretary Tom Price to a meeting with Republican lawmakers Friday morning (March 17) to explain changes the administration plans to make to Medicaid without the help of Congress. Following the meeting, Republicans responded to questions about the timing of a floor vote, vote counts and changes to the legislative package that they're entertaining, but Rep. Diane Black (R-TN) said the meeting focused on "phase two" of the GOP's health care overhaul, which represents what the party can accomplish through administrative changes.

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  • BPC Exec: Extend CHIP Funding By April Budget Deadline

    As Republicans' health overhaul hits intra-party opposition, one bipartisan think tank is calling for reauthorization of CHIP when funding for the government runs out this spring, rather than waiting until lawmakers complete their work on the American Health Care Act.

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  • Growing GOP Support To Remove Planned Parenthood Provision From AHCA

    Another Republican has shown support for removing the provision in the American Health Care Act that would block federal Medicaid funding for Planned Parenthood for a year. Rep. John Faso (R-NY) voted in favor of a motion to strip the provision during the House Budget Committee hearing Thursday (March 16).

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  • AHCA Passes Budget Committee Despite 3 GOP Defectors

    The American Health Care Act passed the House Budget Committee without amendments 19-17 with GOP Reps. Mark Sanford (SC), Dave Brat (MI) and Gary Palmer (AL) voting against the measure.

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  • Association Health Plans Bill Heads To House Floor Alongside Other Reforms

    House Republicans are slated to bring to the floor next week legislation that would promote creation of association health plans by exempting them from states regulations, as well as a handful of other health reform bills that could be taken up alongside the reconciliation bill that repeals and replaces part of Obamacare. But it is unclear whether Republicans hope to add the association health plan language to the reconciliation package or hold a separate vote that would require 60 votes for passage.

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  • McCarthy, Patients At Odds On AHCA's Effect On HCBS

    Capping federal Medicaid funding would likely lead to cuts in services that disabled beneficiaries receive in their homes and communities, lobbyists for disabled patients say, but House Majority Leader Kevin McCarthy (R-CA) says beneficiaries that need home and community-based services would be better off under the GOP's health care bill -- and without Medicaid expansion -- because states are less able to care for disabled beneficiaries when they expand Medicaid to childless adults.

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  • CMS: 12.2M Enrolled In Exchange During 2017 Open Enrollment

    A total 12.2 million people either signed up for or were automatically re-enrolled in coverage through a state-based (3 million) or federally run (9.2 million) health insurance exchange in the 2017 open enrollment period that ended Jan. 31, about 500,000 fewer than last year, according to CMS' final enrollment report released Wednesday. ACA supporters had expected lower numbers this year due to uncertainty over President Trump's Executive Order calling for administrative efforts to unravel the ACA as well as HHS' decision to halt advertising for Healthcare.gov during the final week of enrollment.

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  • RSC Floats 'Managers Amendment' With Changes To Medicaid, Tax Credits

    The Republican Study Committee is seeking several changes to the House GOP's health care bill through a manager's amendment that would freeze Medicaid enrollment as of Jan. 1, 2018, institute a work requirement for childless adults, and reduce the per-capita growth rate so that it doesn't exceed historical rates, according to details obtained by Inside Health Policy, all of which are likely to be blasted by GOP moderates and governors in states that expanded Medicaid.

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  • Price, Verma Urge Governors To Revamp Medicaid

    HHS Secretary Tom Price and CMS Administrator Seema Verma wrote to governors Tuesday that Medicaid expansion is "a clear departure from the core, historical mission" of the program, and began overtures to states to revamp the program. They said tax dollars should go to the most vulnerable, urged states to shift to private insurance models and use 1115 waivers to incentivize employment for Medicaid-eligible, poor adults, and said HHS will review all managed care regulations and put off enforcing the 2014 home and community-based services rule.

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