Health Exchange Alert Weekly Report - 05/16/2018
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In the wake of their failed congressional pitch for Affordable Care Act market stabilization legislation, Senators Lamar Alexander (R-TN) and Susan Collins (R-ME) are now talking with CMS Administrator Seema Verma about administrative solutions to mitigate Obamacare premium increases -- including possible agency action to let states easily replicate already-approved 1332 waivers, speed up the waiver approval processes, and facilitate the creation of invisible high-risk pools.
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A pro-ACA group Wednesday launched a campaign that casts blame on the Trump administration and the GOP-led Congress for premium increases, holding up the GOP's repeal of the individual mandate penalty, cutback of ACA advertising and outreach, and proposed non-ACA compliant plan options that could undermine the risk pools. Democrats say they want to work with the GOP on ways to reverse the rate hikes but see little hope for a way forward.
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Health policy experts at the Urban Institute are advancing a new universal health care proposal that would build off existing health care programs. The Healthy America plan, which the authors note is unlikely to move in the near term, would expand income-related federal subsidies for insurance coverage that would be offered in marketplaces that mirror the Medicare market, restructure the tax penalty for those who don't buy coverage, and integrate Medicaid and Children's Health Insurance Program into private coverage.
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Affordable Care Act enrollment could decline by 3-10 percent due to consumer exodus to Association Health Plans if the administration moves forward with its AHP proposal, according to a Friday (May 11) study published by the Society of Actuaries. The study also found that the projected movement from ACA plans to AHPs could vary drastically depending on an enrollee's coverage status, and how much care they need.
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CMS has received Ohio's request to add work requirements to its Medicaid program, the agency said Tuesday (May 15).
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Louisiana is warning 37,000 Medicaid beneficiaries -- most of them in nursing homes or group homes -- that they may lose their benefits on July 1 if state lawmakers cannot resolve a budget shortfall. The state has not yet submitted a state plan amendment to CMS requesting permission for the cuts, and state health experts said the state is delaying that submission for as long as possible in the hope that lawmakers will reach a deal to save the affected programs.
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Many of the policies in the president's drug price plan put the onus on patients to get cheaper drugs: such as including prices in drug ads, giving patients information on competing drug prices during office visits, posting drug prices on Medicare's "dashboard" website and banning gag orders that stop pharmacists from telling customers when it is cheaper to buy drugs without insurance. Other immediate actions weaken patient protections in Part D by letting plans limit coverage to one drug in each class and allowing for medication management in the six protected classes.
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HHS Secretary Alex Azar told senators that the administration's proposed short-term, limited duration plans are meant to serve as a Band-Aid for consumers facing skyrocketing costs in the absence of congressional action to shore up the ACA markets. As he defended the plans on Capitol Hill, Azar also repeatedly emphasized that short-term plans are not a good option for all consumers and argued that mandating coverage for preexisting conditions in short-term plans would drive up costs.
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HHS Secretary Alex Azar would not say whether the administration will take executive action to bar Planned Parenthood from receiving Title X funding, while sparring with Sen. Patty Murray (D-WA) during a Thursday (May 10) Senate Appropriations hearing on the HHS budget.
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GOP Governor Scott Walker's effort to shore up Wisconsin's ACA market via a reinsurance program continues to move forward at a rapid clip, with the administration saying Wednesday (May 9) that the waiver application is complete only three weeks after the state submitted a proposal. The program, if approved, would lower premiums by about 11 percent, according to the state.
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Kids' advocates railed against the Trump administration's request to rescind $7 billion from the Children's Health Insurance Program, concerned that nearly $2 billion would be taken out of a contingency fund states might need and that the proposed remaining $5 billion cut still hits health funding, if not CHIP directly, because lawmakers routinely use that money to plug holes in HHS' budget.
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North Dakota Insurance Commissioner Jon Godfread announced Tuesday (May 8) that the state is looking to mitigate Affordable Care Act premium increases for the 2020 plan year by creating a state reinsurance program, modifying the state's risk pools or implementing a plan similar to Idaho's state-based plan initiative. Idaho's proposed plans, which would be ACA non-compliant, have yet to receive approval from the Trump administration, and North Dakota is the first state to publicly express interest in copying Idaho's approach.
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