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Health Exchange Alert Weekly Report - 12/13/2017

  • Physician Groups Ask HHS Not To Condition Medicaid Coverage On Work

    Six physician groups on Friday (Dec. 8) wrote to Acting HHS Secretary Eric Hargan and and CMS Administrator Seema Verma asking them not to use Medicaid waivers to place limits and barriers on coverage, such as by conditioning coverage on work. The groups also ask the Trump administration to ensure that 1115 waivers help people maintain affordable coverage.

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  • CMS May Axe Grace Period For Consumers 'In-Line' To Enroll At OE Deadline

    Stakeholders expect CMS to shut out potential enrollees attempting to register for a plan on healthcare.gov as the clock strikes midnight on Dec. 15 and not afford them a grace period for sign-ups as the agency has done in years past -- and the agency wouldn't deny that might be the case when asked about it by Inside Health Policy.

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  • Collins, Alexander Still Upbeat On Stabilization Bills After Huddle With Pence

    After huddling with Vice President Mike Pence outside the GOP Conference lunch Tuesday, Sens. Susan Collins (R-ME) and Lamar Alexander (R-TN) expressed confidence that market stabilization bills to fund the ACA's cost-sharing reduction payments and set up reinsurance funding would be included in must-pass legislation before the end of the year.

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  • W&M Bills Would Reduce, Delay ACA Taxes; Pause Employer Mandate

    House Ways & Means Republicans on Tuesday (Dec. 12) introduced a package of bills that would delay the Affordable Care Act's medical device tax by five years, reduce the tax on health issuers that are able to rebate consumers in 2018 and provide full relief to all issuers in 2019, stop implementation of the employer mandate, push the start date for the controversial Cadillac tax by one year to 2021, and freeze for two years the ban on using consumer-directed accounts to purchase over- the-counter medications.

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  • Sources: Health Insurance Tax Delay Could Exclude Some Plans

    House Ways & Means Committee Chairman Kevin Brady (R-TX) said he is still working with Democrats on year-end legislation that would delay the health insurance tax for two years, but lobbyists working on the effort are concerned that Congress may restrict the HIT delay to exchange, Medicare Advantage and Part D plans for 2018, meaning employer-sponsored and Medicaid plans would still be hit by the tax, while all plans would have relief starting in 2019.

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  • Lawmakers Hope To Fund CHIP This Month, But Omnibus May Slip

    Lawmakers still hope to fund the Children's Health Insurance Program by year's end, even though the omnibus appropriations bill on which lobbyists thought CHIP would ride seems to be slipping into next year. Lobbyists and congressional aides said CHIP could be attached to a second continuing resolution bill that temporarily funds the government.

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  • Wyden, Murray Call On CMS To Extend ACA Open Enrollment Period

    Three days before the 2018 Affordable Care Act open enrollment period comes to an end, the ranking Democrats on the Senate Finance and Health committees are asking the Trump administration to extend the Affordable Care Act's open enrollment period to Jan. 31 amid speculation among Washington insiders that an extension or grace period isn't forthcoming. A bipartisan group of Virginia lawmakers, led by Sens. Tim Kaine (D) and Mark Warner (D) and Rep. Tom Garrett (R), also recently asked HHS to extend the open enrollment period, which they said would also give Congress more time to pass legislation aimed at stabilizing the market.

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  • LePage Doubles Down On Fight Against Maine Medicaid Expansion

    Maine Gov. Paul LePage (R) on Monday (Dec. 11) sent the state legislature a list of demands he says must be met before the state expands Medicaid, as called for by Mainers in the Nov. 7 election. The legislature's budget committee is scheduled to discuss funding for the expansion on Wednesday (Dec. 13).

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  • PhRMA Challenges Constitutionality Of CA Drug-Price Transparency Law

    Brand drug makers on Friday (Dec. 8) challenged the constitutionality of a California drug-price transparency law. The lawsuit by the Pharmaceutical Research and Manufacturers of America argues the law violates numerous constitutional provisions, including the Commerce Clause, the First Amendment and the Fourteenth Amendment's Due Process Clause, and it raises concerns the law would set national pricing policy.

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  • IRS Issues Guidance On Exemptions In Areas With No Bronze Plans

    The IRS in recent guidance explains that individuals living in areas in which no bronze-level plans are offered can request a hardship exemption from the Affordable Care Act's individual mandate if the lowest cost plan in that region, which would generally be a silver-level plan, is unaffordable. The Affordable Care Act requires Americans to either purchase coverage or pay a penalty, but allows people to claim an exemption if the lowest cost plan in their service is more than a certain percentage of income, or 8.16 percent for 2017.

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  • Alexander Cites Avalere Study In Press For CSR, Reinsurance Funding

    Senate health committee Chairman Lamar Alexander (R-TN) cited Avalere research, which found cost-sharing reduction and reinsurance funding could lower premiums by as much as 18 percent in 2019, on the Senate floor Thursday (Dec. 7) in a press for Congress to pass the Alexander-Murray CSR deal and $10 billion in reinsurance funding by year's end.

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  • Brady Indicates Caddy Tax Delay Possible For CR; Stakeholders Rally

    Stakeholders lobbying to remove the Affordable Care Act's 40 percent tax on high-cost employer plans now set to go into effect in 2020 are hopeful a two-year delay of the tax will make it into a year-end spending bill, and note that if Congress fails to act soon employers will begin making health benefit decisions that will be impossible to reverse. Ways & Means Chair Kevin Brady (R-TX) has indicated a delay of the so-called Cadillac tax on the table.

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  • Experts Worry Exchange Sign-Ups Slowing As Plan Selections Hit 3.6M

    Enrollment in the states using healthcare.gov is now at 3.6 million new or actively renewed consumers, far more than the same time last year, but ACA advocates worry that the pace is slowing, and place the blame on the Trump administration's decision to slash the advertising budget. Open enrollment for healthcare.gov will end Dec.15, and in previous years officials had ramped up marketing in the final days.

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  • CMS Pushing For Approval Of Medicaid Work Requirements By End Of Year

    CMS' general counsel is gearing up to combat expected litigation from health care advocates if the agency moves forward with its plan to let states impose Medicaid work requirements, and CMS Administrator Seema Verma and state officials reportedly now are working to roll out approvals by the end of the year, according to those familiar with the process.

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  • Paul Proposes Letting Rx Makers Vary Discounts To Move Away From Rebates

    Sen. Rand Paul (R-KY) on Tuesday (Dec. 12) proposed letting drug companies offer varying up-front discounts because doing so would move industry away from rebates that are blamed for obscuring business deals many lobbyists and policy analysts say contribute to price increases. Paul said allowing discounts directly from the manufacturer is a way to achieve price transparency without mandating it.

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  • National Health Spending Growth Declines, But Larger Piece Of Economy

    National health care spending growth decelerated in 2016 following two years of coverage expansion under the Affordable Care Act and high retail prescription drug spending growth, but even though the rate of spending growth declined, the share of the economy devoted to health care grew slightly as that spending increased 1.5 percentage points faster than the gross domestic product.

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