GOP Health Reform

A case that could define the extent of CMS’ authority to issue legal interpretations without conducting notice-and-comment rulemaking will be argued before the Supreme Court on Jan. 15.

The Trump administration released four policy concepts that states could pursue under the controversial new Section 1332 guidance out last month, including an accounts-based system that lets state direct public funds into a consumer account for the purchase of coverage and other health expenses.

House Speaker-nominee Nancy Pelosi (D-CA) welcomed a Democratic-led caucus with a health care mandate, proclaiming the party’s campaign focus on protecting the Affordable Care Act helped Democrats secure the chamber. Pelosi, who faces a formal vote to be speaker in January, vowed the House would spend the next two years continuing that focus while combatting the Trump administration’s past two years of action to unravel parts of the ACA.

CMS has approved HealthSherpa as its first partner to use the new enhanced direct enrollment pathway that will allow consumers, including those eligible for subsidies, to purchase exchange plans from web entities, including web-brokers, private exchanges and insurers, without having to visit healthcare.gov, sources tell Inside Health Policy.

CMS is expected to release on Thursday (Nov. 29) some specific examples of potential Section 1332 waivers that could be approved under the administration’s revised guidance, according to CMS Administrator Seema Verma and another knowledgeable source.

MS proposed Monday (Nov. 26) letting Part D plans exclude drugs in protected classes from Part D formularies when their makers raise prices faster than inflation or when drug companies make new formulations of drugs already on the market.

SAN FRANCISCO -- Consumer advocates are urging state insurance regulators to use their positions to help get the word out about open enrollment since the federal government has slashed funding for marketing and outreach.

The Department of Justice asked Maryland to both withdraw its lawsuit to protect the Affordable Care Act and to dismiss its request that acting Attorney General Matthew Whitaker be removed from the case, arguing that Maryland doesn’t have a legal right to determine the law’s constitutionality.

SAN FRANCISCO -- CMS director of exchange policy Randy Pate told state regulators that the agency will provide more specific examples of potential waivers under the new 1332 guidance but continued to stress state officials should bring ideas to the table.