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Health-Exchange-Alert

February 21, 2019 | Daily News

Top House and Senate Democrats sent a letter to CMS Administrator Seema Verma requesting the Trump administration rescind several new policies outlined in the proposed exchange rule for 2020, warning the policies could cause thousands of people to lose health care coverage and raise premiums by millions of dollars.

February 21, 2019 | Daily News

The heads of the 13 state-based health insurance exchanges jointly warn CMS that stopping the automatic re-enrollment process or preventing issuers from silver-loading -- two ideas the agency has said it is considering -- would cause market instability and uncertainty, confuse consumers, hike premiums and increase the number of uninsured.

February 20, 2019 | Daily News

Health care spending is set to rise an average of 5.5 percent annually over the next decade and will reach 19.4 percent of gross domestic product in 2027, CMS’ Office of the Actuary estimated in a report released Wednesday (Feb. 20).

February 20, 2019 | Daily News

Rural hospital groups in Pennsylvania are cautiously optimistic about an all-payer demonstration for rural hospitals that began in January, modeled after a similar demo in Maryland that prevented rural hospitals in the state from closing.

February 20, 2019 | Daily News

Providers groups are praising the inclusion of primary care physicians in Maryland’s expansion of an all-payer model run through the CMS’ Center for Medicare and Medicaid Innovation (CMMI).

February 20, 2019 | Daily News

A bill that takes a unique, aggressive strategy to require pharmacy benefit managers pass drug rebates through to plans was passed out of a Montana Senate committee with only Republican support Thursday (Feb. 14).

February 19, 2019 | Daily News

Eight major hospital associations are asking House and Senate leadership to again delay Medicaid Disproportionate Share Hospital payments, as they say the coverage rates envisioned by the Affordable Care Act haven’t materialized and Medicaid already underpays providers.

February 19, 2019 | Daily News

CMS intends to release an extensive guidance document within the next several weeks that will counsel states on how to implement and evaluate 1115 waivers in Medicaid, with a focus on work-requirement programs.

February 19, 2019 | Daily News

The Trump administration is rejecting a recommendation from the federal Medicaid advisory commission to pause Arkansas’ controversial program of Medicaid work requirements, CMS Administrator Seema Verma told the commission’s chairwoman in a letter obtained by Inside Health Policy.

February 17, 2019 | Daily News

The U.S. Court of Federal Claims handed issuers major wins in four cost-sharing reduction (CSR) cases, including a class action suit brought by Wisconsin’s Common Ground Health Cooperative in which Judge Margaret Sweeney ruled that the government is responsible for reimbursing plans unpaid CSRs in 2017 as well as in 2018, despite the silver-loading workaround. Sweeney issued that decision on Friday (Feb. 15), the same day she ruled in favor of Texas non-profit Community Health Choices and Maine Community Health Options.

February 15, 2019 | Daily News

The insurance industry notched a win Friday with a federal judge ruling that the Trump administration violated the Affordable Care Act and breached an implied contract when it cut off cost-sharing reduction payments and is responsible for reimbursing Texas non-profit plan Community Health Choices, Inc. (CHC) for not only the fourth quarter of 2017, but also for 2018, despite the silver-loading workaround that resulted in higher premium tax credits.

February 15, 2019 | Daily News

Rep. Lloyd Doggett (D-TX) reintroduced his bill requiring hospitals notify patients if the care they are receiving is out of their insurance network, joining efforts by several other Capitol Hill lawmakers to cut back on surprise billing practices.

February 15, 2019 | Daily News

The federal judge overseeing two lawsuits challenging Medicaid work requirements scheduled back-to-back hearings in the cases for March 14.

February 14, 2019 | Daily News

The Fifth Circuit Court of Appeals on Thursday (Feb. 14) decided to let the Democratic-led House intervene in 19 GOP-led states’ controversial challenge to the Affordable Care Act, Texas v. Azar, and said four additional states can join the 17 Democratic attorneys general who are already party to the case.

February 14, 2019 | Daily News

Sen. Brian Schatz (D-HI) and Rep. Ben Ray Lujan (D-NM), along with 61 Democratic co-sponsors, reintroduced legislation to let anyone not currently eligible for Medicaid to buy into the program or leverage it to enhance their coverage in the individual market.

February 14, 2019 | Daily News

A health policy expert last week suggested to House Appropriations health subcommittee members that revoking the Trump administration’s rule that promotes short-term health plans could help offset the costs of removing the Affordable Care Act’s so-called subsidy cliff which several Democratic lawmakers have proposed in various reform bills.

February 13, 2019 | Daily News

House Energy & Commerce health subcommittee Democrats jumped at the chance to criticize GOP-led changes to the Affordable Care Act during a Wednesday hearing examining legislation that could reverse several health policy decisions made by the Trump administration.

February 13, 2019 | Daily News

A bipartisan group of eight House lawmakers is seeking support for a bill to permanently repeal the Affordable Care Act's 2.3 percent excise tax on medical devices.

February 13, 2019 | Daily News

An analysis released by the Urban Institute on Monday (Feb. 11) finds that growth in spending per enrollee in Medicare and Medicaid was much slower than in private insurance between 2006 and 2017, with the authors blaming health care cost containment issues on private insurance.

February 13, 2019 | Daily News

Democratic Sens. Debbie Stabenow (MI) and Tammy Baldwin (WI), along with Democratic Reps. Brian Higgins (NY) and Joe Courtney (CT), unveiled legislation that would let people between the ages of 50 and 64 buy into Medicare, and would let them use existing tax credits and federal contributions under the Affordable Care Act to do so.

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