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Health-Exchange-Alert

March 08, 2019 | Daily News

The Depart of Justice immediately appealed a closely watched lawsuit worth potentially billions of dollars to dozens of insurers late Thursday (March 7) after a federal court formally ordered the government to pay Community Health Choices a total $71 million in cost-sharing reduction reimbursements for the 2017 and 2018 plan years.

March 08, 2019 | Daily News

A coalition of business groups and other stakeholders tell Senate health committee Chair Lamar Alexander (R-TN) and ranking Democrat Patty Murray (WA) that repealing the Affordable Care Act’s 40 percent tax on high-cost plans would be a critical first step in improving the health system, and also urge the lawmakers to reject any attempt to tax employer-sponsored coverage.

March 07, 2019 | Daily News

CMS is seeking feedback from stakeholders on how to eliminate barriers to selling insurance across state lines, which the agency says builds on the president’s October 2017 Executive Order seeking ways to increase health care choice and competition.

March 06, 2019 | Daily News

House Energy & Commerce health subcommittee Republicans debated the usefulness of Democratic legislation to prop up the Affordable Care Act markets via reinsurance and increased funding for exchange programs, arguing the Democrats’ reinsurance proposal would not give states enough flexibility and a boost in navigator funding would not be worth it because navigators don’t sign up enough people.

March 06, 2019 | Daily News

The Department of Justice is asking the federal claims court to issue a final judgment of about $71 million in 2017 and 2018 cost-sharing reduction payments for Community Health Choice (CHC), in order to smooth the way for a quick appeal, but wants the court to wait until CMS completes the 2018 reconciliation process before entering a judgment for Maine Community Health Options (MCHO) and the class action suit led by Common Ground Health Co-Op.

March 05, 2019 | Daily News

The moderate New Democrat Coalition is urging the committees of jurisdiction over health care to prioritize policies that would strengthen the Affordable Care Act while continuing to build a path toward affordable coverage for all Americans.

March 05, 2019 | Daily News

Republican Sen. Susan Collins (ME) joined a group of Senate Democrats and advocacy groups on Tuesday in expressing opposition to Sixth Circuit Court of Appeals nominee Chad Readler, arguing that Readler’s controversial refusal to fully defend the Affordable Care Act against a constitutional challenge while at the Justice Department disqualifies him from a promotion.

March 05, 2019 | Daily News

A Kaiser Family Foundation analysis of data collected on plans offered through healthcare.gov finds an average 19 percent of in-network claims were denied, yet denial rates varied significantly for specific issuers, from 1 percent to more than 40 percent.

March 04, 2019 | Daily News

A federal judge last week granted a short deadline extension for the federal government and health insurance plans to report to the U.S. Court of Claims the amount of reimbursement issuers are owed for the 2017 and 2018 cost-sharing reductions following the outcome of three similar lawsuits.

March 04, 2019 | Daily News

The House Energy & Commerce health subcommittee will examine legislation to strengthen the Affordable Care Act by establishing state reinsurance programs, increasing funding for the navigator programs and providing states with more federal funds to establish state-based marketplaces.

March 01, 2019 | Daily News

BlueCross BlueShield Association on Thursday (Feb. 28) urged Congress to lower premiums in the individual market by enacting a reinsurance program, reinstating cost-sharing reduction payments, extending premium tax credits up to 600 percent of the federal poverty level and introducing age-adjusted premium subsidies.

March 01, 2019 | Daily News

The coalition of groups suing to overturn the administration’s expansion of short-term plans is asking a federal judge to immediately rule in its favor, and the Department of Treasury, which is defending the plans, is also seeking a quick resolution.

February 28, 2019 | Daily News

Sen. Bill Cassidy (R-LA) said that he plans to release final surprise billing legislation in March together with Sen. Maggie Hassan (D-NH), and that his bipartisan working group is seeking a middle ground between plans and insurers on payment rates.

February 28, 2019 | Daily News

FDA Commissioner Scott Gottlieb told lawmakers that his agency will undertake the first update of its drug efficacy trial standards in 20 years under a multi-pronged plan aimed at making the investigational new drug process more efficient, lowering development costs and possibly making prescription drugs more affordable.

February 27, 2019 | Daily News

Liberal House Democrats introduced on Wednesday (Feb. 27) a bill to replace private insurance in two years with a government-run, single-payer system.

February 27, 2019 | Daily News

As members of the Congressional Progressive Caucus introduced their Medicare for All bill on Wednesday morning (Feb. 27), the Democratic chair of the House Energy & Commerce Committee Frank Pallone and a freshman House Democrat Lauren Underwood expressed their support for universal health care, but were wary of supporting Medicare for All, instead suggesting alternatives.

February 27, 2019 | Daily News

House Energy & Commerce Chair Frank Pallone (D-NJ) made clear Wednesday (Feb. 27) that his committee will focus on policies to fix the Affordable Care Act like expanding subsidies, restoring cost-sharing reductions and reinstating a federal reinsurance program that have a realistic chance of passing over the next few years, over more far reaching changes like Medicare for All.

February 27, 2019 | Daily News

HHS Secretary Alex Azar once again touted the Trump administration’s actions to expand short-term plans and associated health plans and update the state innovation waiver guidance as reasons the Affordable Care Act exchanges remained stable and premiums decreased over the past year.

February 27, 2019 | Daily News

CMS’ top exchange official is urging agents and brokers to talk with state policymakers about potential changes to the health care system available under the Affordable Care Act’s section 1332 state innovation waivers.

February 26, 2019 | Daily News

The insurance and hospital lobbies issued a pre-emptive strike against the Medicare for All bill that House Progressive Caucus Co-Chair Pramila Jayapal (D-WA) is slated to introduce Wednesday (Feb. 27).

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