Health-Exchange-Alert

Sen. Elizabeth Warren (D-MA) and Reps. Mark Pocan (D-WI) and Lloyd Doggett (D-TX) are questioning private equity firms about their role in surprise billing in hospital settings and in emergency transport.

Federal Judge Margaret Sweeney issued a final judgment in the class action case Common Ground Healthcare Cooperative v. United States ordering the government to reimburse the class of about 100 Affordable Care Act plan issuers nearly $1.6 billion in cost-sharing reduction payments owed for the 2017 and the 2018 plan years.

House Democrats on the House Energy & Commerce oversight subcommittee criticized the Trump administration for not having an Affordable Care Act replacement plan ready to go and asked CMS Administrator Seema Verma why CMS has not intervened to defend parts of the health law that protect coverage for people with preexisting conditions in the high-profile Texas case.

The Ninth Circuit Court of Appeals upheld a lower court ruling that barred HHS from enforcing the Trump administration’s rule that allows employers to easily avoid covering birth control without cost-sharing in the 14 plaintiff states.

The head of Tennessee’s Medicaid program pledged that the state will not limit eligibility or cut benefits if CMS approves its plan to adopt a block-grant-style funding structure, but opponents of the plan say the unprecedented new freedom from regulatory oversight sought by the state would allow Tennessee to severely curtail coverage, despite its assurances to the contrary.

The average benchmark premiums for health plans sold through the federally facilitated exchanges will decrease by 4 % for a 27-year-old, the second rate drop in as many years, and more insurers will be competing in the Affordable Care Act marketplaces in 2020, HHS Secretary Alex Azar and CMS Administrator Seema Verma announced Monday (Oct. 21).

A key house panel is poised to mark up this week legislation that slaps a tax on nicotine concentrates used for vaping, and another that lets consumers use tax-free health savings accounts to pay for direct pay primary care arrangements.

The House Oversight & Reform Committee will likely maintain its health care focus following Rep. Elijah Cummings’ death because health care is a defining Democratic policy area and committee staff typically continue work on investigations when leadership changes within the same party, said Henry Waxman (D-CA), who chaired both the Oversight and Energy & Commerce committees.

The Trump administration is focusing on protecting and improving job-based coverage, Medicare and Medicaid that covers the vast majority of Americans and has no plans to draft an Affordable Care Act replacement until there’s a willing Congress or the court makes a final decision, HHS Secretary Alex Azar said during the TIME 100 Health Summit on Thursday (Oct16).