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Health-Exchange-Alert

January 30, 2019 | Daily News

California’s state-based exchange reported Wednesday (Jan. 30) a nearly 24 percent drop in new consumers signing up for coverage, which the exchange attributes to the loss of the federal mandate to buy coverage, yet overall enrollment slipped only a half a percent largely due to strong re-enrollment numbers.

January 30, 2019 | Daily News

Consumer advocacy group Families USA is out with an issue brief calling on lawmakers to consider enhancing and expanding financial assistance to improve exchange plan affordability rather than focusing on reinstating the Affordable Care Act’s reinsurance program, which was phased out after 2016.

January 29, 2019 | Daily News

Democrats on the House Ways & Means Committee used Tuesday’s (Jan. 29) hearing on preexisting conditions to again highlight Republicans’ attempts to repeal the health law during the last Congress, whereas GOP members tried to pivot away from problems with the Affordable Care Act and steer to other health care issues.

January 29, 2019 | Daily News

The parties appealing Texas U.S. District Judge Reed O’Connor’s ruling in the high-profile challenge to the Affordable Care Act now have until Feb. 8 to respond to House Democrats’ motion to intervene at the U.S. Court of Appeals for the Fifth Circuit.

January 29, 2019 | Daily News

CMS Administrator Seema Verma says the agency is taking a closer look at medically necessary dental benefits for Medicare beneficiaries -- coming as beneficiary advocates say CMS already has authority to cover medically necessary oral health care and lawmakers on both sides of Capitol Hill are weighing changes to the statute to establish a Medicare oral health benefit including preventive care.

January 28, 2019 | Daily News

After Medicaid expansion made dramatic inroads in several red states in 2018, early signs from the opening days of this year’s state legislative sessions suggest that expansion may be on the horizon in even more red states in 2019.

January 28, 2019 | Daily News

Higher-than-expected medical claims coupled with state and federal policy requirements drove premium increases and market participation in the health insurance exchanges, the Government Accountability Office (GAO) concluded in an Affordable Care Act-mandated report released Monday (Jan. 26).

January 28, 2019 | Daily News

The American College of Emergency Physicians is joining the effort to craft legislation that would mitigate so-called surprise billing and is pushing insurers to make more of an effort to cover emergency services and to take responsibility for payments.

January 28, 2019 | Daily News

Washington state’s health care authority is in the final stages of a plan to pay a subscription for hepatitis C drugs that would cover its Medicaid beneficiaries, prisoners and state employees, including teachers, and the winner-take-all model could be extended to the commercial market and other states.

January 25, 2019 | Daily News

Philadelphia on Friday (Jan. 25) signed onto the multi-city lawsuit that alleges the administration violated the Constitution’s “take care” clause by acting to undermine the Affordable Care Act.

January 25, 2019 | Daily News

CMS recently provided states with four concepts could consider under the revised guidance for the Affordable Care Acts 1332 waivers, but Administrator Seema Verma is making clear that she has a favorite: In an editorial published last week, Verma strongly endorsed the idea of allowing states to create health expense accounts that consumers could use to purchase health coverage, similar to the Health Indiana Plan Medicaid waiver that she helped craft as a consultant.

January 25, 2019 | Daily News

Massachusetts Governor Charlie Baker (R) is requesting state legislation to let its Medicaid program negotiate supplemental rebates for expensive drugs.

January 24, 2019 | Daily News

D.C. federal district court judge John Bates showed interest in the Democratic attorneys general’s complaints challenging the Trump administration’s expansion of association health plans, repeatedly saying during Thursday’s hearing that the administration’s underlying intention in the rule was to modify the Affordable Care Act, not the definition of an employer under ERISA.

January 24, 2019 | Daily News

A bipartisan group of House lawmakers on Thursday (Jan. 24) reintroduced legislation that would fully repeal the 40 percent excise tax on high-cost health plans, commonly known as the “Cadillac tax,” garnering immediate praise from wide-ranging stakeholders that have long worked to strike the provision from the Affordable Care Act.

January 23, 2019 | Daily News

Medicare for All is picking up support among the American public and federal lawmakers are beginning to consider the idea more seriously.

January 23, 2019 | Daily News

CMS’ annual letter describing key policy changes for health and dental plan issuers seeking to participate in the federally facilitated marketplaces in the 2020 plan year largely relies on processes spelled out in previous letters, but it does warn the agency may audit issuers to ensure they’re following rules on cost-sharing for out-of-network services provided in an in-network setting.

January 22, 2019 | Daily News

The proposed 2020 Notice of Benefit and Payment Parameters includes a proposal requiring insurers that offer Affordable Care Act plans covering abortion also to offer at least one other identical plan that does not cover abortion.

January 22, 2019 | Daily News

Federal DC District Judge John Bates is slated to hear oral arguments Thursday (Jan. 24) on the Department of Justice’s motion to dismiss or move to judgment the lawsuit brought by 12 Democratic attorneys general over the Trump administration’s final association health plan (AHP) rule.

January 18, 2019 | Daily News

Arizona is the eighth state to receive permission from the Trump administration to add work requirements to its Medicaid program, and after months of behind-the-scenes negotiations between state officials and CMS lawyers, CMS allowed the state to exempt some Native Americans from the requirements.

January 17, 2019 | Daily News

CMS on Thursday (Jan. 17) released its long-awaited exchange policy regulation, and while it avoided making changes to the silver-loading process, the agency did propose several other policies including allowing mid-year drug formulary changes, creating a new special enrollment period for people newly eligible for subsidies, increasing maximum out-of-pocket spending limits, and reducing the user fee by half of a percentage point.

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