Azar Pushes For Price Transparency In Healthcare.
The New York Times (3/8, Pear, Subscription Publication) reports that on Thursday, HHS Secretary Alex Azar said physicians “and hospitals should tell patients how much their care would cost before patients received treatment.” Azar said, “You ought to have the right to know what a health care service will cost – and what it will really cost – before you get that service.” He warned that if the healthcare industry fails to make this change “voluntarily…the government may use its leverage to force them to disclose the information.” Azar made the comments at a conference held by America’s Health Insurance Plans.
White House Wants Congress To Exclude CSR Payments For 2017 From The Omnibus Bill.
Modern Healthcare (3/8, Luthi, Subscription Publication) reports that on Thursday, the White House urged Congress “to pass legislation that does not authorize cost-sharing reduction payments for insurers in 2017, even though individual market insurers had to pay into the program on behalf of their low-income enrollees.” The article says this move “could nullify claims insurers might make for unpaid CSRs, as it clarifies that insurers are on the hook to pay back any of the excess money paid out by the federal government before President Donald Trump cut off CSRs starting Oct. 1, 2017.” The piece mentions that on Thursday, HHS Secretary Alex Azar “told reporters…that the department is seeking comment on its legal authority to allow auto-renewals for short-term plans.”
Healthcare Gap Between Red, Blue States Widening As Trump Administration Begins Rolling Back ACA.
The Atlantic (3/8, Brownstein) reports that states are becoming the battleground for healthcare fights. The article says that the most immediate impact “of the recent steps taken by Donald Trump and congressional Republicans to unravel the Affordable Care Act will be to create an even deeper gulf between red and blue states in the availability and quality of health insurance.” The piece adds that blue states are searching for ways to limit the impact of changes implemented by the Administration, while red states “are leaning into the rollback – both by seeking to limit access to Medicaid, and by embracing Trump’s efforts to deregulate insurance markets in ways that will restore the pre-ACA separation between the healthy and sick.”
New Hampshire House Passes Bill Protecting Consumers From “Surprise” Medical Bill Charges.
The New Hampshire Union Leader (3/8) reports that “with overwhelming support,” the New Hampshire House passed a bill aimed at protecting consumers from surprise charges on medical bills due to unexpected “out of network” charges. The need for the bill arose after lawmakers heard several complaints from constituents about unexpected charges for “out of network” services, even though they were served by a provider, clinic, or hospital that was in the network of their managed-care company.
ACA Stabilization Bills Still Face Hurdles.
Paige Winfield Cunningham writes in the Washington Post (3/8) “The Health 202” blog that Congress will soon have “yet another shot at helping stabilize the Obamacare marketplaces for 2019. But the political barriers appear even higher than before.” Cunningham says conservatives have reservations about the two bills which are being considered. As a result, “they’ve been stuck in limbo since last fall – and it’s looking more likely than not they’ll stay that way instead of getting rolled into a $1.3 trillion catchall spending bill lawmakers must pass by March 23.”
Proposed Bill Would Allow Young Adults To Receive Higher ACA Subsidies.
The Washington Examiner (3/8, Leonard) reports that Sen. Tammy Baldwin (D-WI) has put forward “a bill that would increase the amount of Obamacare subsidies that go toward younger adults, aiming to bring more of them into the exchanges to help stabilize the marketplace.” The proposal, called the “Advancing Youth Enrollment Act,” would allow consumers aged 18-34 to receive higher federal subsidies “so that the cost of private Obamacare plans for them would be lower.” Under the bill, “young adults would see the maximum percentage of income they must pay toward health insurance under Obamacare decrease by 2.5 percentage points for people between the ages of 18 to 30. Each year after, until the age of 34, they would see a gradual phaseout of 0.5 percentage points a year.”
AHIP, AHA Criticize Administration Rule That Would Expand Access To Association Health Plans.
Fierce Healthcare (3/8, Minemyer) reports that the Trump Administration intends “to expand association health plans to offer additional choices for small businesses and their employees, but healthcare industry groups warn that these plans offer weak consumer protections.” According to Matthew Eyles, senior EVP and COO for America’s Health Insurance Plans, “association health plans as envisioned in the” Department of Labor’s “rule lack consumer protections that could pose a risk of ‘fraud and insolvency’ to potential members.” Meanwhile, the American Hospital Association warned that “the rule ‘fails to protect against discriminatory insurance practices’ and would likely decrease access to affordable coverage as it increases market instability.”
Public Health and Private Healthcare Systems
ACA Premiums Could Rise By 35% To 94% In The Next Three Years, Analysis Indicates.
The Washington Post (3/8, Goldstein) says that premiums for ACA plans could rise by 35 percent to 94 percent in the next three years, according to an analysis conducted by California’s ACA exchange, which is called Covered California. Data show “wide variations [from] state to state, with a broad swath of the South and parts of the Midwest in danger of what the report calls ‘catastrophic’ average rate increases by 2021.” The analysis attributes much of the increase to the fact that the repeal of the ACA’s individual mandate will take effect in 2019. That alone could “increase premiums by 7 to 15 percent next year, depending on the state, and [by] as much as 10 percent each of the following two years.”
The Hill (3/8, Hellmann) reports that the analysis “estimates that states like Wisconsin, Michigan and Texas could see cumulative increases of 90 percent by 2021.”
Trump Administration Issues Warning To Idaho About Its Health Plans That Do Not Comply With ACA.
The Washington Post (3/8, Goldstein) reports the administrator of the Centers for Medicare and Medicaid Services, Seema Verma, issued a written warning to Idaho Gov. C.L. “Butch” Otter and its insurance director for its maneuver to allow health plans that do not comply with the Affordable Care Act. The Post says the letter is a “strong signal … that the Department of Health and Human Services is unwilling to allow Idaho to move forward on its own.” Idaho’s decision “has been widely considered a significant test of HHS Secretary Alex Azar in his initial weeks on the job.”
The New York Times (3/8, Pear, Subscription Publication) reports the letter said that the Affordable Care Act “remains the law, and we have a duty to enforce and uphold the law.” While Verma indicated that Idaho’s current rule was unacceptable, she “encouraged the state to keep trying, and she suggested that, ‘with certain modifications,’ its proposal might be acceptable.”
Virginia Legislators Deadlocked Over Budget Because Of Dissension About Medicaid Expansion.
The Washington Post (3/8, Vozzella) reports a fight “over Medicaid will keep Virginia’s House and Senate from passing the two-year state budget on time, legislators acknowledged Thursday, just two days before the General Assembly’s scheduled conclusion.” This means that legislators must “extend the current session or convene for a special session to continue work on the spending plan.” The article says Virginia “must have a budget in place by July 1, the start of the new fiscal year, to avoid what would be” the state’s “first government shutdown.”
New Hampshire Senate Backs Plan To Continue Medicaid Expansion.
The New Hampshire Union Leader (3/9, Landrigan) reports the “plan to continue New Hampshire’s Medicaid expansion program cleared a critical hurdle by winning strong bipartisan support in the state Senate Thursday night.” The 17-7 vote sends the bill to the Republican-led House of Representatives “that has always loomed as a more challenging political venue,” according to the article. Gov. Chris Sununu (R) praised the Senate’s passage of this measure, which has become a top priority for him, although prior to running for governor in 2016, Sununu was a critic of it.
Utah Senate Approves Medicaid Expansion Bill.
The Deseret (UT) News (3/8, Lockhart) reports that the Utah Senate passed a Medicaid expansion bill Thursday that could potentially expand coverage to an additional 65,000 to 70,000 Utahns, “but health advocates are skeptical about whether the move will be approved by the federal government.” The bill “is a request made to the State Health Department to seek a federal waiver expanding Medicaid benefits to certain Utahns whose household income is 100 percent or less of the federal poverty level,” according to the article. Coverage of those who are newly eligible under the expansion would be funded 10 percent by the state and 90 percent by the federal government.
Utah Senate Approves Bill That Would Require State To Submit Waiver To Use Medicaid Funds For MCOTs.
The Deseret (UT) News (3/8, Lockhart) reports that on Wednesday, Utah legislators “overwhelmingly passed a bill seeking a federal waiver to allow the state to use Medicaid money to help pay for mobile crisis outreach teams.” The article says these mobile crisis outreach teams, or MCOTs, “would be made up largely of mental health experts who could respond to behavioral health crises that are best suited with a treatment-oriented home visit rather than an emergency room trip or a police presence at the home,” Sen. Daniel Thatcher, R-West Valley City, said.
Enrollment In Montana’s Expanded Medicaid Program Exceeds 93K.
The AP (3/8) reports that approximately “one in every seven working-age adults in Montana is now enrolled in the state’s Medicaid expansion program,” according to state health officials. On Thursday, they said “93,950 people between the ages of 18 and 64 are beneficiaries of the program that offers Medicaid services to the working poor.”
Michigan Legislators Pushing For Medicaid Work Requirements.
The Detroit News (3/8, Oosting) reports that Michigan plans to “join a small but growing number of states requiring Medicaid recipients to work or continue school to maintain government health care coverage under Republican legislation introduced this week.” The article says state Sen. Mike Shirkey (R-Clarklake) “is proposing a 30-hour work or school requirement for poor but able-bodied adults,” and Rep. Jim Runestad’s (R-White Lake Township) bill has similar requirements. Shirkey said, “It’s a dignity issue to me.”
Arkansas Governor Signs Measure That Preserves Medicaid Expansion.
The AP (3/8) reports that Arkansas Gov. Asa Hutchinson (R) “has signed into law legislation to continue the state’s Medicaid expansion, which will impose a work requirement on thousands of participants this year.” Legislators “reauthorized the program this week after federal officials approved the state’s plan to require thousands on it to work or volunteer in order to keep their coverage.” The article says about 285,000 Arkansans are enrolled in the program.
House Dems Urge Azar Not To Approve States’ Requests To Impose Medicaid Lifetime Limits.
The Hill (3/8, Weixel) reports that Democrats on the House Energy and Commerce Committee are warning the Trump Administration “not to approve requests from states that want to put a lifetime cap on how long people can be enrolled in the Medicaid program.” The lawmakers wrote to HHS Secretary Alex Azar, saying that “lifetime limits would harm patients and the agency doesn’t even have the statutory authority to approve them.” They said the limits would be “cruel,” and added, “We ask that you swiftly make clear that any such proposals will be rejected.”
HHS-OIG Warns That Inaccurate Patient Lists Could Indicate Medicare Fraud, Safety Issues.
Congressional Quarterly (3/8, Williams, Subscription Publication) reports that certain “home health providers failed to supply accurate lists of all of their Medicare patients to oversight agencies, prompting concerns that companies could conceal fraudulent activity or health and safety violations,” the HHS-OIG said on Thursday. Data show “nine out of 28 patient rosters reviewed were missing one or more beneficiaries.” Of those, two “lists had 10 or more patients missing, including one that omitted more than 150, or nearly 90 percent, of its consumers.” According to the OIG, “it’s unclear why some patients were missing from provider lists but that the reasons could range from inadvertent errors to intentional omissions aimed at avoiding scrutiny.” The article says the OIG “urged the Centers for Medicare and Medicaid Services to explore actions to mitigate the problem and better protect Medicare patients.”
The Atlanta Journal-Constitution (3/8, Norder) reports that home health agencies are required to undergo surveys at least every three years, where some patients’ records are checked and some patients may be interviewed at their homes. However, home health agencies themselves supply the list of patients to be reviewed. The OIG found that some lists which agencies supplied were missing the names of Medicare patients.
Editorial Discusses Minnesota’s Rising Uninsured Rate.
The Minneapolis Star Tribune (3/8) editorializes on the Minnesota Department of Health’s report that the uninsured rate in the state jumped from 4.3 percent to 6.3 percent from 2015 to 2017, calling the trend “disturbing.” The editorial points out a “stunning data point” that a majority of the uninsured in the state are potentially eligible for coverage through MinnesotaCare, Medicaid, or other state programs. The editorial suggests a marketing program to push enrollment in those programs.