Governors From Both Parties Urge Congress To Stabilize ACA Marketplaces.
The Washington Post (9/7, Eilperin, Goldstein) reports that on Thursday, five governors from both parties urged Congress “to bolster the insurance exchanges created under the law, challenging President Trump’s argument that those marketplaces are unsalvageable.” The governors were testifying before the Senate Health, Education, Labor and Pensions (HELP) Committee whose members are working on a way to shore up ACA marketplaces. The article says these governors concurred that “guaranteeing subsidies paid to ACA insurers to help defray certain coverage expenses for consumers ranks as the most urgent step Congress should take.” In addition, they said the payment guarantee should last more than the one year which Sen. Lamar Alexander (R-TN), the committee’s chairman, had recommended.
USA Today (9/7, Collins) reports that the group of governors was comprised of three Republicans and two Democrats, and their testimony should aid senators who are seeking “a short-term fix to stabilize” ACA exchanges. Sen. Alexander “said he hopes senators can forge a bipartisan agreement by the end of next week and pass limited legislation by the end of the month to keep prices down and make it possible for everyone in the individual market to be able to afford insurance.”
The New York Times (9/7, Pear, Subscription Publication) reports that Tennessee Gov. Bill Haslam (R) said, “Congress should take steps now to prevent the total collapse of the health insurance market” by providing money for the “cost-sharing” subsidies. Montana Gov. Steve Bullock (D) agreed, saying “If this committee is genuinely concerned with stabilizing the individual marketplace, the most important step it can take in the near term is ensuring funding for the cost-sharing reduction payments for at least the next two years.”
The AP (9/7, Fram) reports that the governors’ support for continued ACA subsidy payments to insurers “seemed to further isolate Trump on the issue.” The President has threatened to eliminate the payments on several occasions. The article says, however, that “with partisan feelings heightened by the failed Republican effort to dismantle former President Barack Obama’s health law, the prospects for a modest effort to shore up the Affordable Care Act are uncertain.”
The Hill (9/7, Sullivan) reports that the group of governors who testified included Utah Gov. Gary Herbert (R), Massachusetts Gov. Charlie Baker (R), Colorado Gov. John Hickenlooper (D), Tennessee Gov. Bill Haslam (R), and Montana Gov. Steve Bullock (D). Herbert said, “It would be irresponsible to allow these markets to collapse.” He added that “while he is ‘not a fan’ of the payments, he thinks they should continue for one or two years. The market ‘needs predictability.’”
Cassidy, Graham, Heller Pushing Another ACA Repeal Bill.
USA Today (9/7, Collins, Berry) reports Sens. Lindsey Graham (R-SC), Bill Cassidy (R-LA), and Dean Heller (R-NV) are “launching a last ditch effort” to pass a measure that would give states block grants to decide their own health insurance systems. Their effort “got a boost” Wednesday after White House adviser Kellyanne Conway said on Fox that President Trump would sign the measure if it passed. Sen. Cassidy stated, “It will take both the president committed to it, but also probably the governors because everybody understands that governors are the ones who implement this, and if they sign off, I think folks can be comfortable.”
Reuters (9/7, Morgan) reports that Cassidy will introduce the bill in the US Senate on Monday, and that he was optimistic the legislation could pass before the September 30 deadline. Republican senators need to use reconciliation to move the healthcare legislation on a simple majority through the Senate, but that tool requires that it be included in a 2017 budget resolution that will expire with the fiscal year on September 30.
The Wall Street Journal (9/7, Hackman, Subscription Publication) reports that Sen. John McCain (R-AZ) said earlier this week that he favored the measure, but later issued a statement saying that he would have to see the bill’s text.
Bloomberg News (9/7, Litvan, Dennis) reports that Majority Leader Mitch McConnell (R-KY) promised a vote in September if the three senators can “line up 50 of their colleagues to back the measure,” Cassidy said. Graham added, “This literally would repeal and replace Obamacare with a fundamentally different approach.”
Senate Republicans Appear To Have Abandoned ACA Repeal Efforts For Now. Politico (9/7, Everett) reports Senate GOP lawmakers “are throwing cold water on the idea of holding another” vote to repeal the ACA before the end of September. They say this would be nearly impossible, even though President Trump and some Senate Republicans are urging a vote on a new repeal plan put forward by Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA). The article says the proposal is still incomplete, “there is no Congressional Budget Office score, and some Republicans are working with Democrats on a bipartisan plan to shore up insurance markets.” In addition, it remains unclear if such a bill would garner 50 votes, all of which “means the dream of repealing the law with all GOP votes is slipping away, at least for now.”
Roll Call (9/7, Williams) reports that this “last-ditch attempt by Senate Republicans to repeal and replace the 2010 health care law appears unlikely to get off the ground, as lawmakers from both parties” turn their focus to stabilizing ACA marketplaces. The article adds that despite a push by some conservatives to take up another ACA repeal bill, “optimism is low among several Republican lawmakers and aides that it will be successful.”
Health Centers Urging Congress To Continue Funds From ACA, CHIP Reauthorization Act.
Modern Healthcare (9/7, Dickson, Subscription Publication) reports health centers across the country are anxiously awaiting action from Congress to continue federal funding through the Affordable Care Act and the Medicare Access and Chip Reauthorization Act, without which health centers may be unable to serve the 27 million Americans that currently use their services. Brian Toomey, CEO of North Carolina’s Piedmont Health Services, is concerned that “the fallout from Hurricane Harvey, the need to increase the debt ceiling and pressing calls to draft a new law to protect undocumented children,” will result in the healthcare priorities “[falling] through the cracks.” However, healthcare policy experts remain confident that Congress will act before the deadlines pass at the end of the month.
Warren Signals Support For Sanders’ “Medicare For All” Bill.
The AP (9/7) reports that on Thursday, Sen. Elizabeth Warren (D-MA) said she intends “to co-sponsor a bill by Sen. Bernie Sanders (I-VT) that would guarantee everyone in the country is covered by health insurance.” In an email to supporters, Warren said “she’s backing Sanders’ ‘Medicare for All’ bill” which is expected to be unveiled this month.
The Boston Globe (9/7, McGrane) reports that Warren wrote, “There is something fundamentally wrong when one of the richest and most powerful countries on the planet can’t make sure that a person can afford to see a doctor when they’re sick. This isn’t any way to live.” She added, “Health care is a basic human right and it’s time to fight for it.”
The Hill (9/7, Savransky) reports that Warren also stated, “I believe it’s time to take a step back and ask: what is the best way to deliver high quality, low cost health care to all Americans? …. Everything should be on the table – and that’s why I’m co-sponsoring Bernie Sanders’ Medicare for All bill that will be introduced later this month.”
Also covering the story are Newsweek (9/7, Haltiwanger), Vox (9/7, Stein) and the Washington Examiner (9/7, King).
Murphy Preparing Medicare “Buy In” Legislation To Advance Single-Payer Healthcare.
Politico (9/7, Schor) reports that Sen. Chris Murphy (D-CT) “is working on legislation expected this fall that would let individuals and businesses buy into Medicare as part of ACA exchanges.” While Sen. Bernie Sanders (I-VT) “and other potential challengers to President Donald Trump flock to ‘Medicare for all,’” Murphy “is taking a conspicuously more pragmatic approach designed to get Democrats closer to that lofty but potentially unobtainable goal.” Said Murphy, “We’re not going to pass a single-payer health care bill any time in the next few years. And so we need to have a conversation about how we get there.”
Public Health and Private Healthcare Systems
New York State Extends ACA Open Enrollment Period.
The New York Daily News (9/7, Blain) reports, “Defying the wishes of the Trump administration, state health officials on Thursday announced they will keep Obamacare enrollment open in New York until Jan. 31.” According to officials, New York State’s ACA open enrollment period will last from November 1 through January 31. Earlier this year, CMS shortened the open enrollment period for states which use HealthCare.gov from three months to 45 days.
The Hill (9/7, Hellmann) reports that state officials extended the open enrollment period, “citing concerns about an earlier deadline set by the federal government.” Donna Frescatore, executive director of New York State of Health, said, “Our goal is to ensure that consumers have adequate time to shop for and enroll in the health plan that is best for their family.” The article adds that New York and several other states with independent ACA exchanges have decided to set longer open enrollment periods.
WTEN-TV Albany, NY (9/7) also covers the story on its website.
Maine Secretary Of State Scratches “Insurance” From Medicaid Expansion Ballot Question.
The AP (9/7) reports Maine Secretary of State Matt Dunlap (D) removed the word “insurance” from an upcoming November 7 ballot referendum to expand Medicaid because it could be seen as biased. Dunlap decided to use the phrase “healthcare coverage” instead. Maine Governor Paul LePage (R) has repeatedly rejected Medicaid expansion and, along with other Republicans, objected to using the term “insurance” in reference to Medicaid.
The Bangor (ME) Daily News (9/7, Cousins) reports that the question will read: “Do you want Maine to expand Medicaid to provide healthcare coverage for qualified adults under age 65 with incomes at or below 138% of the federal poverty level, which in 2017 means $16,643 for a single person and $22,412 for a family of two?” The piece adds that another change to the question was the addition of the specific income thresholds to qualify for the program. The question is one of four ballot issues on the ballot.
The Portland (ME) Press Herald (9/7, Miller) reports that the Medicaid ballot question will decide whether MaineCare will be extended to an additional 70,000 low-income adults. Maine Republican Party Executive Director Jason Savage said of the decision, “It is encouraging to see a correct and non-partisan decision made in the interest of informing voters about this very expensive proposal to expand Maine’s welfare benefits.” David Farmer of Mainers For Health Care, a proponent of the ballot measure, also said the Secretary of State “did a good job of accurately describing what the initiative will do and who it will help.”
Medicare Alters Rules To Help Harvey Victims Get Access To Medical Supplies.
The Dallas Morning News (9/7, Rice) reports that the Centers for Medicare and Medicaid Services (CMS) announced Thursday that it has altered rules in order to allow some Texans and Louisianans enrolled in Medicare to replace products like home oxygen equipment, breathing devices, diabetes testing supplies, artificial limbs, canes, and wheelchairs lost or damaged due to Hurricane Harvey. The rules usually require patients to “see a physician face-to-face and obtain documents showing new medical necessity” are being waived. The announcement did not say how long the altered rules would remain in effect.
Pennsylvanians Who Purchase ACA Plans Unhappy About Premium Hikes For 2018.
The Pittsburgh Tribune-Review (9/7, Venteicher) reports that Pennsylvania state regulators believe “health insurance rate increases averaging 8.8 percent for next year signal the Affordable Care Act’s volatile marketplace is stabilizing.” However, for “people who faced rate hikes averaging 33 percent last year and double-digit increases the year before, more increases are difficult to stomach.” One woman who purchases ACA coverage said the increases are “unacceptable.”
Covered California Small Business Exchange Premiums To Rise 5.6 Percent In 2018.
The San Francisco Chronicle (9/7, Ho) reports health insurance premiums are set to rise 5.6 percent on Covered California’s small business exchange in 2018. “Nearly 36,000 Californians receive health insurance through the small business exchange,” which is less widely used than the exchange for individuals. The article also reports that Western Health Advantage will not be offering plans on the small business exchange in 2018.
Idaho Officials Introduce New Healthcare Plan To Control Costs, Close “Medicaid Gap.”
The Idaho Statesman (9/7, Dutton) reports that the Idaho Department of Health and Welfare proposed a new “two-pronged overhaul dubbed the Idaho Health Care Plan” to lower insurance costs and expand access to healthcare for Idaho’s “working poor.” The proposal was included in the departments fiscal 2018 budget request. In order to control insurance costs on the individual insurance marketplace, the plan proposes to allow some of Idaho’s sickest adults to get insurance through Medicaid by expanding its current program for low-income women with breast and cervical cancers to include other costly diseases such as stage 4 cancer, hemophilia, and cystic fibrosis. Removing them from the exchanges, proponents argue, would “take out a large chunk of the medical spending that is driving double-digit increases.” The plan also would close the “Medicaid Gap” affecting around 38,000 people who do not qualify for Medicaid nor do they qualify for subsidized plans on the Idaho exchange.
Missouri Legislature May Call Special Session To Reverse Cuts To Medicaid Nursing Services.
The St. Louis Post-Dispatch (9/7, Suntrup, Erickson) reports that “momentum” was building for a special legislative session in Missouri for the state to address cuts to healthcare “that will affect about 8,000 Missourians’ access to in-home and specialty nursing services through Medicaid.” The lawmakers need to “find a funding source so that access to specialty and in-home nursing care is not restricted,” after Missouri Gov. Eric Greitens (R) vetoed a “last-minute” maneuver to gather around $35 million from “other state accounts.” Two possibilities that the legislature may consider to find the funding are to reform the state’s “so-called ‘circuit breaker’ tax credit program” or to craft “another fund-sweep scheme that can gain Greitens’ approval.”
Uninsured Rate Rising For Three Groups, Study Indicates.
Sarah Kliff writes in a Vox (9/7) piece that the uninsured rate in the US has declined steadily since the ACA took effect, which “makes a new Commonwealth Fund study quite surprising: It shows the uninsured rate going up for certain demographics.” Data indicate “the uninsured rate rose among three groups: middle-aged Americans between 35 and 49, middle- and high-income Americans, and those in states that did not expand Medicaid.” Kliff says it remains unclear why the uninsured rate is rising for these groups.