House Republicans Mulling Proposal That Would Allow Them To Approve CSR Payments.
The Hill (3/1, Sullivan) reports that House GOP lawmakers are considering “whether to use a complicated budget maneuver to help pay for additional” ACA “funding, sources say.” The article says the proposal “is controversial because it would help fund key” ACA “payments, something that many conservatives decry as a ‘bailout’ of the law.” The idea entails the Congressional Budget Office taking ACA “payments known as cost-sharing reductions (CSRs) out of its ‘baseline’ for projecting federal spending.” Once that happens, the CBO would score any proposed CSR payments as savings for the federal government. The piece adds that this maneuver “would allow Republicans to fund the” ACA “payments without having to find a budget offset to pay for them.”
Judge Sides With Health Insurer In Suit Over ACA’s Risk Adjustment Program.
The Albuquerque (NM) Journal (3/1, Baca) reports, “A federal judge has ruled in favor of New Mexico Health Connections in a case that calls into question billions of dollars in payments that have been made nationally under the Affordable Care Act.” The article says Health Connections sued the federal government in 2016, alleging its risk adjustment program, which redistributes funds from insurers with healthier customers to those with sicker customers, was using “a flawed formula.” The piece adds that the court concurred “with Health Connections, and ruled that the methodology used by the federal Health and Human Services department was unsound.”
Public Health and Private Healthcare Systems
Sen. Grassley Seeks More Transparency Over Drug Discounts In 340B Program.
STAT Plus (3/1, Mershon, Subscription Publication) reports Sen. Chuck Grassley (R-IA) introduced proposed legislation Thursday which would require hospitals participating in the 340B program to “disclose how much they pay for drugs under the program, and how much they are reimbursed for the same drugs by Medicare.” Grassley said, “I’ve long fought for transparency measures throughout government agencies and programs because they help weed out wrongdoing and ensure taxpayer dollars are being used efficiently and effectively, and for their intended purposes.” STAT explains that the debate over the program has positioned pharmaceutical companies against public and nonprofit hospitals.
Hearing Seeks To Determine If New Mexico Is Providing Timely Access To Medicaid, Other Benefits.
The AP (3/1) says a report about “whether New Mexico is providing timely access to emergency food benefits and health coverage under Medicaid is the focus of a hearing in federal court…as activists pressure the state to address what they say are persistent processing delays.” The article adds that this hearing “is part of an ongoing legal battle over the state Human Services Department’s progress in meeting court orders related to a backlog of food and medical assistance claims.”
Data Show Thousands Of Medicaid Recipients In Arkansas Not Paying Premiums.
Kaiser Health News (3/1, Galewitz) reports that two years ago, when Arkansas legislators were debating “whether to renew the state’s Medicaid expansion, many Republican lawmakers were swayed only if some of the 300,000 adults who gained coverage would have to start paying premiums.” At the time, Arkansas Gov. Asa Hutchinson (R) said the premiums were designed “to encourage more personal responsibility. … We want to incentivize better, healthy living.” But data show “few enrollees are paying the $13 monthly premiums, which apply only to Medicaid recipients whose earnings surpass the poverty level.” Indeed, last year, “just 20 percent of the 63,000 Arkansas enrollees paid. Medicaid enrollees in Arkansas don’t lose coverage for lack of payment.”
Arkansas Legislators Have Yet To Discuss Medicaid Expansion As Fiscal Session Draws To A Close.
The Arkansas Democrat Gazette (3/1, Wickline) reports that on Wednesday, top legislators in Arkansas said “they hope to wrap up this year’s fiscal session by the end of next week, but lawmakers’ to-do list includes approving an appropriation for the Medicaid expansion program for the coming fiscal year and completing negotiations on the state’s proposed revenue budget.” The article says Arkansas “is seeking a waiver from the Trump administration so it can impose a work requirement on many of its 280,000 enrollees in the Medicaid expansion, called Arkansas Works.” Officials also want “to reduce the program eligibility threshold from 138 percent of the poverty level to 100 percent.”
Alabama Medicaid Preparing To Add Work Requirements For Medicaid.
The Montgomery (AL) Advertiser (3/1, Lyman) reports the Alabama Medicaid Agency has begun asking for comments as it prepares its request for a waiver from the Centers for Medicare and Medicaid Services to allow the state to impose work requirements on the “program’s relatively small number of able-bodied adults.” Around 20 percent of the state’s population is on Medicaid; however, officials estimate that the work requirement would affect 74,000 people – or seven percent of the total on Medicaid.
The AP (3/1, Chandler) reports Alabama Gov. Kay Ivey (R) said, “Implementing work requirements…will save taxpayer dollars and will reserve Medicaid services for those that are truly in need of assistance.”
Utah Panel Clears Medicaid Expansion Bill.
The Salt Lake (UT) Tribune (3/2, Ramseth) reports a partial Medicaid expansion bill that would cover around 60,000 Utahns whose incomes are below the federal poverty level was approved by the House Business and Labor Committee Thursday night. The proposal would also establish work requirements and an enrollment cap. The proposal aims to provide an option for those in the “coverage gap” who make too little to be able to afford an ACA plan, but too much to qualify for Medicaid.
New Jersey Proposal Would Make Medicaid Data More Accessible.
NJ Spotlight (3/2, Stainton) reports a New Jersey lawmaker has proposed legislation that would allow citizens and policymakers to access “de-identified” healthcare “encounter” data, which would show “details about a patient’s treatment, providers, and reimbursements – without exposing personal details.” The article explains that experts “agree that factual information about individual medical care and the resulting bills are critical for consumers responsible for their family’s care, and for policymakers charged with protecting public health.” The proposal was identified as a top priority for Gov. Phil Murphy’s (D) healthcare transition team.
Minnesota Governor, Democrats Propose Significant Expansion Of MinnesotaCare Health Plan.
The Minneapolis Star Tribune (3/1, Olson) reports that Minnesota Gov. Mark Dayton (D) and several Democratic legislators “are proposing a dramatic expansion of the MinnesotaCare health plan, creating what is known as a ‘public option’ that would offer health insurance for any Minnesotan who is struggling to find and afford coverage.” Dayton argued that the “buy-in option – removing MinnesotaCare’s income restrictions and allowing anyone to purchase coverage – is ‘the single most significant step that Minnesota can take’ to shore up its unstable insurance market for individuals.” He added that the current system is “not working for Minnesotans.”
The Duluth (MN) News Tribune (3/1, Davis) reports that this proposal is not new. Dayton also proposed the plan last year, unsuccessfully. The article says “the Republican-controlled Legislature did not consider it.” There is no indication “that the GOP has changed, but Dayton said the Nov. 6 election could influence Republicans to change their votes.”
Virginia Senate Committee Votes Against Proposal For Medicaid Work Requirements.
The Richmond (VA) Times-Dispatch (3/1, Martz) reports that “Senate Republicans dismissed a proposed work requirement for Medicaid recipients on Thursday as ‘camouflage’ for an attempt by the House of Delegates to expand the program to hundreds of thousands of uninsured Virginians, many of them childless adults.” The Senate Education and Health Committee voted 10-6 against House Bill 338, which was “proposed by Del. Jason Miyares, R-Virginia Beach.” The article says this “escalating battle over Medicaid expansion in the budget loomed over the discussion on Miyares’ bill, despite his effort to distance his legislation from the larger dispute as it heads into a conference committee on the budget.”
BCBS Posts ACA Profits Which Wipe Out Three Years Of Losses.
The Raleigh (NC) News & Observer (3/1, Murawski) reports that Blue Cross and Blue Shield, the largest insurer in North Carolina, posted “its first profit ever on the Affordable Care Act, netting about $600 million last year on customers the company covers under the federal health care law.” Indeed, the company “said its ACA profit helped drive a company-wide net income of $734 million last year.” The article adds that following three consecutive years of “losses on ACA plans, the Blue Cross ACA business is now in the black by $118 million because of the profit generated” last year.
Researchers Predict 378,000 Californians May Forgo Health Insurance Next Year.
The Modesto (CA) Bee (3/1, Carlson) reports a study by Harvard Medical School researchers predicts that as many as 378,000 Californians on the individual insurance market in California may drop coverage next year now that they will not face a tax penalty. The drop would represent nearly 18 percent of customers. The study , published in the online blog for Health Affairs, surveyed 3,010 adults.