Leading the News
Short-Term Plans Could Have Greater Impact, Cost More Than Anticipated, Analysis Concludes.
The Hill Share to (5/16, Weixel) reports that the Trump Administration’s plan “to allow insurers to sell more limited, short-term plans would cost the federal government more money and affect more people than the administration previously estimated,” according to an analysis conducted by Medicare’s chief actuary. Data indicate “the short-term plans would siphon off the healthiest people from the ObamaCare exchanges, leaving a risk pool that is older and sicker than is currently the case.” The analysis concluded that some 1.4 million people could “sign up for short-term plans in 2019.” That figure is expected to increase to 1.9 million by 2022. Last week, HHS Secretary Alex Azar “said the short-term plans ‘may not be the right option for everybody’ but noted that for some individuals, ‘it may be better than nothing.’”
Congressional Quarterly Share to (5/16, Clason, Subscription Publication) reports that the analysis estimates about “600,000 fewer people would be enrolled in the marketplace in 2019 mostly because of the plans, higher than the department’s previous projection of up to 200,000.”
Legislation and Policy
House, Trump Administration Resolve Suit Over Funding For ACA’s Cost-Sharing Payments To Insurers.
The Washington Times Share to (5/16, Howell) reports that on Wednesday, top House Republicans “declared victory…in a long-running dispute with the executive branch, noting a new settlement preserves a judge’s ruling that President Barack Obama reimbursed insurers unlawfully under his signature health program.” After the US Court of Appeals for the District of Columbia Circuit moved to dismiss an appeal, House Speaker Paul Ryan (R-WI) said, “In a battle over the separation of powers, the House has prevailed.” The article says that in 2016, US District Court Judge Rosemary Collyer ruled that “Mr. Obama could not make ‘cost-sharing payments’ to insurers who pick up low-income customers’ costs on Obamacare’s exchanges because Congress never appropriated the money.” But that ruling was stayed pending an appeal.
Congressional Quarterly Share to (5/16, McIntire, Subscription Publication) reports that the Obama Administration had appealed Collyer’s ruling; however, “the case was put on hold when the Trump administration took office and congressional Republicans sought to dismantle the law.” The article adds that last year, the Trump Administration “cut off funding for the payments, known as CSRs…a move which resulted in higher premiums for some plans sold on the federal and state marketplaces this year.”
Modern Healthcare Share to (5/16, Luthi, Subscription Publication) also covers the story.
House Passes Bill To Expand Veterans’ Healthcare Access Outside Of VA.
The AP Share to (5/16, Yen) reports that on Wednesday, the US House “voted to give veterans more freedom to see doctors outside the Veterans Affairs health system” although some Democrats “cast it as a risky step toward dismantling the struggling agency.” The plan would “fulfill President Donald Trump’s promise to expand private care to veterans” who feel VA healthcare is inadequate by allowing them to seek care from private physicians. Legislators passed the $5 billion bill in a 347-70 vote.
Congressional Quarterly Share to (5/16, Clason, Subscription Publication) reports the vote comes as “a major overhaul to a veterans health care program just two weeks before funds dry up.” The $5.2 billion funding will extend the Veterans Choice Program “before combining the program with other community care programs offered by the Department of Veterans Affairs in 2019.”
Some Republicans Balking At Trump’s Plan To Cut $15 Billion From CHIP, Other Programs.
The Washington Post Share to (5/16, Werner) reports that amid concerns that voting for President Trump’s plan “to cut $15 billion from programs including” the Children’s Health Insurance Program “and Ebola disaster relief,” Republicans are pushing back against the effort. While the vote could aid House Republicans “facing upcoming primary challenges from the right in states including Alabama, California, Florida and New York,” other Republicans “are balking, raising questions about whether the House will be able to pass the administration’s spending-cut request.” A vote House leaders had been planning for this week “has now been delayed and may not take place until after Congress’s Memorial Day break.” The article adds that since “few expect” the package to pass in the Senate, it “raises even more questions for some GOP House members about why they should vote on it in the first place.”
Graham Revamping ACA Repeal And Replace Bill.
The Hill Share to (5/16, Sullivan) reports that on Wednesday, Sen. Lindsey Graham (R-SC) said “he is working on a new version of his ObamaCare repeal-and-replace bill and has not given up on efforts to do away with the law despite Republicans’ failure last year.” Graham is quoted as saying, “I haven’t given up. … Will there be another effort to replace ObamaCare with a state-centric plan? I hope so.” The article says, however, that the proposal “appears to have little, if any, chance of passing this year.”
Judge Rules Democratic States Can Intervene In Suit Which Seeks To Dismantle ACA.
The Hill Share to (5/16, Hellmann) reports a federal judge has ruled that states led by Democrats can intervene in a Texas suit which seeks to dismantle the ACA. The article says California Attorney General Xavier Becerra and 16 other AGs from “Democratic states were granted the right to intervene in the lawsuit.” Commenting on the ruling, Becerra said it “allows us to protect the health and wellbeing of these Americans by defending affordable access to healthcare. Before the Affordable Care Act, Americans had shorter lives and paid twice as much for their healthcare as other developed countries. The passage of the ACA was the first step toward fixing that problem. We must continue to move forward, not backward.”
Axios Share to (5/16, Baker) also covers the story.
Vermont Governor Signs Law That Would Allow Importation Of Prescription Drugs From Canada, Pending HHS Approval.
Reuters Share to (5/16, Krothapalli) reports Vermont Gov. Phil Scott signed a law that would allow prescription drugs to be imported from Canada, but the US Department of Health and Human Services would have to approve the law for it to go into effect. The article notes that the Trump Administration is opposed to the idea, and Secretary of Health and Human Services Alex Azar said, “Canada simply doesn’t have enough drugs to sell them to us for less money, and drug companies won’t sell Canada or Europe more just to have them imported here.”
The AP Share to (5/16) reports Azar also said that importing drugs “has been assessed multiple times by the Congressional Budget Office, and CBO has said it would have no meaningful effect.”
Also covering the story are The Hill Share to (5/16, Seipel), Politico Share to (5/16, Pradhan), and the Washington Examiner Share to (5/16, Leonard).
Some States Mulling End To “Gag Clauses” As A Way To Reduce Drug Prices.
The Philadelphia Inquirer Share to (5/16, Gantz) reports that Americans deal with “high, confusing and widely varying drug costs because of many factors.” However, “there’s one idea advocates are latching onto – and it even got an endorsement from President Trump last week.” The article says “gag clauses” which prevent “pharmacists from telling consumers when they could save money by paying cash instead of their insurance copay have been part of some contracts between pharmacies and the companies that manage prescription drug programs for insurance plans.” The piece adds that although “pharmacy benefit managers…insist their contracts do not have gag clauses, and their members are offered the lowest available price,” ending “gag rules is a small step toward price transparency that dozens of states are pursuing.”
Public Health and Private Healthcare Systems
Maine Supreme Court Considers MaineCare Abortion Coverage Ban.
The AP Share to (5/16) reports that an attorney representing the American Civil Liberties of Maine told Maine supreme court justices Wednesday the state is “putting its thumb on the scale of a highly personal decision” by funding care for low-income pregnant women while refusing to pay if they elect to terminate their pregnancies. But the state attorney general’s litigation chief told justices that there is no obligation for taxpayers to fund abortions even though women have a right to the procedure. The court heard arguments in the appeal of a decision that upheld the state’s decision not to fund abortions through MaineCare, the state’s Medicaid program.
The Bangor (ME) Daily News Share to (5/16, Harrison) also covers the story.
Medicaid Expansion In Connecticut Resulted In Fewer Uninsured, More Usage Of Preventive Health Services, Analysis Concludes.
The Hartford (CT) Business Journal Share to (5/16, Stearns) says the move “by Connecticut leaders to expand Medicaid in 2010 to low-income adults without dependent children reduced the state’s uninsured rate and drove greater use of preventive health services and behavioral health care by those patients, according to a new report released by the Connecticut Health Foundation.” The analysis “examines the impact of ‘Husky D,’ as the Medicaid expansion is known, and found more than 200,000 state residents, ages 19-64, were covered under the plan as of 2017.” Of that number, “18,404, were in Hartford, which had the highest number of Husky D enrollees in the state.” Overall, the program covers more than 750,000 residents.
New Legislation Could Allow Expanded Opioid Treatment Under Medicaid.
Modern Healthcare Share to (5/16, Luthi, Subscription Publication) reports, “In Cincinnati, wait times for opioid addicts seeking residential treatment have dropped as the city’s providers are banding together to manage the barrage of cases across different settings.” This move is essential “to managing the scope of opioid addiction cases, said Shawn Ryan, founder and chief medical officer of the outpatient treatment center BrightView, because it matches patient needs with what providers offer.” Yet, “there is a constraint on long-term treatment for mental illness and substance abuse that hinders creative use of hospitals, nursing homes and other facilities.” The article says that since the 1970s, Medicaid has been prohibited from paying for stays at institutions for mental disease (IMDs) with more than 16 beds. The House is tackling legislation to provide an exception so that victims of the opioid epidemic can receive covered treatment for up to 30 days.
Proposed Medicare Reforms Have Drug Makers Worried.
STAT Plus Share to (5/16, Mershon, Subscription Publication) reports HHS Secretary Alex Azar has been talking up the Administration’s “push to consolidate the two disparate Medicare programs that pay for prescription drugs” this week. The proposal would “bring the negotiating power of the Part D program, which covers seniors’ prescription drugs, into the Part B program, which covers other treatments,” and that, the article says, is “worrying drug makers.” Azar said, “Let me be really clear about this: We are going to bring negotiation to Part B drugs, and we are going to give Part D plans more bargaining power. It’s going to happen.” He warned, “If pharma doesn’t come to us with a plan for which drugs make sense to move from Part B to D, we’ll decide that for them.”
Also in the News
Switching Health Insurers Could Save University Of Nebraska System $12.3 Million.
The AP Share to (5/16) reports that University of Nebraska officials say switching health insurance companies could save the institution “around $12.3 million next year.” A proposal headed to the Board of Regents for its consideration next month would move the coverage from Blue Cross and Blue Shield of Nebraska to UMR next year, according to the AP.