Republicans Who Wanted To Repeal ACA Now Working To Keep Premiums Down.
The Wall Street Journal (2/15, Armour, Subscription Publication) reports that after trying to repeal and replace the Affordable Care Act, state and federal Republicans are now attempting to stabilize the law and lower premiums in an effort to curb insurance premium increases which may pose a political problem during upcoming elections. For instance, Wisconsin Gov. Scott Walker (R) has presented a $200 million reinsurance plan and some congressional Republicans have come out in favor of a federal reinsurance program.
More States Launching Investigations Of Aetna Following CNN Story.
On its website, CNN (2/15, Drash) reports that Colorado, Washington and Connecticut have joined California in initiating “investigations of Aetna after a former medical director for the insurer admitted under oath that he never looked at patients’ medical records when deciding whether to approve or deny care.” California began its probe after CNN published a story which included the statement made “during a sworn deposition in a lawsuit against Aetna.” However, Aetna, which has about 23.1 million customers and is the third-largest insurer in the US, is arguing that CNN took comments from the deposition “out of context” and that “medical records were in fact an integral part of the clinical review process.”
On its website, Fox News (2/15, Flood) also says Aetna is accusing CNN of taking the “deposition ‘out of context to create media and courtroom leverage,’ and calling a report from the network ‘a gross misrepresentation.’”
Modern Healthcare (2/15, Livingston, Subscription Publication) reports that six state regulators are looking into the matter, although Aetna did not identify these states. The article says “California’s and Connecticut’s insurance commissioners confirmed they are launching investigations, while Colorado and Washington are among the others scrutinizing Aetna’s practices.” The piece adds that “a putative class action lawsuit was also filed Monday in the U.S. District Court for the Northern District of California, alleging that Aetna has failed to ensure patients get appropriate care, causing patients to suffer damages.”
Fierce Healthcare (2/15, Small) also covers the story.
“Powerful” Republican Delegate Expresses Support For Medicaid Expansion In Virginia.
The Washington Post (2/15, Vozzella) reports that on Thursday, Del. Terry G. Kilgore (R-Scott), chairman of the “powerful” Virginia House Commerce and Labor Committee, announced his support for Medicaid expansion in the state, a move which “could make it easier for other rural conservatives to get on board after four years of steadfast opposition.” Kilgore “said his struggling coal-country district would get the ‘hand up’ it desperately needs if more uninsured Virginians were made eligible for the federal-state health-care program.” He added that “it’s the right thing to do” for his district and his state.
The AP (2/15, Suderman) reports that Kilgore, who is “a powerful” GOP legislator, “publicly endorsed expanding Medicaid in Virginia after years of opposition, boosting the chances the Old Dominion will join 32 other states in expanding the program” under the ACA. The article says that “Kilgore, whose district in Virginia’s southwest coal country voted overwhelmingly for Republican President Donald Trump, said Thursday that he’s now in favor of Medicaid expansion with some conditions, like work requirements and small copays.” The piece adds that Del. Will Morefield, another GOP legislator “from Southwest Virginia, said he’s not ready to endorse any form of Medicaid expansion just yet, but is much more receptive than in the past.”
The Hill (2/15, Weixel) reports that Kilgore hinted “he is not the only Republican who supports the expansion.” He said, “I’m not that far out on a limb. … We have to step up, we can’t be the party of ‘no.’”
The Richmond (VA) Times-Dispatch (2/15, Martz) reports that Republicans in the state House who have opposed “Medicaid expansion for more than four years already have engaged in negotiations with Gov. Ralph Northam, a Democrat who strongly supports the budget proposal by his predecessor, Gov. Terry McAuliffe, to accept $3.2 billion in federal funds in the next two years to expand the program under the Affordable Care Act.”
The Newport News (VA) Daily Press (2/15, Ress, Subscription Publication) also covers the story.
New Hampshire’s Senate Republicans Release Medicaid Expansion Proposal Online.
The Concord (NH) Monitor (2/15, DeWitt) reports a “placeholder bill” released online Thursday provides insight into New Hampshire Senate Republicans’ plans for the state’s Medicaid expansion program. The bill would “replace the state’s existing New Hampshire Health Protection Program – which currently provides services to around 50,000 low-income residents – and create a new, five-year initiative carrying significant changes to structure and funding.” The proposed measure, called the “Granite Advantage Health Care Program,” would “work to move the program’s present recipients off the individual insurance market and move them into the state’s existing Medicaid care organizations, the bill states.” The bill would also add work requirements as a condition for receiving Medicaid for some adults.
Nebraskans, Iowans Who Lost Coverage When Insurers Exited ACA Marketplaces Have Until March 1 To Enroll In New Plans.
The Omaha (NE) World-Herald (2/15, Jordon) reports that according to state officials, thousands of Nebraskans and Iowans who lost healthcare coverage when insurers exited ACA marketplaces in their states “can still get coverage for 2018 if they sign up by March 1.” The article says ACA rules allow “special enrollment periods in such cases, among other circumstances.” But it remains to be seen if these consumers will be able to afford premiums for this year.
Idaho Governor Defends Little’s Involvement In Plan To Allow Insurers To Sell Coverage Which Does Not Meet ACA Requirements.
The AP (2/15, Kruesi) reports that on Thursday, Gov. C.L. ‘Butch’ Otter (R) “defended Lt. Gov. Brad Little’s involvement in a plan to reduce health care coverage for Idahoans.” The article says Little, who is also a Republican, is running for governor since Otter is not seeking a fourth term. The piece adds that recently, “Little signed an executive order with Otter to permit insurance companies to sell cheap policies” which do not meet ACA requirements. Otter said the only people complaining that Little was using the plan to bolster his campaign are his opponents and the media.
Anthem Makes Changes To Controversial ED Policy Amid Pushback.
Modern Healthcare (2/15, Livingston, Subscription Publication) reports that after pushback from healthcare providers and lawmakers, Anthem has made changes to its controversial emergency department policy under which the insurer refused to cover patient ED visits for conditions later determined not to have been an emergency. However, some providers argue the changes are not enough to mitigate the harm that Anthem’s policy is causing patients. For instance, Dr. Paul Kivela, president of the American College of Emergency Physicians, said the changes “do not address the underlying problem of putting patients in a potentially dangerous position of having to decide whether their symptoms are medical emergencies or not before they seek emergency care, or pay the entire bill if it’s not an emergency.”
ACA Startup Oscar Health Seeks To Raise $200M In New Round Of Funding, Sources Say.
The Wall Street Journal (2/15, Chernova, Subscription Publication) reports that Oscar Health Insurance Corp., a startup which was co-founded by Joshua Kushner, wants to raise more than $200 million and it is seeking a higher valuation than the $2.7 billion it received during the last funding round in 2016, according to unnamed sources. The article says Oscar went through a difficult period last year when Republicans were threatening to repeal the ACA, on which the company is based. The Journal adds that some of that uncertainty has been resolved, hence Oscar’s latest move.
Critics Say Maine Slow To Expand Opioid Treatment For Uninsured People.
The AP (2/15, Villeneuve) reports the Maine Department of Health and Human Services spent $13,000 on opioid addiction treatment for five uninsured Mainers in 2017, while it spent about $43,600 on 50 members of MaineCare, prompting “criticism that Republican Gov. Paul LePage’s administration has been far too slow to roll out the program at a time when one Mainer a day is dying of a drug overdose.” The department said Maine now has 18 approved Opioid Health Home sites across the state, however critics say requirements are too restrictive and that DHHS “should have instead provided more funds for existing contracts for treatment services,” the AP reports.
The Portland (ME) Press Herald (2/15, Lawlor) reports that “less than $60,000 has been spent so far on the Opioid Health Home program almost a year after it was launched, according to a Feb. 6 memo” from DHHS. The article says that the need among uninsured people could be “in the thousands” as “many people with a substance use disorder lose their jobs and are uninsured” at a time when the LePage Administration “has tightened Medicaid eligibility for adults – a pathway to treatment because Medicaid reimburses for substance use treatment programs.”