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Policy

 

Two Senate Democrats have asked CMS and HHS to make a last-minute extension of the open enrollment period for the Affordable Care Act (ACA)’s insurance exchanges, arguing the Dec. 15 deadline will leave too many interested customers either without health coverage or automatically enrolled into plans which “may no longer be the best choice for their families.”

The repeal of the Affordable Care Act’s individual mandate has been projected to cause insurance premiums to rise by an average of 10 percent through 2027. Those hikes would be mitigated, however, if Congress funded the ACA’s cost-sharing reduction subsidies and a $10 billion, two-year reinsurance program, according to an analysis from Avalere.

The American Hospital Association (AHA) suggested the Medicare Payment Advisory Commission (MedPAC) pump the brakes on advocating for major changes to Merit-based Incentive Payment System (MIPS), saying any major shifts wouldn’t have “the benefit of data or experience” considering this is the program’s first performance year.

The largest health insurers—UnitedHealthcare, Aetna, Anthem, Cigna and Humana—are getting nearly 60 percent of their total combined revenue from Medicare and Medicaid plans, according to a Health Affairs study, with that money more than doubling since the Affordable Care Act (ACA) was passed.

In a final rule issued on Nov. 30, CMS finalized changes to several mandatory bundled payment programs, canceling two surrounding hip fractures and cardiac care and reducing requirements in a joint replacement bundle.

 

Recent Headlines

Actuaries to Congress: Repealing individual mandate could threaten insurer solvency

If the Affordable Care Act’s individual mandate is repealed as part of a Republican tax cut plan, premiums will likely rise and insurers will exit the individual market, according to the American Academy of Actuaries.

Insurers in Massachusetts have to cover birth control without copay under new law

Massachusetts Gov. Charlie Baker signed a law on Nov. 21 to require insurers cover birth control products without copays, allow women to obtain a year’s supply at once and prevent most employers from opting out of contraceptive coverage on moral or religious grounds.

HHS nominee made millions in pharma

Alex Azar, President Donald Trump’s nominee for HHS Secretary, was paid nearly $2 million in his final year as an executive at pharmaceutical giant Eli Lilly and built a portfolio worth as much as $20.6 million in his nearly 10-year tenure at the company.

Fighting opioid abuse, lowering drug prices, deregulation are goals of Medicare Part D rule

Several changes to Medicare Advantage and Medicare Part D prescription drug plans have been included in a proposed rule by CMS in an effort to fight opioid abuse among seniors while taking another step towards reducing regulations.

ACA enrollment up in first weeks—and if it falls, poll says Trump will be blamed

Between Nov. 1 and Nov. 11, nearly 1.5 million people signed up for health insurance coverage on the Healthcare.gov exchange, an increase of almost 500,000 from the same period last year.

Senate GOP includes repeal of ACA individual mandate in tax reform

Republican leaders in the Senate announced Nov. 14 they will include a repeal of the Affordable Care Act’s individual mandate in their tax reform proposal. After failing numerous times to repeal and replace the ACA, GOP leaders are hoping to include the healthcare reform in the tax bill.

FDA issues strong warning about kratom to treat pain, opioid addiction

The U.S. Food and Drug Administration (FDA) announced a public health advisory about risks associated with kratom, an herbal supplement used to treat pain and reduce opioid withdrawal symptoms.

AHA, ACC lower bar for high blood pressure to 130/80

In the first update to U.S. guidelines on blood pressure in 14 years, a writing committee changed the definition of high blood pressure from 140/90 millimeters of mercury or higher to 130/80 or higher.

Final MACRA rule too strict for some, too loose for others: ‘Do we need MIPS at all?’

While the proposed rule for the second year of the Medicare Access and CHIP Reauthorization Act (MACRA)’s Quality Payment Program (QPP) earned mostly praise from the healthcare industry, the finalized rule earned a mixed reaction from groups alternating saying it’ll burden providers and it’s allowing too many physicians to avoid the program altogether.

Healthcare policy put to voters in Maine, Ohio on Election Day 2017

Two state ballot referendums on Nov. 7 dealt with healthcare issues, with voters in Maine approving an expansion of Medicaid eligibility while Ohio voters soundly rejected a measure to tie pharmaceutical prices paid by the state to rates paid by the U.S. Department of Veteran Affairs (VA).

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