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Policy

 

The Affordable Care Act’s taxes on health insurance, high-cost health plans and medical devices would be delayed under a series of bills introduced by House Republicans, with the Medical Imaging & Technology Alliance (MITA) quickly coming out in support of suspending the device tax.

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.

 

Recent Headlines

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).

CMS administrator signals big changes to Medicaid

States will have more flexibility to change their Medicaid programs, CMS Administrator Seema Verma said in a speech that criticized the Affordable Care Act (ACA)’s expansion of eligibility and called opposition to work requirements for able-bodied beneficiaries “soft bigotry” from the last administration.

More clinicians will be exempt from MIPS in 2018, won’t be able to opt in

CMS has finalized the rule for the second year of Medicare Access and CHIP Reauthorization Act’s (MACRA) Quality Payment Program (QPP), raising the low-volume threshold for the Merit-based Incentive Payment System (MIPS) but not allowing clinicians the option to participate if they don’t meet the minimum requirements.

5 things about the final OPPS rule and hospitals’ lawsuit over 340B change

CMS released its final hospital outpatient prospective payment system (OPPS) rule for 2018, which included a significant cut to drug payments to hospitals which use the 340B drug discount program. The result was the quick threat of a lawsuit from three major medical groups.

10 things Democrats want from the next HHS Secretary

The top Democrats on the Senate’s finance and health committees have outlined 51 criteria for judging President Donald Trump’s next nominee to run HHS, with many of their priorities going against the policies touted by Trump and former HHS Secretary Tom Price, MD.

CMS proposes letting states change ACA’s essential health benefits, medical loss ratio

The definition of “essential health benefits” which Affordable Care Act-compliant health plans have to cover would be up for states to decide under a rule proposed by CMS, echoing similar provisions which had been included in Republican legislative efforts to repeal and replace the ACA.

6 states could be out of CHIP funds by January

Federal funding for the Children’s Health Insurance Program (CHIP) expired at the end of September, and with no quick renewal expected from Congress, states are on their own to keep the program afloat. According to a report from the Georgetown University Center for Children and Families, six states won’t be able to do so past early January.

Trump declaration of public health emergency on opioids could impact physicians

President Donald Trump followed through on a months-old promise to declare a national public health emergency on the opioid addiction epidemic, which could increase access to addiction treatment and additional training for physicians prescribing opioids.

Judge denies request to block Trump from halting ACA insurer subsidies

A federal judge in California denied the request of 19 attorneys general to force the immediate reinstatement of the Affordable Care Act (ACA)’s cost-sharing reduction subsidies to insurers, which were cut off by President Donald Trump.

CBO: Funding ACA insurer subsidies would reduce federal deficit by $3.8B

Legislation to fund the Affordable Care Act (ACA)’s cost-sharing reduction subsidies for two years while expanding state waivers and availability of catastrophic insurance plans would preserve the current level of health insurance coverage while lowering federal spending, according to the Congressional Budget Office (CBO).

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