Leading the News
Trump Administration’s Policy Change Regarding Medicaid Work Requirements Facing Difficult Legal Challenges, Experts Say.
Reuters (1/25, Pierson) reports that a suit challenging CMS’ “approval of work requirements for Medicaid recipients in Kentucky could rein in the power of the Trump administration to reshape the health insurance program for the poor, legal experts said.” The lawsuit, which is seeking class-action status, alleges that “the administration’s approval of the requirements has ‘effectively rewritten’ the federal Medicaid statute in violation of the law.” According to one expert, “There is...good evidence that such requirements add enrollment hurdles that cause people to lose eligibility.”
Legislation and Policy
House, Senate GOP Lawmakers Pushing Competing Reinsurance Measures.
Modern Healthcare (1/25, Luthi, Subscription Publication) reports that House and Senate leaders “want reinsurance,” although “they want it in different ways.” The article says there are “two different Republican measures on the table, each handling the mechanics differently.” It remains to be seen “which one will win out if congressional Republicans go through with their plan to address stabilization in an upcoming spending bill.” The piece adds that the House bill “allocates $30 billion over three years at the full discretion of the HHS secretary,” while the Senate’s “would leverage 1332 waivers to let states draw down from a $2.25 billion pool – available annually for two years – for their own reinsurance program.”
Idaho Plans To Allow Insurers To Offer Policies Which Do Not Meet ACA Requirements.
The Wall Street Journal (1/25, Mathews, Subscription Publication) reports that on Wednesday, Idaho officials said they will allow insurers to sell plans which do not meet ACA requirements. The article says this action will be a test of how far states can go in their efforts to determine their own healthcare policies under the Trump Administration. The piece adds that experts are saying it remains to be seen if Idaho has the authority to implement the proposal, or if it is legal for insurers to sell such plans, given that the ACA remains the law of the land.
The Hill (1/25, Weixel) also reports that Idaho’s action “could test how committed the Trump administration is to enforcing” the ACA. The proposed changes will allow insurers “to offer ‘state-based plans’ to consumers that won’t be required to meet some of the basic rules of” ACA “plans, such as the essential health benefits that plans must cover.”
Massachusetts Commission Says It Will Reconsider “Drastic Changes” To Health Benefits For Public Employees.
The Boston Globe (1/25, McCluskey) reports that a Massachusetts commission which “is under fire for making drastic changes to public employee health benefits with little notice last week said Thursday that it will reconsider the widely condemned decision.” In light of widespread criticism, “the Group Insurance Commission will reconsider its vote on Feb. 1,” officials said. Attorney General Maura Healey’s office “said the commission, which manages health benefits for about 442,000 state and municipal employees, retirees, and their families may have violated the law at its Jan. 18 meeting, where the commission took the controversial vote limiting health plan options.”
Sen. Warren Says Democratic Party Must Push For Expansion Of Public Healthcare Programs.
The Hill (1/25, Sullivan) reports that on Thursday, Sen. Elizabeth Warren (D-MA) “said it was time to go on ‘offense’ on health care after a year of defending ObamaCare against repeal efforts.” During a speech, Warren outlined several “ways to build on the Affordable Care Act, and attacked health insurance companies for how they treat consumers.”
The Huffington Post (1/25, Marans) reports that Warren made the comments during a Families USA event. She said “she wholeheartedly supports efforts to expand public health insurance programs, including a ‘single-payer’ bill introduced by Sen. Bernie Sanders (I-Vt.) that would expand Medicare to the entire population.” But until that goal can be achieved, “the federal government needs to impose new standards on private insurers to build on the accomplishments of the Affordable Care Act.” The article says Warren discussed how to hold insurers accountable, including cracking down “on the practice of shifting costs onto consumers,” forcing “private insurers to provide coverage as affordable as Medicare and Medicaid,” and “‘call[ing] their bluff’ if they resist complying with the first two planks.”
Congressional Quarterly (1/25, Clason, Subscription Publication) quotes Warren as saying, “Let me be absolutely clear: we will defend Medicaid and the Affordable Care Act with everything we have. ... But we have to do more than play defense. Millions of families are counting on us, and I believe it’s time to go on offense.”
Public Health and Private Healthcare Systems
Effort To Expand Medicaid In Virginia “Off To A Rough Start.”
The Washington Post (1/25, Schneider) reports that if Virginia is supposed to expand Medicaid this year, “the effort got off to a rough start Thursday when a GOP-controlled Senate committee killed a package of bills on a party-line vote.” The article says Thursday’s vote “highlighted the party divide that remains even after the issue of expanding Medicaid helped drive big Democratic wins in the fall’s statewide elections.” The piece adds that polls have found “a majority of Virginians support expanding access to health care, and the hospital industry and several regional Chambers of Commerce have come out in favor of expansion.”
The Hill (1/25, Weixel) reports that Virginia’s “Education and Health Committee voted down the bill 8-7.” The measure can be reconsidered at a later date, “but if the committee doesn’t take further action, the bill is dead.”
The Richmond (VA) Times-Dispatch (1/25, Martz) also covers the story.
Experts Say CMS Likely To Approve Indiana’s Request For Changes To Medicaid Program.
Congressional Quarterly (1/25, Williams, Subscription Publication) reports that the Trump Administration will soon make a decision about whether or not “to approve Indiana’s request to make fundamental changes to its Medicaid program for poor Hoosiers.” Analysts are predicting that CMS is “likely to green light the state’s plan to extend and revamp its existing program because it’s similar to the Kentucky proposal federal officials approved earlier this month.” The article says both states’ proposals include work requirements. The piece adds that CMS Administrator Seema Verma “was heavily involved in constructing both the Indiana and Kentucky waivers during her time as a health care consultant prior to joining the administration last year.”
Federal Judge Rules Against Wills Eye In Hospital’s Medicare Status Dispute.
The Philadelphia Inquirer (1/25, Brubaker) reports a federal judge on Thursday “turned down Wills Eye Hospital’s bid to win certification as a hospital under Medicare.” U.S. District Judge Eduardo C. Robreno said that the Centers for Medicare and Medicaid Services “was within its rights when it decided in 2013 that Wills did not provide enough inpatient care to qualify as a hospital,” the Inquirer reports.
Also in the News
No Consensus Has Emerged On How To Lower Drug Prices, Leading To Standstill In Congress.
STAT (1/26, Mershon) reports that despite President Trump’s popular promise to lower drug prices, “congressional efforts to lower drug prices are at a total standstill.” The article explains that lobbyists, lawmakers, and Congressional staffers say that “most powerful health industry players conspicuously disagree about exactly how to move forward,” which creates a “cacophony that makes it unlikely that crushing drug prices will change any time soon.”