What’s New in Health Care Reform: Dec. 14

shutterstock_184172777_960x540What's New in Health Care Reform provides an overview of the past week’s news, updates, and commentary in health care reform and utilization management.


52M with Pre-Existing Conditions Could Be Denied Coverage without Obamacare

A new study finds that 27% of adults under 65 have pre-existing health conditions that could lead to them being denied coverage if Obamacare were repealed. Obamacare banned insurance companies from rejecting people because of their pre-existing health conditions, but the study released by the Kaiser Family Foundation found that if pre-Obamacare rules returned, 52 million Americans could be denied coverage. Via The Hill.

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Republicans Face Dilemma on Timing of Health-Law Replacement

Republicans united in their desire to overturn the Affordable Care Act are divided over whether to replace it before or after the 2018 elections, a choice that holds political peril either way. Waiting until after the midterms could pose a political risk to the most conservative Republicans who campaigned on the repeal and whose constituents want the law to be gone as quickly as possible. Via Wall Street Journal.

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New Push to Replace Obamacare Reignites Old GOP Tensions

Republicans on Capitol Hill are already laying the groundwork for a rapid repeal of President Obama’s signature health-care law beginning on the first day of the new Congress, before President-elect Donald Trump is even sworn in. But the urgent efforts to make good on a Republican campaign promise six years in the making obscure major GOP divisions over what exactly to replace Obamacare with and how to go about it, and how long a transition period to allow before the law’s insurance would go away. Via Washington Post.

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Price, Ryan Say Length of Obamacare Transition Still Undetermined

House Speaker Paul Ryan and House Budget Committee Chairman Rep. Tom Price (R-Ga.) said they are still talking about how long a transition period will last after Congress repeals Obamacare early next year. “That’s all a matter of discussion, it’s what we’re talking about right now,” Price told reporters, adding that he hasn’t seen draft language of a budget resolution yet. Price has been named as President-elect Donald Trump’s pick to lead Health and Human Services. Via Morning Consult.

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HHS Chief Warns Senate Democrats of "Chaos" Under ACA Repeal

The nation’s top health official spoke with Senate Democrats about the repeal of the Affordable Care Act, warning that undoing the law without having a replacement ready could be disastrous. “It’s very important to understand that a repeal and delay of a replacement is a situation where it is basically repeal and chaos,” Health and Human Services Secretary Sylvia Burwell told reporters after meeting with lawmakers. Via Morning Consult.

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GOP Eyes Big Gamble on Obamacare

Republicans are betting that they can force Democrats to negotiate a replacement for Obamacare if they repeal the law first. GOP leaders are planning a strategy to quickly repeal the law with a simple majority in the Senate, but then delay repeal going into effect for a few years to buy time to craft a replacement. But passing a replacement won’t be easy. It would require the usual 60 votes in the Senate to advance, meaning some Democratic support would be needed. Via The Hill.

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Under Trump, Congress Likely to Pull Plug on Medical Device Tax

When Donald Trump takes over as president on Jan. 20, one of the first business tax breaks he delivers is likely to go to the U.S. medical device industry and companies like Mark Throdahl's. The chief executive of OrthoPediatrics Corp, based in northern Indiana, said his company has been able to hire more workers since the temporary suspension effective last January of a federal tax on medical devices. The tax was imposed as part of outgoing President Barack Obama's signature 2010 health care law. Throdahl said he hopes the incoming Republican-led Congress and president will permanently repeal the tax. Via Reuters.

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Senate Approves Landmark Mental Health Bill as Part of 21st Century Cures Act

The new legislation places a strong emphasis on science, pushing federal agencies to fund only programs that are backed by solid research and to collect data on whether patients are actually helped. The bill strengthens laws mandating parity for mental and physical health care and includes grants to increase the number of psychologists and psychiatrists, who are in short supply across the country. The bill, which combines mental health proposals from several lawmakers, also pushes states to provide early intervention for psychosis, a treatment program that has been hailed as one of the most promising mental health developments in decades. Via Kaiser Health News.

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In Time Interview, Trump Vows to Lower Drug Prices

President-elect Donald Trump has vowed to lower drug prices, opening up another major health policy debate as his inauguration nears. “I’m going to bring down drug prices,” Tump said in an interview with TIME Magazine, which named him Person of the Year. “I don’t like what’s happened with drug prices.” Via Morning Consult.

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CMS Cracks Down on Providers Steering Patients into Private Plans

The CMS has issued an interim final rule that attempts to stop providers and organizations from steering patients eligible for Medicaid or Medicare into private insurance as a way to receive higher reimbursement rates. The rule issued requires dialysis centers that help patients pay private insurance premiums either directly or through charities to clarify what plans in their region pay for and how that compares to Medicare or Medicaid. Via Modern Healthcare.

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Andy Tofilon

Andy Tofilon is a Marketing Segment Manager at Mayo Medical Laboratories. He leads strategies for corporate communications, public relations, and new media innovations. Andy has worked at Mayo Clinic since 2003. Outside of work, Andy can be found running, hiking, snapping photos, and most importantly, spending time with his family.