What’s New in Health Care Reform: Dec. 21

shutterstock_96827071_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.


Obamacare Sign-Ups Close to Last Year

More than 4 million people signed up for insurance coverage on Obamacare as of Dec. 10, the Centers for Medicare and Medicaid Services said. Of the 4 million sign-ups that have taken place since Nov. 1, 1.1 million have been from new customers, 2.9 million have been people renewing coverage. The sign-up period has been open for six weeks. Via Morning Consult.

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Democrats Open to Replacing Obamacare

Senate Democrats will never vote to repeal Obamacare. But once the deed is done, a surprising number of them say they’re open to helping Republicans replace it. Via Politico.

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Study: Premium Hikes Add $10B to Taxpayers’ Health Tab

Taxpayers will fork over nearly $10 billion more next year to cover double-digit premium hikes for subsidized health insurance under President Barack Obama's law, according to a study. The analysis from the Center for Health and Economy comes as the Republican-led Congress is preparing to repeal "Obamacare" and replace it with a GOP alternative whose details have yet to be worked out. With incoming President Donald Trump likely to sign such legislation, historic coverage gains under the 2010 health law are at stake. Via AP.

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G.O.P. Plans to Replace Health Care Law with "Universal Access"

House Republicans, responding to criticism that repealing the Affordable Care Act would leave millions without health insurance, said that their goal in replacing President Obama’s health law was to guarantee “universal access” to health care and coverage, not necessarily to ensure that everyone actually has insurance. In defending the Affordable Care Act, the Obama administration, congressional Democrats and advocacy groups have focused on the 20 million people covered by the law, which has pushed the percentage of Americans without health insurance to record lows. The American Medical Association recently said that “any new reform proposal should not cause individuals currently covered to become uninsured.” Via NY Times.

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Republicans Could Keep Parts of Obamacare for up to Four Years

Congressional Republicans say they will vote on repealing and replacing Obamacare “very quickly” early next year but may keep Obamacare in place for as long as four years. The incoming Trump administration and Republicans on Capitol Hill are sorting out the details of how to best deconstruct the Affordable Care Act. One of the thorniest problems is how long to leave parts of the law intact — to give 20 million Americans time to find other arrangements and health insurance companies the ability to develop and price new plans. Via Politico.

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Health Insurers Get Only 1.6% of $6 Billion They Are Owed for Costly ACA Customers

Hundreds of insurers selling health plans in Affordable Care Act marketplaces are being paid less than 2% of nearly $6 billion the government owes them for covering customers last year with unexpectedly high medical expenses. The $96 million that insurers will get is just one-fourth of the sum that provoked an industry outcry a year ago, when federal health officials announced that they had enough money to pay health plans only 12.6% of what the law entitles them to receive. Via Washington Post.

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Obama: Thursday Was Busiest Day on Record for HealthCare.gov

President Barack Obama said sign-ups for health insurance on HealthCare.gov hit a new record Thursday, Dec. 15, with 670,000 people signing up for plans. Obama touted the new record at his annual year-end White House press conference on Friday, and noted the increase in people who have gained health insurance under his presidency. Thursday was supposed to be the last day to sign up for 2017 coverage, but officials extended the deadline through Monday, citing high demand. Via Morning Consult.

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Feds Issue New Rules Aimed to Strengthen Obamacare Market

The Obama administration issued new rules making tweaks to the ObamaCare insurance marketplaces for next year, seeking to address lingering issues even as Republicans push forward with plans to repeal the law. The 465-page final regulation for 2018, part of an annual process to set the rules for the law’s marketplaces, seeks to address some insurer complaints with how the marketplaces operate. Via The Hill.

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Republicans Press CMS on Medicaid Expansion Policies

Congressional Republicans are pressing Obama administration officials for details on the Affordable Care Act’s Medicaid expansion before they leave office next month. Sen. Orrin Hatch (Utah) and Reps. Joe Pitts (Pa.) and Tim Murphy (Pa.) wrote to Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt, asking how the agency ensures ineligible people aren’t enrolling in Medicaid. The members asked Slavitt to respond within 30 days of receiving the letter. Via Morning Consult.

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New Special Enrollment Rules Will Shift Paperwork Burden to Consumers

People who want to sign up for a policy on healthcare.gov after the annual open enrollment period ends Jan. 31 may have to produce a paper trail proving that they qualify for a “special enrollment period” before their coverage can begin, according to details of a pilot program described last week by federal officials. But the verification measures, long sought by insurance companies, may deter the very consumers the marketplace needs to attract: Healthy people who may not bother signing up if doing so is a hassle. Via Kaiser Health News.

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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.