What’s New in Health Care Reform: April 19

What'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.

Trump Says Health-Care Revamp Still Priority ahead of Tax Overhaul

President Donald Trump said he would keep pressing to enact a health-care overhaul even if it means delaying another one of his policy goals: revamping the tax code. Last month, House Republicans conceded they didn’t have enough votes to pass their health-care bill, despite an aggressive lobbying effort by the White House. Mr. Trump and congressional Republicans say they haven’t given up and are still working to assemble the votes needed to overturn major pieces of former President Barack Obama’s Affordable Care Act. Via WSJ.

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Insurers Want Greater Certainty on Obamacare Subsidies

Health insurers want more certainty about whether the government plans to keep paying them subsidies in order to decide whether to participate in the individual market exchanges next year. In a statement provided to Morning Consult last week, the Department of Health and Human Services said it hasn’t changed the precedent that it would keep paying the Affordable Care Act’s cost-sharing reduction payments to health insurers while a lawsuit about the subsidies continues. Via Morning Consult.

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Health Groups Warn of Higher Costs if ACA Subsidies not Financed

A coalition of eight health groups is making a direct appeal to the Trump administration and congressional leaders to fund the Affordable Care Act’s cost-sharing reductions for this year and next, calling it “the most critical action” that could be taken to stabilize health insurance exchanges. The future of the payments has been a source of uncertainty for insurers, who are preparing their policy proposals for the ACA exchanges in 2018. Without more information about whether they would receive the payments, which help low-income people afford out-of-pocket health care expenses, insurers say it is difficult to develop premium rates. Via Morning Consult.

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Latest Trumpcare Idea: Let Different Health Plans Fight It Out

White House officials and top Republicans have been trading new ideas over the recess to get Obamacare repeal back on track—and one of the latest ideas is to allow more market competition between health plans that follow Obamacare's rules and plans that don't, according to sources familiar with the talks. They're also trying to narrow the language of the proposal to let states opt out of some of the law's insurance regulations. That's a concession to moderates who don't want to undermine Obamacare's protections for people with pre-existing conditions. Via Axios.

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GOP House Leader Says There Are Ways Republicans Can Forge ahead on Health Care

Rep. Greg Walden, who helped craft the failed House GOP health-care proposal as a key committee chairman, said that Republicans may have to wait even longer to act on it. Walden, an Oregon Republican and chairman of the House Energy and Commerce Committee, said the GOP may have to use a future budget measure to pass its version of repealing and replacing Obamacare. Via Washington Post.

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Get Set for Trump Revisions to Your Affordable Care Act Insurance

The Trump administration's proposed rule aimed at stabilizing the existing health law's insurance marketplace could have rapid, dramatic effects—perhaps as soon as early summer on people who do not get insurance through work, and buy it on the Affordable Care Act's exchanges instead. If the changes the administration proposed in February hold up in the final draft—which is expected out soon—look for a shorter enrollment window, tighter vetting of people who sign up outside of those open periods and efforts to penalize consumers who don't maintain "continuous coverage." Via NPR.

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Trump Administration Makes First Mark on Obamacare with Regulation

The Trump administration released a final rule that slashes the open enrollment period for Affordable Care Act coverage in 2018 in half, among other changes, in its first major regulatory change affecting Obamacare. The regulation, which aims to stabilize the ACA exchanges, could have a significant impact on the marketplace, but it leaves unanswered insurers’ biggest question: whether the government would continue funding the ACA’s cost-sharing subsidies, which help lower-income consumers afford out-of-pocket health costs. Via Morning Consult.

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Trump’s Threat Prompts Democrats to Play Hardball over Obamacare Payments

Democrats signaled that they will seek to secure payments owed to health insurers under the Affordable Care Act as part of pending negotiations over a government spending bill Thursday—a new wrinkle in sensitive talks that emerged a day after President Trump threatened to use the payments to force Democrats to negotiate a replacement for the ACA. The “cost-sharing reduction” payments are meant to subsidize out-of-pocket expenses for low-income Americans who receive insurance through ACA marketplaces, and the payments are seen as a key factor in maintaining the stability of the market for individual insurance in many states. Via Washington Post.

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Obamacare Repeal Bill Is the Zombie GOP Can’t Kill—Or Bring back to Life

Republicans in Congress for the first time are lowering expectations for how much of Obamacare they can repeal and how quickly they can do it. As they meet constituents back home, GOP lawmakers seem trapped between the reality of their failed repeal effort and President Donald Trump’s renewed promises this week to finish off Obamacare before taking on tax reform. Vice President Mike Pence is also still trying to keep the repeal dream alive, working with conservatives on new tweaks to the stalled House bill. But even if the ultra-conservatives come on board, there’s no sign that the moderate Republicans needed to pass a bill are ready to sign on. Via Politico.

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New Medicare Model for Paying Doctors Passes Key Test

A far-reaching Medicare payment proposal cleared a crucial hurdle this week, as the federal health program seeks to reward doctors for keeping patients healthy. The pitch from the American College of Surgeons would allow more than 75 different specialty doctors to participate in Medicare’s new value-based payment system. Specialty physicians have been largely left out of the system, commonly known as MACRA after the bill that created it. Via The Hill.

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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.