What’s New in Health Care Reform: April 26

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.

Friction in Republican Party over Health Care Sparks into Flames at Town Halls

Lawmakers on recess take heat from their constituents for the Republicans' botched attempts to pass a health care bill. After nearly two hours of fielding mostly health-care questions from hundreds of rowdy constituents at a full auditorium here this week, Republican Rep. Mike Coffman threw up his arms in frustration. “Those of you on the extreme left will never be satisfied,” he told the group of about 500 people assembled at a town hall here at the University of Colorado Anschutz Medical Campus. The crowd erupted in boos. Via Kaiser Health News.

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Tax Day Is Zero Hour for Health Insurance, Too

Your federal income taxes are due April 18 and, likely for several million people, so is a fine for failing to get health insurance. Despite a lengthy debate, Congress has not yet acted on a bill to repeal portions of the Affordable Care Act. That means the law and almost all of its regulations remain in force, for now. Via Kaiser Health News.

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Trump’s Renewed Focus on Health Bill Vexes GOP Tax Overhaul Strategy

President Donald Trump’s revived enthusiasm for tackling health-care legislation before tax policy has highlighted the complicated interplay between Republicans’ health care overhaul and their planned tax bill. Mr. Trump signaled last week that one of the reasons he has reprioritized health care is that he was relying on savings from the health bill to bolster the tax plan. Via WSJ.

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GOP Eyes Insurer Fund to Save Obamacare Repeal

If Republicans move ahead with repealing Obamacare, a proposed Patient and State Stability Fund would likely be a key component to keeping the fragile insurance market intact amid massive changes. The $100 billion fund, included in the embattled House GOP bill, is the result of months of meetings between congressional staff, insurance commissioners, and other officials that began before Republicans took complete control of Washington. Via The Hill.

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Obamacare’s Insurers Struggle for Stability Amid Trump Threats

Obamacare is stuck in limbo, and insurers and state regulators are struggling to set their plans for what’s increasingly shaping up as a chaotic year for the health-care program. After the failure of Republicans’ first attempt to repeal and replace the Affordable Care Act and President Donald Trump’s subsequent threats to let the program “explode,” more health insurers are threatening to pull out next year, while others may sharply raise the premiums they charge. They’ll start to declare in the next few weeks whether they’re in or out. Via Bloomberg.

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Insurers Push for ACA Subsidy Payments in Meeting with Verma

A meeting with a top U.S. health official did not appear to give health insurers greater confidence about whether the government plans to make key payments under the Affordable Care Act. Insurance executives, as well as the head of the trade group America’s Health Insurance Plans, met with Seema Verma, administrator of the Centers for Medicare and Medicaid Services. Insurers have been pressuring administration officials and lawmakers to fund the ACA’s cost-sharing reduction payments. Via Morning Consult.

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CMS Calls for Comments on Health Care Policy Improvement

CMS seeks public input on how to improve the health care delivery system and the Medicare program. The agency released its 2018 Medicare Inpatient Prospective Payment System proposed rule. As part of the proposed rule, CMS included a request for information on "improvements that can be made to the healthcare delivery system that reduce unnecessary burdens for clinicians, other providers and patients and their families." CMS added: "We aim to increase quality of care, lower costs, improve program integrity, and make the health care system more effective, simple, and accessible." Via Becker's Hospital Review.

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Sen. Grassley Demands Scrutiny of Medicare Advantage Plans

Sen. Chuck Grassley (R-Iowa) wants federal health officials to tighten scrutiny of private Medicare Advantage health plans amid ongoing concern that insurers overbill the government by billions of dollars every year. Grassley, the influential chairman of the Senate Judiciary Committee, has asked Centers for Medicare and Medicaid Services (CMS) officials to explain why they failed to collect nearly $125 million in potential overcharges identified at five Medicare Advantage plans audited in a single year. Via Kaiser Health News.

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Ryan: GOP Putting "Finishing Touches" on Health Care Bill

Speaker Paul Ryan (R-Wis.) said Republicans are putting the “finishing touches” on an effort to revive their Obamacare replacement bill. “We’re in the midst of negotiating sort of finishing touches, because our members want to make sure that we lower premiums,” Ryan sai during a question-and-answer session during a trip to London. Via The Hill.

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Groups Warn of Rural Health "Crisis" under Obamacare Repeal

Rural areas would be hit particularly hard if Congress and the Trump administration don’t send clear signals that they’re committed to helping keep Obamacare’s insurance marketplaces stable next year, advocates warn. Insurers are in the midst of deciding which Obamacare markets to enter, and they need assurances that they won’t have to pay billions for out-of-pocket costs for certain low-income consumers. Rural areas already have fewer care options than their urban peers. 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.