What’s New in Health Care Reform: June 14

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.

Iowa Seeks to Revamp Affordable Care Act

Iowa officials are seeking federal permission to implement a plan that would alter major aspects of the Affordable Care Act in the state, in what could be a key test of the ability to modify the health law through executive authority. Trump administration officials said they were open to supporting the Iowa proposal to the extent possible under the current health law. Via Wall Street Journal.

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Medical Responses to Opioid Addiction Vary by State, Analysis Finds

Location, location, location. That mantra may apply even when it comes to how opioid addiction is treated. Specifically, patients with private insurance who are diagnosed with opioid dependency or abuse may get different medical services depending on where they live, a white paper to be released in the upcoming week by a national databank indicates. Via Kaiser Health News.

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Opioid Crisis Complicates GOP’s Health-Law Push

The nation’s worsening opioid crisis has become another sticking point in Republican plans to dismantle major portions of the Affordable Care Act, with key GOP senators hesitating to support a bill that could threaten addiction treatment for millions of people. Via Wall Street Journal.

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Administration Weighs How to Stabilize Exchanges Amid Insurer Uncertainty

Senate Republicans said that President Donald Trump was open to their suggestions about how to stabilize the Obamacare exchanges, but did not give any clear policy updates, leaving insurers hanging. Health and Human Services Secretary Tom Price also highlighted the individual and small group markets as one of the “toughest challenges” for his employees, without providing specific steps that HHS would take. The focus on stabilizing the Affordable Care Act’s individual marketplace comes even as Senate Republicans are struggling to reach consensus on a bill that would overhaul major parts of the ACA. Via Morning Consult.

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Federal Actuary: 13M More Uninsured under GOP Repeal Package

The House-passed Obamacare repeal bill would leave 12.6 million more Americans uninsured over the next decade and reduce federal spending by $328 billion, according to an analysis released today by CMS’ Office of the Actuary. The coverage estimate is well below the 23 million more uninsured that the CBO has projected under the American Health Care Act. The congressional scorekeeper additionally estimated that the American Health Care Act would reduce spending by only $119 billion over a decade. Via Politico.

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Centene to Expand Obamacare Insurance to 3 New States in 2018

Centene Corp, one of the largest players in the Obamacare individual insurance market, said it would expand into three new states in 2018, despite uncertainty over the future of the legislation under President Donald Trump's administration. The company said it plans to enter Kansas, Missouri, and Nevada in 2018, as well as expand its operations in six existing markets: Florida, Georgia, Indiana, Ohio, Texas, and Washington. Via Reuters.

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Under ACA, Increased Coverage Paired with More Jobs

The House health care plan, which the Senate is currently editing, would cause an estimated 23 million people to lose insurance, according to the Congressional Budget Office. If that's true—and Republicans dispute the estimate—it stands to reason that this could lead to a slowdown in one of the fastest-growing job markets. Via Axios.

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500,000 Providers Will Get 2% Payment Cuts under Medicare's Quality Reporting System

More than 500,000 physicians and other providers face a 2% cut in their Medicare payments this year due to poor performance under the Physician Quality Reporting System. Under PQRS, which is being phased out, clinicians choose from a list of quality measures they want to be evaluated by, such as how well they performed care management or if they helped patients keep their diabetes in check. The penalties are based on 2015 claims data. Via Modern Healthcare.

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FDA Delays Rolling out New Nutrition Facts Label

The U.S. Food & Drug Administration delayed indefinitely implementation of a new nutrition facts label that would enlarge calorie counts, itemize added sugar, and bring serving sizes in line with actual average portions. The rule, which had been championed by former first lady Michelle Obama, had been scheduled to go into effect on July 26, 2018. Via Reuters.

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Supreme Court Speeds Copycat Biologic Drugs to Market

The U.S. Supreme Court cut the time it will take for copycat versions of biologic drugs to get to the market in a pivotal ruling about an expensive class of medicines that can yield billions of dollars in sales for drug companies. Via Reuters.

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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.