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.
Number of Americans without Health Insurance Grows in Trump's First Year, New Figures Show
The number of Americans without health coverage, which declined for years after passage of the Affordable Care Act, shot up in President Trump’s first year in office, according to data from a new national survey. At the end of 2017, 12.2% of U.S. adults lacked health insurance, up from 10.9% at the end of 2016, as President Obama was completing his final term. Via LA Times.
Court Battle Brewing over Work Rules for Medicaid
A battle is brewing in the courts over the Trump administration's move to let states impose work requirements for recipients of Medicaid, the health insurance program for the poor. Advocacy groups are gearing up to sue the administration, arguing that it doesn’t have the power to allow work requirements and other rules for Medicaid without action from Congress. Via The Hill.
Individual Mandate Now Gone, G.O.P. Targets the One for Employers
Having wiped out the requirement for people to have health insurance, Republicans in Congress are taking aim at a new target: the mandate in the Affordable Care Act that employers offer coverage to employees. And many employers are cheering the effort. Via NY Times.
Estimated Number of Health Plans on Federal Exchange Plummets by Two-Thirds
The Trump administration is estimating there are now only 700 issuers in the individual and small group markets, which is down from 2,400 in an earlier estimate. The CMS posted the updated figure in an information collection notice posted Jan. 8. The agency is seeking permission from the White House's OMB to continue an annual data collection from exchange plans about the risk profile of their enrollees. Via Modern Healthcare.
Trump Administration Says States May Impose Work Requirements for Medicaid
The Trump administration said that it would allow states to impose work requirements in Medicaid, a major policy shift that moves toward fulfilling a conservative vision for one of the nation’s largest social insurance programs for low-income people. Federal officials said they would support state efforts to require able-bodied adults to work or participate in other “community engagement activities” as a condition of eligibility for Medicaid. Via NY Times.
Trump Administration Freezes Database of Addiction and Mental Health Programs
The National Registry of Evidence-based Programs and Practices is housed within the Health and Human Services Department’s Substance Abuse and Mental Health Services Administration. The registry, which was launched in 1997, offers a database of hundreds of mental health and substance abuse programs that have been assessed by an independent contractor and deemed scientifically sound. Getting a program or therapeutic approach included in this registry amounts to receiving federal recognition as an evidence-based practice. Mental health and addiction specialists say they rely on this database as a key source for finding appropriate and effective therapies. Via Washington Post.
Major Shift as Trump Opens Way for Medicaid Work Requirement
In a major policy shift that could affect millions of low-income people, the Trump administration said it is offering a path for states that want to seek work requirements on Medicaid recipients. Seema Verma, head of the Centers for Medicare and Medicaid Services, said work and community involvement can make a positive difference in people’s lives and in their health. Still, the plan probably will face strong political opposition and even legal challenges over concerns people would lose coverage. Via AP.
House GOP Considers Adding Health Measures to Funding Bill
House Republicans are considering adding a six-year extension of the Children's Health Insurance Program (CHIP), as well as delays of certain Obamacare taxes, to a short-term government funding bill this week, sources say. The six-year extension of CHIP would help put to rest a months-long delay in renewing the funding for that program, which has been caught up in a partisan dispute over how to pay for it. There was a breakthrough last week when the Congressional Budget Office revised down the cost so that a six-year extension would essentially cost nothing. Via The Hill.
Lawmakers Weigh Measure to Fight High Drug Prices
Lawmakers are considering adding a measure aimed at fighting high drug prices to an upcoming spending deal, in what would be a rare defeat for the powerful pharmaceutical industry. The measure, known as the Creating and Restoring Equal Access to Equivalent Samples Act, is intended to prevent branded drug companies from using tactics to delay competition from cheaper generic drugs. It is co-sponsored by a set of unusual bedfellows in both parties. Via The Hill.
As the Opioid Crisis Grows, States Are Opening Medicaid to Alternative Medicine
The quickest way to erase pain is to give patients an opioid. But a rise in prescriptions has fueled a national epidemic of fatal overdoses, with a large share of the deaths occurring in low-income communities. Under intense pressure to combat the problem, states across the country are expanding their Medicaid programs to cover alternative treatments such as acupuncture, massage, and yoga. The effort could increase non-opioid options for low-income patients suffering from pain. But it also opens states to criticism from skeptics who say taxpayers are being forced to fund unproven treatments based on political expediency instead of sound science. Via STAT.