Latest Morning Briefing Stories
The state’s managed care program is in the spotlight after it was reported that high costs that would not have been reimbursed prevented it from providing important care and services. Other Medicaid news comes from Connecticut and Indiana.
As the Trump administration moves forward with its final rule allowing small businesses and self-employed workers ti get coverage through association health plans, fraud experts are concerned that the “unauthorized or bogus” plans that flooded the marketplace in the early 2000s will crop up again. Meanwhile, New York and Massachusetts will sue the federal government over the rule.
The health world has been closely watching to see who Amazon, Berkshire Hathaway and JPMorgan Chase would choose to lead their health care initiative geared toward reining in astronomical costs. Atul Gawande, a highly respected doctor and writer on health care policy, is a “well-known luminary” in the field, but the pick was also a surprise to some because he lacks hands-on experience running a large organization.
Veterans are being sent letters that they’ll have to start paying money out of their monthly entitlements for combat-related disabilities because they’re enrolled in a Survivor Benefit Plan.
Most Republican lawmakers don’t want to touch the issue with a ten-foot pool this close to the midterm elections, but conservative groups are still pushing for a change. The proposal, which focuses on giving control to the states, was drafted by groups led by the Heritage Foundation, the Galen Institute and former Sen. Rick Santorum (R-Pa.).
The Trump administration announced the finalized rule yesterday that would give small businesses access to insurance options like those available to large companies and let them skirt some of the health law’s requirements. While President Donald Trump said the rule will save people “massive amounts of money,” Democrats and others in the health industry say the insurance plans are “junk” and they will further destabilize the marketplace.
If it ends with them saving money, the younger consumers were happy to let insurers trawl through their digital data. As the ages went up, people were less inclined to be alright with the tactic.
Maine voters approved the expansion of the state’s Medicaid program last year and two courts have recently ordered the plan enacted. But Gov. Paul LePage (R) continues to say he won’t do it unless lawmakers come up with a way to cover the cost.
The plans, which let small businesses and self-employed individuals band together for more affordable coverage, won’t have to meet all the strict regulations laid out by the Affordable Care Act. The Trump administration says they will help bring down premiums, but experts warn that they’ll siphon healthy people away from the exchanges.
Medica, which was the sole provider of coverage in Iowa under the health law this year, announced it will stay in the marketplace. Wellmark has also announced it will resume selling individual policies next year.
Even as lawmakers and government officials start to embrace Medicaid, advocates in states are building momentum with a push to get expansion on ballots. Medicaid news comes out of Michigan, Tennessee, Iowa, Ohio, Massachusetts and Texas, as well.
Hospitals, doctors, medical schools, patient-advocacy groups and insurers have filed friends of the court briefs arguing that a ruling in favor of this latest challenge to the health law’s constitutionality would “have a devastating impact on doctors, patients, and the American health care system as a whole.”
The panel said the government doesn’t have to pay insurers the money because Congress had taken action — after the health law’s passage — requiring the program to be budget neutral year after year. The program in contention was aimed at enticing insurers into the market with promises of covering their financial risks.
As more and more states start adding work requirements to their Medicaid programs, this court will decide if they’re legal. Medicaid news comes out of Kansas and Iowa, as well.
If the pre-existing conditions provision of the health law is stripped away by an upcoming court case — which the Justice Department announced last week it will not defend — it won’t just affect people who buy their health care on the health law marketplace. Meanwhile, a group of Democratic lawmakers are demanding more information on the administration’s decision, and candidates plan on using it as a talking point in the upcoming midterms.
To cut high health care costs, insurers are slowly starting to look at an area that’s always been off-limits before: emergency room visits. But it’s not going over well with hospitals, doctors or lawmakers.
Democratic lawmakers questioned HHS Secretary Alex Azar about why the Trump administration backed away from defending the health law’s provision that protects people with pre-existing conditions. Azar said the decision was driven by constitutional considerations not policy ones. Meanwhile, Senate Majority Leader Mitch McConnell (R-Ky.) says that “everybody” he knows in the Senate wants to keep pre-existing conditions protections in place.
The provision would end the state’s expansion of Medicaid if the government fails within 12 months to approve a work requirements waiver that includes a time limit on benefits. Medicaid news comes out of Iowa, Connecticut, and D.C., as well.
The Justice Department’s announcement that it won’t defend the health law provision that protects people with pre-existing conditions hands a potentially powerful political weapon to the Democrats ahead of the midterm elections. Meanwhile, media outlets take a look at how the decision will affect the marketplace, and California Attorney General Xavier Becerra vows to redouble his energies defending the law.
Whether to expand the program has been a contentious question in Virginia, even holding up the budget negotiations this spring. Virginia Gov. Ralph Northam (D) signed the legislation Thursday, making Virginia the 33rd state to expand Medicaid.