Latest Morning Briefing Stories
The publicly available tool, funded by a Robert Wood Johnson Foundation grant, may help companies trying to set their premiums for 2021. In other news, insurers offer new options for COVID-19 testing.
On Tuesday, voters approved the ballot measure that amended the state’s constitution to make it possible for the Medicaid program to provide health insurance to tens of thousands of low-income residents. Support for the effort was concentrated in the state’s urban areas, while rural voters largely opposed it.
CMS announced Thursday that 487,000 people signed up for an Affordable Care Act exchange plan since the last open enrollment period closed in December. Losing job-based health coverage is one of the life events that qualifies someone for HealthCare.gov special enrollment. Meanwhile, more issues with short-term health plans are reported.
According to a proposed rule, CMS would permanently allow telehealth costs to be reimbursable for home health agencies. And CMS’ Center for Medicare and Medicaid Innovation announced an extension for its pilot Medicare Care Choices Model program.
If the Supreme Court invalidated the health law, more than 20 million Americans could lose their coverage and protections for pre-existing conditions during the COVID-19 pandemic. Democrats seized on the Trump administration’s move, calling it an “unfathomable cruelty.”
“[Donald Trump’s] like a child who can’t believe this has happened to him — all his whining and self-pity,” presumptive Democratic presidential nominee Joe Biden said during a campaign speech in Lancaster, Pennsylvania. “Well, this pandemic didn’t happen to him. It happened to all of us. And his job isn’t to whine about it. His job is to do something about it, to lead.” Biden also criticized the president’s “heartless” actions around the ACA and called for a public option. Meanwhile, Trump campaign message continues to sidestep the resurgence of coronavirus cases.
The House Democrats are set to unveil a health care plan that focuses on increasing subsidies and negotiating powers for Medicare drug prices. But the plan falls far short of the progressive health care push that was seen earlier in the year, pre-pandemic. Although it would be dead-on-arrival in the Senate, the legislation will help Democrats anchor their election messaging.
The American Hospital Association argued that the administration did not have the legal authority to force facilities to reveal prices that were negotiated with insurers. The outcome of the negotiations have long been closely guarded by both sides, but the Trump administration sees transparency as a way to force down health care costs.
The White House is expected to file legal briefs this week asking the Supreme Court to put an end to the Affordable Care Act. But some Republicans are now wondering if that’s the most political savvy move during a pandemic. Meanwhile, Democrats want to expand subsidies and Medicaid incentives. In other news, lawmakers push for more information on federal aid distribution.
Officials also said that they expect health insurers to cover the vaccine without any copays and that the administration plans to distribute a vaccine on a tiered system, prioritizing those who are most at risk of infection.
Tens of millions of Americans have lost jobs–and health care coverage–in recent months creating a crisis where patients who need care aren’t going because they can’t afford it. In other health industry news: charity care, health care worker job losses, new affiliations and inpatient rehab.
After getting lifesaving treatment for COVID-19, some patients are being sent eye-popping medical bills. While the hospitals and insurers say that is a mistake, the confusion over costs in the midst of the pandemic persists. In other health industry news: hospitals’ survival and payments.
House Majority Leader Steny Hoyer (D-Md.) only offered a vague statement about the plan, but said the changes will help lower premiums and co-pays. In other health industry news: ER bill mark-ups, insurance coverage during a pandemic and hospital stocks.
Some of the groups that have been most susceptible to COVID-19 were also the ones with the highest rates of being underinsured or completely uninsured. “In a way lower-income people and racial minorities are in double jeopardy because of the way our healthcare system is financed,” said lead study author Dr. Adam Gaffney.
The Federal Communications Commission has accused two Texas men, John Spiller and Jakob Mears, of trying to sell consumers fake health insurance plans from major carriers such as Aetna and Cigna.
There are regulatory barriers in place though that would will require HHS coordination with and support from other federal agencies, Congress and state governments in order to make some of the current practices permanent. In other technology news, investment interest in health IT companies dips.
With all of the elective procedures canceled, insurers have actually been coming out ahead financially during the crisis. Regulators, like state insurance commissioners, are starting to pay attention to what the companies are giving back to their consumers.
Several states had planned to take steps to expand health care options for their residents. Then COVID-19 came along. In other health industry news, struggling hospitals try to kick-start non-coronavirus procedures again.
Some states that opened special enrollment periods for worker who lost their jobs because of the pandemic, but those sessions are coming to an end, and industry officials fear that only a small fraction of people who need coverage even know where to look. In other industry and costs news: federal aid for hospitals, plummeting profits, and medical bills.
Although people could already sign up for coverage if they had an unexpected life event, California specifically created a special enrollment period to make it easier. In other health industry and insurer news: MLR rebates, accountable care organizations, and Medicare payments.