Major Health Policy Developments coming out of the Federal Administration

While Congressional efforts to change or repeal the Patient Protection and Affordable Care Act (ACA) continue to be stalled, the federal administration announced two significant health policy developments at the end of last week – an Executive Order aimed at promoting access to plans not subject to the full range of ACA protections as well as the decision to stop making cost-sharing reduction payments immediately. [More]

Update on the Senate’s efforts to Repeal parts of the ACA

After releasing the Better Care Reconciliation Act at the end of last week, leadership in the U.S. Senate announced this week that it will not be voting on the bill before the July 4th Congressional recess as planned. Instead efforts are underway to overhaul the bill, with a vote is expected sometime after the recess. Senate Majority Leader Mitch McConnell has said that he intends to submit a new version of the bill to be scored by the Congressional Budget Office today. [More]

New ACA-Related announcements from the Federal Administration

The administration is taking more limited steps to influence implementation of the law, including two upcoming changes to enrollment through Marketplaces announcements last month. On May 15, the Centers for Medicare and Medicaid Services (CMS) announced that it will be proposing a rule to have enrollment into Federally-facilitated Small Business Marketplace (known as Small Business Health Options Program or “SHOP”) health insurance plans go directly through insurers as of 2018. Two days later, on May 17, CMS released guidance enabling (but not requiring) full direct enrollment in individual market Federally-facilitated Marketplace (FFM) plans starting for open enrollment for plan year 2018. [More]

PCG creates summary of the House-passed health care bill

The American Health Care Act (“the bill”) passed the House of Representatives on May 4, 2017. As outlined in greater detail in the PCG summary, the bill does not repeal the Affordable Care Act (ACA) in full, but rather proposes changes primarily focused on the ACA’s insurance affordability, Medicaid expansion, coverage requirements and revenue provisions. It also proposes changes to Medicaid funding more generally and allows states to waive medical underwriting prohibitions. [More]

States continue to pursue Section 1332 State Innovation Waivers

With repeal of the Affordable Care Act (ACA) stalled, states are increasingly considering Section 1332 Waivers as a way to expand upon or customize the ACA to best address the unique circumstances within the state. Alaska and Oklahoma are the two most recent states to take formal steps toward State Innovation Waivers, both states following on the heels of the recent Section 1332 Waiver approval granted to Hawaii, which we summarized in the February edition of Health Policy News. [More]

Roundup of federal health policy developments

The debate over the future of the Affordable Care Act (ACA) is well-underway and there are a number of significant developments that warrant a closer look. Here we provide a roundup of recent developments.

Administrative Action
Upon entering office, President Trump signed two Executive Orders. The first, on January 20, entitled... [More]

Patient Freedom Act of 2017

On January 23rd, Senators Bill Cassidy and Susan Collins introduced the Patient Freedom Act of 2017 to largely repeal and replace Title 1 of the Affordable Care Act (ACA), which includes insurance reforms. Certain ACA provisions would remain, including changes to the Medicaid program (e.g., Medicaid expansion) and Medicare and ACA revenue provisions. [More]

Proposed Benefit and Payment Parameters 2018 Released

This year, the Centers for Medicare and Medicaid Services (CMS) released its annual proposed Notice of Benefit and Payment Parameters earlier than in prior years in order to provide more market certainty. The draft regulations, which were released last week and published in the federal register on September 6, outline changes to operations and rules for health insurance Marketplaces and the commercial health insurance market generally for 2018. [More]

UCLA Publishes Study on Hospital Service Utilization in Demonstration Program

The UCLA Center for Health Policy Research published a landmark study on October 17, 2014 entitled, “Increased Service Use Following Medicaid Expansion Is Mostly Temporary: Evidence from California’s Low-Income Health Program.” UCLA analyzed hospital emergency room (ER) use, hospital inpatient admissions, and other hospital outpatient department (OPD) service utilization for individuals who were enrolled in 2011-2013 in the Low-Income Health Program (LIHP) under California’s innovative “Bridge to Reform” Medicaid demonstration waiver. UCLA sorted 182,443 LIHP enrollees in eight counties into four distinct groups based on expected “pent-up demand” in each group (the 69,095 in the highest group had the least access to county funded indigent care before enrolling in LIHP), controlled for other differences such as demographic variables using regression models, and tracked service utilization from the July 1 – September 30, 2011 quarter through the April 1 – June 30, 2013 quarter. [More]