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"If I get cancer, I have to wait 30 days before my treatment is covered. I can't get counseling, mental health care, or treatment for substance abuse issues, and the plan doesn't cover prescription drugs. And you can forget about obesity treatments, LASIK, sex-change operations, childbirth, or abortion, dentistry, or eyeglasses. If I get injured while participating in college sports or the rodeo, I'm on my own."
— Olga Khazan, The Atlantic, comparing Affordable Care Act compliant health plans with unregulated short-term plans
Trump Proposal Could Mean Healthy People Save on Insurance While Others Get Priced OutWashington Post by Carolyn Y. Johnson —The Trump administration's proposal to build up short-term health insurance plans as a "lifeline" for people who can't afford Affordable Care Act coverage could split the insurance market in two, siphoning young, healthy people into cheaper, more minimal plans — while those who remain in ACA plans face premiums that spiral upward even faster. The comment period ends Monday on a Centers for Medicare and Medicaid Services proposal to extend short-term plans to 364 days, from the current three-month limit. The effects of that policy change, combined with zeroing out the individual mandate's financial penalty in 2019 will be harmful to the most vulnerable patients, according to more than 100 patient groups and many health policy wonks. Supporters of the policy say those fears are overblown, and argue that the expanded plans offer needed options for people who are uninsured.
The True Cost of Cheap Health InsuranceThe Atlantic by Vann R. Newkirk II —The rap on short-term plans is that they are often "junk" plans that collect premiums from people who feel they need to have insurance, but might not understand their terms….The tricky thing about many short-term plans, relative to other offerings, is they may not even be that useful for young-and-invincible types. While it's difficult to assess their average value, since they are unregulated and diverse, the cheapest short-term plans appear to do little but avert only the most extreme—and unlikely—cost.
CMS Extension of Transitional Health Plans Could Ding ACA MarketModern Healthcare by Harris Meyer — The Centers for Medicare and Medicaid Services (CMS) has once again allowed insurers and states to renew so-called transitional health plans that pre-dated Affordable Care Act coverage requirements and that don't have to comply with those rules. State officials have the option to end these "grandmothered" plans in the individual and small-group markets. But about three dozen states have allowed them to continue, even though experts say moving transitional plan enrollees into the ACA-regulated market likely would bring down premiums. Earlier this month, the CMS issued a bulletin extending these "grandmothered" plans for current members of the plans for one year, with all such policies ending Dec. 31, 2019. This is the fourth such extension.
20 States Seek to Block Obama's Health Care LawAssociated Press —Twenty Republican-led states are seeking to temporarily invalidate former President Barack Obama's health care law while their larger lawsuit against it proceeds. In a February suit, Texas and Wisconsin led a coalition arguing that the Affordable Care Act is no longer constitutional after the Republican-backed tax overhaul eliminated fines for not having health care coverage. Sixteen states with Democratic governors later sought to intervene. They suggested that Democratic attorneys general will have to defend the law because President Donald Trump's administration won't. Texas Attorney General Ken Paxton said Thursday that a motion seeking a preliminary injunction was filed in U.S. District Court for the Northern District of Texas. Paxton argues that it's "necessary to spare the people of Texas and the other states from the enormous financial burden" of the individual mandate.
Congress Girds for Fight Over Expected Trump Spending CutsReuters — The Trump administration is preparing to submit to the U.S. Congress up to $25 billion in immediate spending cuts, including possible reductions to social safety-net programs, lawmakers said on Wednesday, in a move that could upend a budget deal enacted last month. The White House plan, which has not yet been unveiled, would call on Congress to rescind funding already enacted into law. It likely would be submitted next month, sometime after a recess that ends on May 7. Veteran House of Representatives Republican Tom Cole told reporters that the package of proposed cuts was being scaled back from the $60 billion initially floated by the administration. He added that it could include cuts of funds appropriated for 2016 and 2017 that have not been spent.
U.S. Hospital Profits Fall as Labor Costs Grow and Patient Mix ShiftsWall Street Journal by Melanie Evans — One important measure of U.S. hospital profits last year reached a low not seen in the past decade, as a tight labor market and other factors pressure hospital finances. The median hospital operating cash flow margin—monitored by Moody's Investors Service as a signal of financial strength—fell to 8.1 percent last year from 9.5 percent a year earlier, in a preliminary analysis of 160 nonprofit and public hospitals and hospital systems with credit ratings from the agency, a Moody's report said. That is the lowest level in the past decade, Moody's data show. The prior low point came in 2008, when the median margin reached 9.1 percent. That year, a deep recession sharply slowed growth in insurers' spending on hospital care….Now, the metric's decline points to new challenges for U.S. hospitals as more patients seek medical care in nonhospital settings, and as enrollment surges in Medicare, which typically pays hospitals less than commercial insurers do. Those trends are squeezing hospital revenue, while a tight labor market is driving expenses higher, Moody's said.
HHS Proposes Medicare Payment Rules to Encourage Hospitals to Be Clearer About PricesWashington Post by Amy Goldstein —The Trump administration is proposing to rewrite rules on federal payments to hospitals treating older Americans on Medicare, making it easier for patients to see the prices of procedures and care. As part of annual updates to Medicare payment rules, federal health officials also want to add $1.5 billion for the coming year to the funds for so-called disproportionate share payments that help buffer hospitals from the expense of treating patients who cannot pay their bills. The increase is a sign that the government expects an influx in uninsured patients — something administration officials seldom discuss amid their policies to weaken the Affordable Care Act. In addition, the revisions seek to motivate hospitals to improve electronic medical records, while eliminating certain measures of the quality of care that the government now requires them to report.
Medicaid Won't Look the Same Next YearRoll Call by Misty Williams — This year could mark a significant shift for Medicaid programs across the country, as some states look to expand the government insurance program to more poor Americans while others seek to add more requirements for people who benefit. Initiatives to get Medicaid expansion put on the November ballot are underway in Utah, Nebraska, Idaho and Montana. And Virginia lawmakers appear on the verge of securing an expansion deal, after years of rejecting the idea. Meanwhile, Indiana, Kentucky and Arkansas are poised to make precedent-setting changes to their programs in the coming months, such as adding work requirements, while other states await word from the Trump administration on whether they can make other revisions.
Maine Governor Defies Ballot Initiative Expanding MedicaidPolitico by Rachana Pradhan — Maine residents voted decisively last fall to expand the state's Medicaid program. But almost six months later, Gov. Paul LePage still refuses to take action as the state's legislative session winds down, putting the Obamacare coverage program in doubt. LePage, now in his last year in office, has insisted he won't green-light expansion, which is expected to cover 80,000 low-income Maine adults, unless state lawmakers meet his conditions for funding the program that he contends could otherwise bankrupt the state. As chances of a deal with LePage dwindle, the organizers of the Maine ballot initiative are now preparing for a legal showdown to enforce voters' wishes.
Senate Health Panel Approves Opioid BillThe Hill by Rachel Roubein —The Senate Health Committee unanimously voted Tuesday to send the panel's bipartisan opioid bill to the chamber's floor. The panel held seven hearings on the opioid crisis, including one on the discussion draft of the bill introduced by Health Committee Chairman Lamar Alexander (R-Tenn.) and ranking member Patty Murray (D-Wash.). Lawmakers touted the bipartisan process used to craft the Opioid Crisis Response Act of 2018 aimed at combating the opioid crisis, which has shown no signs of slowing down. Specifically, the bill includes measures attempting to make it easier to prescribe smaller packs of opioids for limited durations, spur the development of non-addictive painkillers and bolster the detection of illegal drugs at the border.
