Week of June 22, 2015
With a decision looming in the U.S. Supreme Court's King vs. Burwell case, the federal Department of Health and Human Services (HHS) has granted conditional approval to the governors of Delaware, Arkansas, and Pennsylvania to begin establishing state-based health insurance marketplaces. All three states can bring small business exchanges online in 2016, though Delaware will not be permitted to open its individual marketplace until 2017. However, any state looking to set up a state-run exchange in time for 2016 faces significant hurdles.
The White House is threatening to veto a bill that would repeal the Affordable Care Act's (ACA) medical device tax. The House bill was overwhelmingly approved by 234 Republicans and 46 Democrats, enough to override a presidential veto. The White House claims the legislation "would take away a funding source for financial assistance that is working to improve coverage and affordability."
A bipartisan group of 44 House members, led by Reps. Renee Ellmers (R-NC) and Ron Kind (D-WI), signed a letter opposing the use of funds allotted for Medicare Part D as an offset for 21st Century Cures legislation. The "pay-for" would require approximately $7 billion from Part D plans, which the letter calls "effectively a tax on America's seniors."
The House approved five bills intended to improve Medicare Advantage by providing more detailed enrollment data (H.R. 2505), improving payment rate transparency (H.R. 2507), authorizing a test of value-based insurance strategies for chronic patients (H.R. 2570), strengthening Medicare Advantage's risk adjustment model (H.R. 2582), and protecting customers whose coverage options may be unfairly limited due to current Star Rating rules (H.R. 2582).
The House Energy and Commerce Subcommittee on Health held a hearing last week examining Rep. Tim Murphy's (R-PA) re-introduced Helping Families in Mental Health Crisis Act (H.R. 2646). Murphy's bill has been adjusted since its inception in 2013, replacing mandates for court-ordered outpatient treatment with incentives, and limiting access to patient information.
The House Appropriations Subcommittee passed a spending bill for fiscal year 2016 that provides $71.3 billion, $64.4 billion, and $11.8 billion for the departments of HHS, Education, and Labor, respectively. The bill appropriates funding for the risk corridors program, but no funds from the Federal Hospital Insurance Trust Fund or the Federal Supplemental Medical Insurance Trust Fund can be used to support risk corridor payments.
From Aetna health reform weekly