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ACA weekly update May 4, 2015

Week of May 4, 2015

Leaders of the Senate and House Budget Committees announced an agreement on a final budget resolution (see below) last week that takes aim once again at the Affordable Care Act (ACA). The budget resolution does not need to be signed by the President and does not become law. But the resolution plays a significant role in establishing a framework for the federal government's overall spending priorities.


The Centers for Medicare and Medicaid Services (CMS) has released new data detailing $103 billion Medicare Part D prescription drug costs in 2013. The release came as part of the administration's efforts to make the health care system more transparent. The data show the names, locations and specialties of physicians and health care organizations who submitted claims to Medicare in 2013, as well as the names, costs and number of prescriptions for each individual drug. CMS has previously released similar info for inpatient hospital charges, outpatient charges and payments to physicians.

The House Energy and Commerce Committee released a new bipartisan draft bill last week that would make major changes in the regulation of drugs and medical devices. The legislation is the product of the committee's 21st Century Cures Initiative, which launched last year. The initiative's goal is to accelerate the development of new medical innovations and their speed to market. The bill includes additional funding for the National Institutes of Health. A full vote on the bill could take place as early as June.

Last week, the House of Representatives voted 226-197 to pass a budget deal that would balance the budget in 10 years through more than $495 billion in domestic spending cuts. The Senate is expected to vote on the measure this week. Afterward, two Senate committees and three House committees will begin to develop their final recommendations for a budget reconciliation bill, including potential ACA repeal legislation. The President has threatened a veto of any budget agreement that would increase defense spending without additional domestic spending. The deadline for the committees to finalize their recommendations is July 24.

From Aetna health reform weekly


ACA weekly update May 11, 2015

Week of May 11, 2015

A new Rand survey shows that the percentage of Americans who are uninsured dropped from 20.5 percent to 15.8 percent between September 2013 and March 2014. Rand estimates that 9.3 million Americans gained health insurance in that timeframe, from new marketplace coverage, new enrollment in employer coverage and expanded Medicaid coverage.


The Senate voted 51-48 last week to pass a joint 2016 House and Senate Budget Resolution. Approved a week earlier by the House, the resolution allows Congress to pass a budget agreement with a simple majority without the threat of a filibuster in the Senate. This is the first time in a decade the House and Senate have passed a budget resolution. The resolution's reconciliation instructions require authorizing committees (Finance, Ways and Means, etc.) to repeal ACA language and find at least $1 billion in net health care savings through cuts to Medicare and Medicaid. The committees have until July 24 to finalize their recommendations.
Senate Finance Committee Chairman Orrin Hatch (R-UT) and Sen. Chuck Grassley (R-IA) sent a letter to CMS Acting Administrator Andy Slavitt requesting further clarification by May 18 on how state-based exchanges can spend federal grant funding. The request follows an Inspector General report that found the marketplaces could be spending the funds illegally. Under the ACA, exchanges are prohibited from using federal grants to cover operational expenses.
Last week, the White House formally nominated Karen DeSalvo to be Department of Health and Human Services (HHS) assistant secretary. She has served as "acting" assistant secretary since October, as well as national coordinator for health IT since January 2014. Her appointment is contingent on confirmation by the Senate.

From Aetna health reform weekly

ACA weekly update April 27, 2015

Week of April 27, 2015

A new Kaiser Family Foundation tracking poll finds that the Affordable Care Act (ACA) has slowly made its way into positive territory in the eyes of the public. The poll found that 43 percent of Americans have a favorable view of the health reform law while 42 percent have an unfavorable view. While the difference is a single percentage point, the latest research marks a plurality of favorable views toward the law for the first time since 2012. Sixty percent say that government action to lower prescription drug prices should be a top priority for the President and Congress, as should transparency related to the prices and quality of health care. While a one-point margin is not statistically significant, the media reports that the overall trend toward increasingly positive views is significant.

Another Kaiser Family Foundation poll found last week that few consumers are using available cost and quality data to obtain better care at lower prices. Despite the trend toward greater transparency in health care costs, about two out of three people say it remains difficult to know how much specific doctors or hospitals charge for medical treatments and procedures.


Reps. Charles Boustany (R-LA) and Kyrsten Sinema (D-AZ) announced last week that a majority of House members have signed on as cosponsors of their bipartisan bill to repeal the ACA health insurance tax. Introduced in February, the legislation has now reached 218 bipartisan cosponsors.

The Senate Finance Committee approved legislation last week to extend Trade Adjustment Assistance (TAA) programs, including health-related budget offsets. Funding provisions in both the Senate bill and a similar House Ways and Means Committee bill partially cover the cost of extending the TAA programs by increasing sequestration cuts for Medicare during the last six months of fiscal year 2024. The legislation also would make adjustments to Medicare coverage and payment policies for renal dialysis services. The measures would also reinstate the health coverage tax credit formerly available to displaced workers who lost their health coverage and jobs as a result of competition from imported products or shifts in production outside the United States.

Secretary of Health and Human Services (HHS) Sylvia Mathews Burwell testified last week on the President's 2016 budget request at a hearing in the Senate Appropriations Subcommittee on Labor, HHS, Education, and Related Agencies. Though focused primarily on the budget, Burwell also discussed the ACA and contingency plans for the Supreme Court's decision on King v. Burwell. Secretary Burwell indicated that Health and Human Services (HHS) has experienced trouble with contingency planning because its authority to deliver subsidies or any aid to federally facilitated marketplace states would be stripped if the Court rules against the law.

On May 28, a U.S. District Court will hear arguments in a lawsuit brought by the House of Representatives against the Obama Administration over changes made in implementation of the ACA. The lawsuit challenges executive changes made to the ACA, such as delays in the employer mandate, and funding for cost-sharing provisions of the law.

From Aetna health reform weekly