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ACA weekly update August 3, 2015

Week of August 3, 2015
After years of only modest growth, health care spending is projected to accelerate over the next decade. In the journal Health Affairs, Centers for Medicare and Medicaid Services (CMS) economists forecast that health care spending will increase by 5.8 percent annually from 2014 to 2024.
A new study published by the Journal of the American Medical Association (JAMA) found that Americans are reporting better insurance coverage, access to primary care and prescription medicine, affordable health care and overall health since the launch of the new health insurance exchanges under the ACA on Jan. 1, 2014

CMS is projecting that Medicare Part D premiums will remain steady for 2016 at approximately $32.50 per month. This comes amid sharp cost increases within the program, which grew by almost 11 percent in 2014.
The Government Accountability Office (GAO) has released a report indicating that the ACA's medical device tax is potentially less consequential for the medical device industry than originally thought. In the first and second years after the 2.3 percent excise tax took effect, industry-wide profits increased by an average of 19 percent and 7 percent, respectively.
The Department of Health and Human Services' Office of Inspector General (HHS OIG) expects that most co-op health plans established through the ACA are losing both money and enrollees too quickly to remain solvent and sustainable. All but two co-ops lost money last year, and over half had enrollment levels significantly below expectations.

From Aetna health reform weekly


ACA update July 27, 2015

Week of July 27, 2015

More than 100 small business owners flew to Washington, D.C. last week to lobby Congress to do away with a new health care regulation that could cost them as much as $36,000 per employee per year for violations. Organized by the National Federation of Independent Businesses (NFIB), the protest stems from a new IRS penalty on employers who offer tax-free reimbursement to employees to help them purchase individual health care coverage.

Senate Majority Leader Mitch McConnell has announced plans to hold a vote on repeal of the Affordable Care Act (ACA), as an amendment to the must-pass highway bill currently being considered by the Senate. The amendment has virtually no chance of clearing the Senate's 60-vote threshold for avoiding a filibuster.
The IRS reported 7.5 million Americans have paid fines for failing to purchase health care coverage in 2014. The ACA mandates that individuals obtain insurance or face a penalty. The IRS also noted that about 300,000 low-income taxpayers reported a payment when they should have claimed a health care coverage exemption. Outreach is planned to these taxpayers.
The Senate Finance Committee held a markup session last week for $22.1 billion worth of tax credit extensions. The committee approved two-year extensions for every expired tax credit under consideration, including the research and development tax credit. Many Representatives in the house prefer permanent extensions for particular tax credits instead of the blanket two-year extension.
The Senate Special Committee on Aging held a hearing last week examining a recent Government Accountability Office (GAO) report that found widespread Medicare provider enrollment fraud. The report records 38 instances of providers receiving payments for services after their deaths. Sixteen providers managed to defraud CMS of $16 million in Medicare payments despite permanent bans on participating in public health care programs.
A Medicare Trustees report confirms that the federal program's hospital trust fund will remain solvent until at least 2030. Its long-term financial outlook is improving as well. However, millions of Medicare beneficiaries could see Part B premiums skyrocket in 2016 due to rising costs of care.

From Aetna health reform weekly


ACA weekly update July 20, 2015

Week of July 20, 2015

A coalition of large employers, business groups and unions is organizing to lobby against the Affordable Care Act's (ACA) "Cadillac" tax. Calling itself the Alliance to Fight the Forty, the partnership is focused on repeal of the 40 percent excise tax on plans considered overly generous under the law. Legislation has been introduced in Congress to repeal the tax.

The House of Representatives passed a bill extending an in-home care pilot program for chronically ill Medicare beneficiaries. The Medicare Independence at Home Medical Practice Demonstration Improvement Act extends for 2 more years. The program allows clinics to sign up to provide in-home primary care services to Medicare beneficiaries with multiple chronic illnesses and other functional limitations that prevent them from visiting a doctor.
The House Energy and Commerce Subcommittee on Oversight and Investigations held a hearing last week examining $712 billion in fraudulent Medicare billings. The hearing specifically focused on fraud in Medicare Part D. A Department of Health and Human Service's Office of Inspector General report identified a number of abuses covered throughout the hearing.
Senators Elizabeth Warren (D-MA) and Orrin Hatch (R-UT) wrote a letter to the Government Accountability Office (GAO) requesting that it begin issuing reports on treatment of Medicaid beneficiaries living in assisted living facilities. Currently, the majority of oversight responsibility is left to the states—an unsustainable option, according to the Senators, "given the growth in federal Medicaid spending."
The Obama administration released an updated reporting system for privately held corporations and religious organizations that object to the ACA's birth control mandates. The reporting system has drawn criticism that it requires religious organizations to indirectly provide birth control to their employees and from others who argue that the system carves out exceptions that are too wide to be effective.

From Aetna health reform weekly