Risk Corridor Lawsuit- A Federal appellate court ruled today that the Federal government does NOT owe issuers any additional risk corridor money. “The court, siding with the Trump administration, said the federal government didn’t have to make the payments because Congress had taken action — after Obamacare’s passage — requiring the program to be budget neutral year after year.” (from Politico) The insurers have the possibility to appeal the case to an en banc and it could eventually make its way to the Supreme Court. If the issuers were to win they would be eligible for approximately 12 billion dollars.
- Lawsuit – A quick additional note on the /Texas case. As a reminder, Texas (and other states) are suing for large portions of the ACA to be overturned given the repeal of the mandate. The Federal government decided not to defend the ACA and asked for the market reform rules (guaranteed issue, rating rules, etc.) to be enjoined (not enforced) starting in January 1, 2019. However, the wording of the ask leaves open the possibility that there would be implications of the Employer market.
Kentucky Lawsuit – As part of the Kentucky lawsuit over work requirements, the Governor of Kentucky is expected to officially present to the court with information that any court ruling against the work requirement could result in ending Medicaid expansion in Kentucky.
Azar Testifies – Secretary Alex Azar (HHS) testified before the Senate HELP committee this week. Azar reiterated the Administration’s Blue Print prescription drug ideas which include: increasing transparency on list prices, getting rid of drug rebates, and shifting drug coverage from Medicare Part B to Medicare Part D.
Opioid Bills- The House began voting on 26 separate opioid bills alongside a bill recently passed by the Senate, all aimed at stemming the opioid crisis.
Employer Medical Cost Trend - Price Waterhouse Cooper projected that employer medical costs would increase at 6% next year. PwC cited easier access and provider consolidation as to reasons for increased costs.