Week in Washington 06/20/24

Happy Summer Solstice!

MA resubmission

CMS announced last week that it would be recalculating the 2024 Medicare Advantage Star Ratings due two lawsuits that favored insurers. The lawsuits centered around CMS not appropriately having notice and comment on its proposal of removing (Tukey) outliers in its Star Rating calculations. The result of the recalculation is not only significantly more payments to some insurers but also that some insurers will be able to resubmit their 2025 bids. CMS is giving affected plans until June 28th to refile their bids.

2025 ACA Filings

Proposed 2025 ACA rate data are starting to emerge. While the majority of states have not yet released proposed rates, ACASignups has a nice summary of those states that have released rates.  To date the majority of states, have average rate increases in excess of 10% suggesting that proposed rates could be higher than normal.

Health Care Taxes

Politico reported Several prominent Republican connected groups have recently started arguing in favor of capping employer health plan tax exclusions. Currently, employers receive tax incentives to provide health coverage to employees. Both the Republican Study Campaign and Paragon, both influential entities, have endorsed capping the tax exclusion. This would be a major shift from current law and could reshape US employer coverage.


Historically the Supreme Court (SCOTUS) finishes releasing it opinions by the end of June. With less than two weeks remaining in the month several very important cases have yet to be decided. Two key health care related cases worth monitoring are Moyle/Idaho vs United Staes (which focuses on emergency abortions and could transform emergency care) and Loper Bright v Raimondo (which focuses on agencies ability to regulate).

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