Week in Washington is brought to you by Michael Cohen, PhD. Tune in each week to read the latest on healthcare policy and get a glimpse of what’s on the horizon.
Week in Washington: Five News Stories to Follow in 2020
No different than any other year, health policy topics will dominate the news in 2020. Here’s my top five news stories to follow in 2020:
1. Supreme Court Rules
At the top of the list is the Supreme Court. There are already a number of cases the Supreme Court is expected to rule on: namely on ACA risk corridors (which could result in billions of dollars being paid to the insurance company) and a key case on states’ ability to regulate PBM (Rutledge v. PCMA). However, the biggest decision the Supreme Court will make is if it will hear a case as to if/what part of the ACA are constitutional. If the court does take the case, a ruling could land in early June.
2. 2020 Presidential Election
While the Presidential election is unlikely to have direct effects on 2020 health policy, the ideas generated and campaigned in 2019 will dominate news in 2021. There is substantial evidence that campaign promises DO in fact matter in terms of how a President governs so what is promised during the campaign should be followed closely.
3. State Referendums and Medicaid Expansion
In 2018 Medicaid Expansion made the ballot in three different states and in each case the initiative passed. Fast forward two years and each of those states is in the process of expanding Medicaid. Currently there are three states (Oklahoma, Missouri, and Florida) that may have Medicaid Expansion on the ballot in 2020.
4. CMS and Medicaid
CMS will have a number of major regulatory decisions on their hands in 2020. Two of the biggest involve block grants and supplemental payments. Tennessee has submitted a waiver asking to become the first state to transform its Medicaid into a block grant program. CMS has yet to weigh in on if it will approve the waiver. Another big regulatory question is if CMS will finalize its proposed rule on supplemental payments. If it does, states may be required to make serious changes to their financing and reduce funding.
5. Will Congress Act on Anything?
Election years are typically a time that Congress does not pass legislation. This particular Congress has passed very few bills. That said, there is pressure on Congress to act on two health issues: Surprise Billing and Prescription Drugs. If Congress is to pass something, it will likely be around May.
Odds and Ends
- Kansas agreed to expand Medicaid in 2021
- A Federal judge ruled in HHS’s favor that the risk adjustment methodology is legal. This should put to rest challenges over the risk adjustment methodology.
- New research at the New England Journal of Medicine found that “hot spotting” (hospitals invest more resources in coordinating care) may not reduce re-admissions.
- HHS released the final 2020 Open Enrollment totals for the Healthcare.gov states. Enrollment was essentially flat nationwide in these states, once controlling for Medicaid Expansion.
- California is thinking about selling its own brand of generic prescription drugs.
12/20/2019: Budget Deal and More
12/13/2019: Risk Corridors at the Supreme Court
12/06/2019: Legislation to Watch
10/18/2019: House Bills, STAR Ratings, and More
10/11/2019: Executive Actions, Public Options, and More
10/04/2019: New Executive Order to Impact Medicare Advantage