Week in Washington

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


Capitol Hill

There were multiple reports this week that House and Senate Democrats had an interest in making the recent American Rescue Plan premium subsidy increases permanent. One question becomes how to pay for the changes. One current idea being floated is for Congress to reinstate cost-sharing reduction (CSR) payments. The return of CSR payments would reduce premium subsidies (APTC) as it would end silver-loading. Consequently, based on CBO’s scoring, a large portion of the ARP extension costs could be paid for by the return of CSR payments.


The NY Times data has a good breakdown of the differences in hospitalization admissions due to COVID by age. As can be seen below, there are now sharp differences in hospitalization increase rates for those that are older (which are declining/flat) and those younger (which are increasing).



ACA News

  • Katie Keith gives a good rundown on the status of the cost-sharing reduction case here. Effectively the litigation over owed CSR amounts in 2018 and beyond has been paused with the change in Administration. However, the Administration is set to file a response at the end of the month. Once the Court renders a final decision, then settlement and damage calculations will be done.
  • CMS released data on their SEP to date. From February 15th to March 31st (i.e., before the additional American Rescue Plan subsidies have been implemented), 500,000 people selected a plan. This is about 150% higher than 2020 plan selections during the same period.


  • KFF released new state by state Medicaid CHIP enrollment data through November 2020. Overall they found that enrollment has grown to 78.9 million or 7.7 million higher than February 2020 (10.8%). Adult enrollment has grown by 14.1% during this time period.


Interesting new research in Health Affairs by Bill Wang et al. They found that shifts from urgent care center visits did not produce savings. Instead, they found that savings from ED visits were offset by the increased number of urgent care visits. Overall each $1,646 lower-acuity ED visit prevented was offset by a $6,327 increase in urgent care center costs.

Previous editions: 

3/25/2021: Week in Washington

3/18/2021: Week in Washington

3/11/2021: Week in Washington

3/04/2021: Week in Washington



2/25/2021: Week in Washington

2/18/2021: Week in Washington

2/11/2021: Week in Washington

2/04/2021: Week in Washington


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