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.


February 15, 2018:   Odds and Ends

Most attention this week in Washington is on the immigration debate.   Here are a few additional odds and ends:

President’s FY 2019 Budget: Each year, by law, the President releases a document outlining policy and budgetary aspirations for the following fiscal year (in this case 2019). As has been tradition for the past few years, Congress then ignores the President’s budget.  The document contains policy proposals that would fund CSRs, embrace a block granting scheme for the ACA individual market/Medicaid, and prescription drug discounting.

Recently Passed Budget: The most recently passed budget bill by the House and Senate does have a number of healthcare effects. It permanently funds SNPs, it removed the Medicare cap for therapy services, it provided a 5-year extension for home health rural add-on payments, expanded telehealth services, delayed Medicaid DSH cuts, extended CHIP by an additional 4 years (10 years total), closing of the Medicare Part D donut hole via drug manufacturing discounts (starting in 2019), repeals IPAB, and more. It did not include any individual market stabilization provisions (reinsurance, CSR funds, etc.).

Idaho: Idaho’s governor has issued an executive order to align non-ACA individual market plans. This week Blue Cross of Idaho announced that it would sell these products.  (As a reminder, the legality of Idaho’s order has been questioned.) HHS has not yet weighed in on their legality.

Medicaid: While work requirements remain one of the hot/controversial topics for Medicaid waivers (see Virginia as the latest state to consider it), one potential topic that the Trump Administration is considering is allowing lifetime limits for Medicaid beneficiaries. Currently, 5 states have submitted waivers with some form of lifetime limit for Medicaid beneficiaries. Legal challenges would be expected if lifetime limit waivers are approved.

The Flu: This year’s flu continues to be one of the worst in years and getting worse. According to CNN, there were approximately 60 flu-related hospitalizations for every 100,000 people in the US in the fifth week of this year.


Previous editions:

02/08/2018:  Budgetorama

02/01/2018:  New Secretary

01/26/2018:  Budget Deals and Lawsuits

01/11/2018:  Medicaid Work Requirements

01/04/2018:  Association Health Plans

12/21/2017:  Taxes, Budgets and 2018




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