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
- Congress continues to negotiate over a COVID stimulus bill. While a deal is close, according to a number of reports, there is no ultimate agreement. One of the outstanding sources of disagreement is on healthcare spending (no money is expected for issuers)
- The news of potential additional stimulus is coming at a time in which there are increasing signs of the economy slowing down. For example, unemployment claims increased this week.
- Congress may also be on the verge of passing a bill that would limit surprise billing. The key hurdles include the short-term horizon and opposition from AMA
- The big news this week is that the Pfizer COVID vaccine was shipped around the country to over 600 locations. Tens of thousands of people have already gotten the first dose of the vaccine. Additionally, Moderna’s vaccine is being reviewed by the FDA this week. The two-shot regime has a 94% effectiveness and is expected to be approved at the end of this week. The AstraZeneca and Johnson & Johnson vaccines are expected to release further data in December/January and could submit their vaccines for approval as early as February. Other vaccines will need to be approved in order for all Americans to have access to a vaccine in the first half of 2021.
- One issue worth monitoring is the costs to consumers for a vaccine (especially given the two-dose regiment). Generally, for those with insurance, there is not supposed to be any cost-sharing for the vaccine or administration of the vaccine (including if the vaccine is given in an out of network setting). The NY Times has a good summary of potential loopholes to the requirement.
- The worst of the COVID pandemic continues to rage across the United States. COVID case numbers, hospitalizations, and deaths remained at or near all-time highs. California appears to be particularly hard hit at the moment as it reported over 50,000 cases in a single day yesterday.
- The IRS released guidance that it would delay ending APTCs for individuals for whom their tax filing data has not yet been processed.
- CMS also released effectuated enrollment data for the first half of 2020. Overall Exchange enrollment is up 3% year over year.
- KFF released a report providing a useful summary on the latest maintenance of eligibility requirements states need to follow to maintain eligibility for the increased Federal funds.
The Office of the Actuary found that overall US health care spending increased 4.6% in 2019 (or about the same amount that spending increased in 2018.
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