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: Public Charge Rule Released and Other Tidbits
Public Charge Rule
Essentially the rule will lay out criteria that influences the chances for green card members to gain citizenship. In particular, usage of low income services (such as Medicaid) make it far less likely that green card holders will be granted citizenship if they or family members use Medicaid or other needs based programs. While the Administration did not include specific estimates on their own, previously KFF has estimated this could reduce Medicaid enrollment by approximately 2 to 5 million. This is based on KFF’s estimates that 13.5 million Medicaid and CHIUP enrollees live a in a household with at least one non-citizen. It should be noted that there is likely spillover effects to the ACA market as the rule makes citizenship more likely for non-citizens that do not receive ACA subsidies.
Already several states and counties have announced they will sue to block enforcement of the rule. While the exact legal outcome may take several years, there is likely negative impacts on Medicaid/ACA enrollment in their intervening time periods due to uncertainty.
- CMS Administrator, Seema Verma, indicated that the Administration was preparing to move ahead with the proposal to tie certain Medicare drug prices to the International Price Index. The proposal has opposition from the pharmaceutical industry and even many Congressional Republicans.
- Enrollment Report – CMS released two enrollment reports on on-Exchange effectuated enrollment for 2019 and a report on ACA individual market enrollment in 2018. Overall enrollment has largely been flat between 2019 and 2018.
- Quality Ratings – CMS announced that for the first time all plans will have their quality rating (QRS) displayed for the 2020 Open Enrollment. Previously only a few states had their quality rating displayed.
- More Insurers Next Year – While the final count has not been made on ACA issuer participation for the 2020 benefit year, all signs point to there being an increase in participation relative to the current year.
08/09/2019: New Analysis on Private Markets
07/26/2019: Health Legislation Takes Center Stage
Subscribe to Wakely's newsletter and blog.