May 23, 2019
HEALTH Bill – Another potential healthcare bill to address healthcare costs was unveiled this week. The bipartisan bill, co-sponsored by Sens Alexander and Murray, has a number of provisions that would have far reaching impacts. The bill would:
- Address Surprise Billing
- Ban certain anti-competitive hospital contracting provisions
- Create a national all-payer claims database (APCD)
- Increase PBM transparency
There’s a long way to go with this bill before it will pass (outlook is cloudy at best) but the fact that it’s on the radar does mean that all of these issues will remain on the table if a healthcare bill is passed.
Poverty Line Changes – The Administration is considering changing how the federal poverty line is calculated. Some of the proposed changes could result in dramatically fewer people qualifying for low income subsidies across numerous healthcare programs. New research from Center for Budget and Policy Priorities has the following projections for how the regulatory change (shifting how FPL is indexed) would affect eligibility after ten years.
- 250,000 seniors and people with disabilities would receive less health care from Medicare’s Part Low-Income Subsidy Program
- 300,000 children and pregnant women would lose eligibility for Medicaid and CHIP
- 150,000 fewer consumers would be eligible for cost-sharing reduction. Millions would receive less premium tax credits.
Regulatory Calendar – OMB released its Spring 2019 Unified Agenda. All major 2019 regulations now have target dates for when OMB is planning on releasing them. These are not binding dates (or regulations) but they do represent the date the administration is planning on releasing currently planned regulations (i.e. this is OMB’s plan but those plans can change). Listed on the agenda included a target date of November for the Safe Harbor Rule, HRA regulation scheduled to be finalized in June, and Payment Notice in September. You can review the HHS calendar here.
Short-term plans – Politico reported that a federal judge reviewing a challenge to the Trump Administration change to short-term plan regulation was skeptical of blocking the new rule. There have been an increase in the number of stories of consumers being confused and accidentally buying short-term plans rather than ACA coverage.
State Watch
Connecticut – The governor of Connecticut and key legislators announced a major health care bill. The bill would:
- Create a Connecticut Option in which individuals and small business could buy cheaper coverage.
- A reinsurance program
- An individual mandate
- Ask the Federal government for a waiver so that the state can import prescription drugs from Canada to reduce costs to its Medicaid program (Vermont, Florida, and Colorado are all currently seeking a similar request)
There was no timetable announced for when the bill would pass.