Week in Washington 061721

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

6/17/2021

SCOTUS: ACA Upheld

The Supreme Court this week ruled in favor of the Affordable Care Act in its California v. Texas decision. The court case revolved around several states suing to overturn the ACA due to lack of penalty associated with the individual mandate. The Court ruled that the states did not have standing to sue. The result is the ACA remains the law of the land. You can read the case here

Congress

There continues to be a swirl of news and rumors on POTENTIAL health care related legislation.

Reconciliation Bill

Democrats on the Hill are beginning to put together a reconciliation bill that would include numerous items from infrastructure to climate change to health policy. The Washington Post reported that initial items in the bill include: lowering the age of Medicare to 60, expansion of Medicare to cover dental, vision, hearing, and changes to lower prescription drug costs for Part D members. A Federal Medicaid option (for individuals caught in the Medicaid coverage gap) is less likely to be included, according to several Hill observers.

Telehealth

Also being discussed is a telehealth bill. The Connect for Health would permanently remove geographic restrictions on telehealth and grant HHS the authority to waive telehealth restrictions.  The bipartisan bill would extend telehealth waivers through 2022, which would allow more time to decide on permanent telehealth policy.

MedPAC/MACPAC June Reports

• MedPAC released its June report on ways to improve the Medicare program. The report includes 10 separate chapters on various topics. Of particular note is an entire chapter on ways to change the MA Benchmark, with a specific goal of reducing Federal costs. 
• MACPAC released its June report on ways to improve the Medicaid program. The report included 6 chapters on ways to improve the program, most notable was the chapter on ways to tackle high-cost specialty drugs.

ACA

HHS published more data on the Special Enrollment Period in the Healthcare.gov states. Since the SEP started 1.2 million people have signed up through Healthcare.gov, which is 50% higher than last year’s plan selections during the same time.

Alzheimer’s Drug

Discussions on the cost of the newly approved Alzheimer’s dru, Adulhelm, continued this week. While the top line cost of drug is high ($56,000 annually) additional costs will be incurred as patients will need diagnostic scans, monitoring, and treatment for potential side-effects. Many of the tests required for the drug are not covered by Medicare, which could result in a high burden on beneficiaries.

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