Week in Washington: ACA Case Updates, New Regulations, and More

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Week in Washington: ACA Case Updates, New Regulations, and More

After a brief hiatus, Week in Washington is back. A few news updates from the past few weeks


Texas v. US:  The timing of the extremely important Texas v. US case (is the ACA constitutional case) that continues to change. The Supreme Court, on February 5, announced it would consider adding the Texas v. US case to the docket of cases to be heard this term. While still a long-shot, the fact that the Supreme Court will consider the issue, does raise the possibility that a ruling on the ACA could come this June. The Supreme Court will discuss the matter February 21.

On the Hill: A key House committee passed a surprise billing bill. There are multiple bills now in the House that will need to be merged before the entire House can vote on it. It does signal that there is still potential for surprise billing legislation this year (if it happens, it’s likely to happen in May).

2020 White House Budget: The White House released its 2021 Budget. The budget should be viewed as a wish list rather than actual policy. Within the budget the President calls for cuts over 10 years to Medicare, Medicaid, and the ACA. Overall, the budget calls for approximately $1 trillion in budget cuts to Medicaid and the ACA over ten years and $500 billion cuts to Medicare over the same timeframe.

Medicare: CMS released its 2021 Medicare Advantage Advance Rate Notice Part II and related memos. Wakely summarized the Notice and related guidance here.


  • ACA Payment Notice: CMS released its 2021 Notice of Benefit of Payment Parameters. Generally status quo with two main exceptions. CMS proposed removing or limiting APTC for enrollees who auto-enroll and their APTC covers the entire premiums as well as states reporting on state mandated benefits for purpose of ensuring that states are appropriately defraying state mandated benefit costs.  
  • Georgia 1332 Waiver: Georgia announced that it would submit a 1332 waiver but would hold off on pursuing Phase II of their initial waiver, which would have dramatically reshaped its individual market.  

Private Insurance: The Health Care Cost Institute (HCCI) released its annual trends in health care cost and utilization report. HCCI found that ESI spending grew 18.4% over the past five years, with 75% of that attributable to increase in prices.

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