January 26, 2018
This week, health policy news centers on budget deals and lawsuits.
Budget Deal Earlier this week Democrats and Republicans agreed on a three-week extension to the 2018 budget. As part of the deal 1) CHIP was funded for six years; 2) a one year (2019) health insurance tax holiday; and a two-year delay in medical device taxes and the Cadillac tax were passed. The holiday on the health insurance tax could reduce premium rates by 1 to 3 percent in 2019.
As a reminder during the last budget deal in December, Congress voted to annul the effects of the tax bill on sequestration. For example, sequestration should remain at 2% for Medicare Advantage Plans. The current spending bill expires in mid-February so further budget talks will permeate the news in the next few weeks.
Lawsuits
There are a number of key lawsuits to keep an eye on.
- Kentucky- This week a lawsuit was filed against the state of Kentucky (alongside CMS/HHS) over the recently approved Medicaid waiver. The waiver would institute work requirements among other changes to the state’s Medicaid program. Multiple states, such as Mississippi, are considering applying for similar waivers so the lawsuits may have spillover effects.
- CSR/Risk Corridors – Multiple issuers have sued the Federal government over non-payment of risk corridors and CSR payments. This would be among the largest judgement fund payouts if issuers were to win.
- Idaho – Idaho announced that individual market issuers could sell products that exclude essential health benefits, deny coverage for pre-existing conditions, and have annual limits. Lawsuits are expected if products in fact are offered.
HHS Watch
The new Secretary of HHS, Alex Azar was confirmed this week. Azar previously worked at Eli Lilly and also worked at HHS under President Bush. His confirmation could mean that a number of regulations such as short-term duration or the 2019 Payment Notice (currently at OMB) will be released shortly. The Washington Post reported that a regulation aimed at relaxing the mandate penalty in 2018 could also be released soon.
Medicaid Expansion
Interestingly the issue of Medicaid Expansion in states that have not expanded has been bubbling up. Currently there are efforts underway to have a ballot initiative in Idaho for Medicaid expansion. Additionally, there has been some talk of Medicaid expansion in Virginia and North Carolina.