Week In Washington: Congress Returns

November 16, 2018

Congress returned this week, with a number of pressing issues to tackle. Top of the priority list will be coming to a budget agreement by December 7th. According the Washington Post there are three major health topics that could be tackled in the lame duck session (now until the end of the year).

  1. Donut Hole- drug makers are pushing to reverse part of the changes to the donut hole that increased costs for drug manufactures.
  2. CREATES Act – which increases the incentives and availability of generic drugs.
  3. Medical Device/Health Insurance Taxes – delays for both of these provisions are on the table.

While it is possible all of these topics could be enacted, it is likely that more pressing topics (budget) will be given first priority. As such expectations are low for these health policy issues to be addressed in the lame duck session and certainly will not be enacted before early December.

Open Enrollment Data

CMS released Week 2 open enrollment data for the Healthcare.gov (FFM) states. Josh Peck, who formerly headed up outreach at CMS, found that compared to last year, enrollment was down approximately 13%. In particular, new enrollees were signing up at a slower rate compared to last year. This finding isn’t reflected everywhere, as to date Washington and Minnesota, have had better open enrollments so far this year relative to last year. Systematic state by state data is not yet available.

Medicare News

  • New research on Medicare Advantage gives a thorough outline of the expected direction of the program. MA enrollment is expected to grow from 34% to 42% of Medicare over the next decade.
  • CMS Administrator, Seema Verma, hinted this week that there could be major changes to Part D’s Protected Classes.

Employer Coverage

  • According to the CDC, nearly half (46.0%) of Americans with private coverage were enrolled in high deductible health plans.