Week in Washington: Executive Actions, Public Options, and More

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: Executive Actions, Public Options, and More


Coverage Requirement for Immigrants President Trump last week issued an order that required all immigrants to have health coverage or be at risk for losing their visa. Furthermore, subsidized coverage on the Exchange would not count as “health coverage”. Consequently, the order could shift immigrants currently receiving subsidized coverage in the individual market to short-term duration coverage (which does count as coverage).

Executive Order Redux – Last week the Trump Administration released an Executive Order on encouraging enrollment in Medicare Advantage and studying other changes to the Medicare program. One interesting part of the Executive Order that is getting more attention this week is a study by the Social Security Administration. Several commenters believe the study may focus on allowing individuals to opt out of Part A (or other parts of Medicare) in lieu of other forms of coverage (or no coverage). Such a change would likely require Congressional action but may become a policy goal of the Administration.

Texas v. US Timing Update – A ruling on the Texas v. US (is the ACA legal) case is expected shortly from the Federal Appeals Court. Afterwards, the case will go the Supreme Court. One of the big questions is when it will go. The Washington Post reported that the White House will ask for a delay in the case so that the Supreme Court will not hear the case until after the election. Democratic states defending the ACA are expected to push for the Supreme Court to hear the case in the winter for a June 2020 ruling. 

Colorado Releases Public Option Plan – In big news the state of Colorado released its potential public option plan for the individual market for 2022. The plan would include a 1332 waiver so that the state can recoup some of the savings. There are a number of hurdles left before this becomes law, including HHS/Treasury approval. 

Anti-Kickback Regulation Coming Soon – CMS will release proposed changes to physician anti-kickback rules (also known as the Stark rules). The new rules will be designed to encourage value-based care arrangements. 

Research You Should Know About

Waste – Research published in JAMA claims that waste accounts for 25% of US healthcare spending.

More SBMs ComingMany states are shifting in the near future to an SBM model and away from HHS run. You can read more about which states, and why here (note states thinking or in the process include: ME, NV, NJ, OR, NM, and PA).


Previous editions: 

10/04/2019: New Executive Order to Impact Medicare Advantage

09/27/2019: Changes in the Employer Market 

09/20/2019: Major Prescription Drug Plan Unveiled

09/13/2019: Uninsured Data, E-Cigarettes and Congress Returns

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