February 1, 2018
This was the first official week for Alex Anzar as new Secretary of HHS and already a large issue has been plopped onto his plate.
Idaho –Recently, Idaho proposed to allow Idaho issuers to sell non-ACA individual market products. The new Secretary eventually will need to make a determination as to the legality of the move. An HHS spokesman being quoted in The Hill stated “While we have not conducted a formal review of Idaho’s new guidelines, the state’s approach does need to be evaluated”. Azar’s position will go a long way in determining the viability of Idaho’s proposal.
CMS Watch: CMS released its MA Rates Notice today. More analysis to come on this…
Health Reform Watch: It is sounding less and less likely that ACA repeal/repeal-and-replace will be on the Congressional docket, at least until after the midterms in November. Politico reported that it is unlikely that Republicans will pass the necessary legislation to use reconciliation as a tool this coming fiscal year. Without reconciliation it is not possible for the Republicans to repeal the ACA without the Democratic party.
2017 Profits: While concerns about the future of the individual market post-mandate repeal abound, 2017 profits for the individual market seem to be positive. For example, Anthem recently announced that it turned a profit in 2017 in its individual line of business. Overall, Kaiser Family Foundation found that issuers’ MLRs in 2017 were significantly improved relative to 2016.
Amazon, JP Morgan, and Berkshire Hathaway Announcement: A big story this week was that three of the most influential firms in the USA announced a partnership to address healthcare. However, details were very scarce on what the partnership would entail or the scope of the activities. Vox has a good explainer of what the project could entail.
Research of the Week: A new article in NEJM Catalyst analyzed the turnover rates of the top 5% of spenders. They found that in 2015, the top 5% of spenders accounted for 53% of healthcare spending. However only 39% of the top 5% of spenders were top spenders the previous years. 61% of top spenders were in a lower spending category the previous year. Churn, even at the highest end of spending, is high.