Week In Washington: New Year, New Congress

January 3, 2019

January 3rd marked the start of the 116th Congress with Nancy Pelosi as the Speaker. First on the agenda will be ending the shutdown. The House is expected to pass a budget bill in the next few days but its fate is unclear after that. As a reminder, the government is partially shut down. So parts of the government (HHS) are operating, others are not (Treasury). Despite HHS being open, the shutdown will slow (and possibly halt) the release of regulations (such as the payment notice or actuarial value calculator). Also as a fun fact you won’t get a tax refund until the shutdown is ended.

ACA Lawsuit: Today California officially appealed the Texas v US lawsuit (the lawsuit that ruled the ACA unconstitutional). California expects the next round of rulings this year which would place a Supreme Court ruling on the matter in 2020.

Final HealthCare.Gov Enrollment Numbers: Josh Peck, former head of HHS outreach, has a good summary of open enrollment. Retention of ACA enrollment is far higher than it has been so despite the far lower new enrollments, open enrollment is not that much lower than last year (at this stage). Overall, the worst performing states were Virginia (Medicaid expansion) and West Virginia while the best performing states included Oklahoma and Mississippi.

HRA Regulation Analysis: Matt Fiedler, of the Brookings Institute, has a good paper discussing the potential effects of weakening the safeguards in the HRA proposal. He found that under certain scenarios individual market premiums could increase between 16% and 90% as a result of the regulation.

Policy Idea of the Week: Comes from three professors who outline ways to reform prescription drugs, with a specific focus on the orphan drug act. Orphan drugs are drugs for small patient populations. As a result of a previous law, orphan drugs are incredibly high-priced (the average price for the top 100 orphan drugs are about $150,000 a year per patient). The professors outlined possible ways to reduce costs for these types of drugs.