Health Plan Payment and Reimbursement

March 19-23 Policy Watch: Push to Include ACA Marketplace Stabilization in Funding Bill

March 16, 2018 9:49 am

Health plan and provider advocates have thrown their weight behind the effort, although the outcome is uncertain.

March 15—Healthcare leaders are renewing their push to include a stabilization measure in a must-pass federal funding bill that is required by the end of next week.

Hospital and insurer advocates are pushing to have language of a revamped bill to stabilize the individual-insurance market included in the omnibus spending bill that must be implemented before the federal government’s funding expires March 23.

“Congress has an important opportunity to act and reduce premiums for consumers for 2019, but time is running short,” industry groups, including the American Hospital Association and America’s Health Insurance Plans, wrote in a March 6 letterto Congress. “We urge you to take immediate action to advance bipartisan legislation that includes both premium reduction/reinsurance and funding for CSR benefits as part of the March 23 omnibus appropriations.”

The groups specifically sought enactment of a reinsurance program to help cover the costs of plan enrollees with significantly larger healthcare costs, and multiyear funding for cost-sharing reduction (CSR) payments, which subsidize out-of-pocket costs for enrollees with incomes that are less than 250 percent of the federal level.

Sen. Lamar Alexander (R-Tenn.) is pushing a bipartisan package, which includes the two elements sought by healthcare industry groups, as well as a provision allowing greater flexibility for state insurance regulators.

Alexander, chairman of the Senate Health, Education, Labor and Pensions Committee, said in a March 15 speech that he was optimistic the package would get added to the omnibus funding bill.

“We have a couple things to work through on ancillary issues, but that shouldn’t cloud the fact that we can reduce rates for working Americans who can’t afford insurance by up to 40 percent,” Alexander said, referring to ongoing disagreements about whether subsidies should go to insurance plans that cover abortions. 

He said the nonpartisan Congressional Budget Office’s preliminary projections have found that the proposal would cut premiums by an average of 10 percent in 2019 and by 20 percent in both 2020 and 2021. The projected impact was less than that found this week in an analysis by consulting firm Oliver Wyman, which projected that such a proposal could cut premiums by up to 40 percent for people in the individual market and cover 3.2 million more people. 

“If we don’t do it, rates will go up, the individual market will probably collapse,” Alexander said. “It was near collapse a year ago, and by ‘collapse’ I mean there will be counties where people can’t buy insurance at all.”

Monday, March 19

An outreach and education webinar will be hosted by the Centers for Medicare & Medicaid Services (CMS) for participants in the Hospital Quality Reporting (HQR) Program on the 2018 CMS Quality Reporting Document Architecture (QRDA) Category I Implementation Guide. Learn more.

The National Heart, Lung, and Blood Institute, along with experts from across the country, will begin to discuss COPD’s impact on rural communities at  “COPD and Rural Health: A Dialogue on the National Action Plan.” The meeting, which will examine challenges, opportunities, and resources, is available through livestream.

Altarum will host a webinar, “The Value of Health: Measuring the Economic Impacts of Prevention, Treatment, and Social Determinants.” Learn more and register..

The Association of American Medical Colleges and the National Institutes of Health (NIH) are hosting a webinar on NIH’s “All of Us” research program, a precision-medicine effort. Learn more

The National Institute for Health Care Management Foundation holds part two of its opioid webinar series, which will explore ways to expand the use of evidence-based treatment. Learn more.

Tuesday, March 20

The House Education and Workforce Committee’s Subcommittee on Health, Employment, Labor, and Pensions will hold a hearing titled “Expanding Affordable Health Care Options: Examining the Department of Labor’s Proposed Rule on Association Health Plans.” Learn more.

CMS holds an Open-Door Forum (2-3 p.m. ET) on the new Medicare card, seeking to give providers an opportunity to ask questions in preparation for accepting the new Medicare Beneficiary Identifier starting April 1. Participant dial-in number: 800-837-1935; conference ID#: 4588156.

The National Academies of Sciences, Engineering, and Medicine will host a workshop in Washington, D.C. (through March 21), on engaging the healthcare system in building capacity to respond to public health and national security threats. Learn more.

Wednesday, March 21

The Senate Veterans Affairs Committee will hold a hearing on the Trump administration’s FY19 budget request for the Department of Veterans Affairs. Learn more.

The House Ways and Means Committee’s Subcommittee on Health will hold a hearing titled “Implementation of MACRA’s Physician Payment Policies.” Learn more.

The House Oversight and Government Reform Committee’s Subcommittee on Government Operations and Subcommittee on Intergovernmental Affairs will hold a hearing titled “Improper Payments in State-Administered Programs: Medicaid.” Learn more.

The House Energy and Commerce Committee’s Subcommittee on Health will hold a two-day hearing titled “Combating the Opioid Crisis: Prevention and Public Health Solutions.” Learn more.

Thursday, March 22

The Alliance for Health Policy will hold a webinar titled “Competition and Consolidation: Understanding Recent Trends in the Health Care Market.” Learn more.

Friday, March 23

Expiration of temporary funding for the federal government.


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