Coffee CAHC is a twice-weekly newsletter where we round up and comment on the latest health coverage policy developments both nationally and here in Maine. We hope you find these updates helpful!
115th Congress, 1st session
128th Maine Legislature, 1st session
February 15, 2017
Good morning, Maine! Everybody have a lovely Valentine’s Day? I’m coming at you live from Washington DC this week, where the temperature today is forecast to be a positively tropical-feeling 49 degrees. I managed to slip out in that brief hour or two between blizzards. Don’t worry, I’ll be back at Winterfell next week, but for now, let’s catch up!
There was an interesting development earlier this week when the Freedom Caucus, a bloc of very conservative members of the U.S. House of Representatives, voted (amongst themselves) on Monday night to oppose anything other than full repeal of the ACA. No compromises, no “half-measures”, no piecemeal approach, no preserving “the popular parts” – just full-on repeal. That’s going to be tricky, when many members of their own party are on record as being strongly opposed to doing this. How House and Senate leadership thread this needle remains to be seen, but I’m reminded of a line from the brilliant musical “Hamilton”: winning was easy, young man, governing’s harder. (It’s from “Cabinet Battle #1” in case anybody is wondering.)
While we keep an eye out for the details on that new federal rule we mentioned a few weeks back, some powerful insurance industry voices are making clear what they want to see come out of this debate: a preserved individual mandate and continued consumer subsidies. Insurers have been pretty vocal in their analysis that the mandate is the foundation for making a lot of the rest of the ACA work.
Speaking of “things insurers aren’t shy about voicing opinions about”, let’s talk about risk corridor payments. This gets a little tricky, but the nutshell version is that these were payments intended to stabilize insurers in the first three years of the ACA. Insurers who did well would pay in, insurers who experienced heavy losses would be paid out. But Congress changed the game in 2014 and said the whole thing had to be “revenue neutral” – in other words, the government could only pay out what it took in. That’s left a lot of insurers on the hook for payments they feel they’re owed from a program that they were counting on. Last week, one judge sided with a big insurer out west, to the tune of a $214 million verdict against the government.
It will be interesting to see what the President and Congress do about this. Republicans have been fairly unequivocal about disliking the risk corridors, but they’re going to need some insurers to play ball to make any credible replacement plan workable.
Oh, and in case anybody hadn’t heard yet, the Anthem-Cigna merger was officially deep-sixed. This was pretty unsurprising after the Aetna-Humana deal went sideways, but still. Now you know!
All quiet on the snowed-in front. Once again, the Legislature canceled business on Monday, which mostly meant a few hearings getting shuffled around. There is some action in Augusta this week, before most of the Legislature takes a break next week – everybody except Appropriations, the committee that figures out the budget. They’ll be holding public hearings all week next week, including on sections of the budget where the Governor has proposed eliminating MaineCare benefits for 19 and 20 year olds and for parents who earn more than 40% of the federal poverty limit.
Would you like to know more?
Sarah Kliff of Vox is at it again, with a brilliant article yesterday about the fears many current ACA enrollees have about their futures if the program is repealed. As Kliff writes, “the Affordable Care Act was an opening of opportunity: the possibility to try a new career path knowing that they didn’t have to worry about where they’d get coverage. The possibility of repeal, they say, feels like a narrowing of choice.”
With Tom Price confirmed as head of HHS, the next confirmation hearing to watch in DC is President Trump’s nominee to be head of CMS, Seema Verma. She’s up this Thursday. This is an older article, but NPR did a story about Verma back in November that’s worth a read.
Until next time, friends, I remain,