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Coffee CAHC policy round-up: February 15, 2017

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!

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Coffee CAHC

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!

 

National level

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!

 

State level

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,

-Steve

Comments are closed.

Open Enrollment for 2018 coverage in the Health Insurance Marketplace created by the Affordable Care Act (ACA, or “Obamacare”) will start again on December 15, 2017. If you did not enroll in a health insurance plan by January 31, 2017, you can not enroll in a plan in 2017 unless you qualify for a Special Enrollment Period. Also, you will likely be penalized at tax time for not enrolling in a health insurance plan. CAHC HelpLine Staff can help you navigate these confusing health coverage systems call them today at 1-800-965-7476! Get covered Find free help from a “navigator” or other local assister in Maine — a service of enroll207.com. Search by city or zip code.

Workshops & Events

  • September, 2017
  • Sep
    26

    5th Annual HC4ME Conference!

    8:00 am - 4:00 pm

    Our conference theme this year is: The Future of Health Care in Maine: Defending Our Gains, Defining Our Vision.

    This year’s conference will offer two interchangeable tracks: a Policy Track, and an Enrollment Track.  The Policy Track will explore the current state-of-the-art in health policy, particularly around coverage and delivery system reforms. The Enrollment Track will explore information enrollment professionals will need or want to know.  The conference will also include panel discussions exploring the current state of health reform.

    ... More
  • October, 2017
  • Oct
    10

    Bangor MaineCare A to Z Workshop

    9:00 pm - 4:00 pm

    This workshop offers an in depth look at MAGI & Non-MAGI MaineCare eligibility rules for families, seniors, and people with disabilities. Participants will review and discuss recent State and Federal level changes to MaineCare related to the Affordable Care Act. Sponsored by Consumers for Affordable Health Care and Maine Equal Justice.

    ... More
  • Oct
    17

    Portland MaineCare A to Z Workshop

    9:00 pm - 4:00 pm

    This workshop offers an in depth look at MAGI & Non-MAGI MaineCare eligibility rules for families, seniors, and people with disabilities. Participants will review and discuss recent State and Federal level changes to MaineCare related to the Affordable Care Act. Sponsored by Consumers for Affordable Health Care and Maine Equal Justice.

    ... More
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