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Coffee CAHC policy round-up: January 5, 2018

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, 2nd regular session


Friday, January 5th, 2018

 Readers, despite the lovely blizzard yesterday and the dreamy forecasted high of -3 tomorrow, I have, for some unknown random reason, and just in the past 24 hours, spontaneously decided to drop everything I have here in Maine and move to Central America*. Before I catch the last flight out of the tundra, though, here’s a Coffee CAHC!


*note: I may be lying, but I’ve certainly entertained some tropical daydream fantasies this week.


National level

Remember back when Senator Collins, after voting all year against bills to dismantle the ACA, agreed to vote for the tax bill – which contained repeal of the ACA’s individual mandate – on the condition that bills to stabilize and shore up the individual market had to pass before the final tax vote?

And then remember when she backed off on that, and the tax package passed first (with her vote in favor), and she said well no worries because those stabilization bills would TOTALLY pass first thing this year, very early, like right away, you can count on it for sure?

Well, as of this week, her new timeline seems to be “hopefully sometime this year, maybe, before 2019 definitely though for sure. Maybe.”

Yes, once again, Senator Collins has changed her tune on how important and vital it is to pass the bills that she hopes will mitigate or ameliorate the devastating blow that she and 50 other senators cheerfully delivered by voting in favor of repealing the individual mandate (just a few months, you may recall, after decisively voting against individual mandate repeal during the debate on the so-called “skinny repeal” bill). I just don’t get it.

In other national news, expect to hear more in the days and weeks ahead about “Association Health Plans”, because the Trump Administration is making a big push for them. Basically (and I’ll tell you right now, I am not an expert in these things yet!), the Administration is proposing new policies that would make it easier for groups of small businesses to clump together and buy insurance plans for their employees that operate, in essence, under some rules that currently apply to large-group policies. That’s important, because that means they wouldn’t have to obey the entire set of consumer protections under the ACA: perhaps most importantly, they would not be subject to rules about essential health benefits.

I haven’t had time yet to do a full deep dive for myself on AHPs and exactly what this proposal means, but I’m working on getting smart about ‘em. Stay tuned to this space for more.


State level

Setting what must be some sort of record, it took all of 20 minutes of being back in Augusta for the Legislature to end up a day behind schedule.

I kid, I kid. Kinda sorta. They cancelled all of the business (committee hearings, e.g.) that was scheduled for yesterday because of the storm. Absolutely the right and the obvious call, and it makes complete sense, but it was a little funny. They hadn’t even officially gaveled in to their first day of session before pulling the plug on the second day!

As a result, I can’t say I have a whole lot of state-level news for ya!


Would you like to know more?

Friends, if you have noticed one thing about this section of Coffee CAHC, it would probably be how much I have relied on the sage and expert analysis of Professor Tim Jost over the past year, to help me understand exactly what was going on in the health policy world at any given moment.

And not just me, either. Tim is a true wonk’s wonk.

Which is why that faint howl you may have heard yesterday was either the wind, or me learning that Tim is stepping back from his prolific blogging role at Health Affairs.

But hey, when a door closes and all that, because I am pleased as punch to see my friend Katie Keith stepping in to fill his shoes. Katie, if you happen to read this, I just want to say that I know you’re gonna knock it outta the park. Congrats and good luck from your pals here at CAHC. (It’s a little bittersweet, actually, because now you’re gonna be so busy that we’ll truly never get you up here to Maine, will we?)

With that, Katie has already provided us with the deep dive we’re looking for on the Trump Administration’s proposed rule on association health plans. Thanks, Katie!


Until next time, friends, I remain,


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