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Coffee CAHC policy round-up: October 6, 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, adjourned
Friday, October 6, 2017
While we all paused to take a breath after the failure of Graham-Cassidy, the march of health policy continued on! While Steve is taking some much deserved vacation time, I am here with your quick rundown of what’s happened in the last week. 
National Level
Tom Price resigned as HHS secretary.
  • What happened? After increasing criticism about his pricey private jet travel, Health and Human Services secretary Tom Price resigned on Friday. This is after offering to pay back a portions of the charter flights he has taken as secretary – about $52,000 for his seats, or 13% of the total $400,000 price tag – an offer that proved to be too little too late.
  • Why does it matter to Maine? The Secretary of HHS plays a big role in implementing the ACA (which is still the law of the land, by the by) including, as well as many other health programs and policies. But most experts do not expect HHS’ agenda to shift, even with new leadership.
  • What’s next? It’s anyone’s guess who Trump will appoint as the next HHS secretary, although Seema Verna (current Administrator of CMS and architect of Indiana’s Medicaid expansion waiver) name is being mentioned an awful lot. For now, longtime HHS official Don J. Wright is serving as Acting Secretary.
Funding ended for the Children’s Health Insurance Program.
  • What happened? While everyone was focused on Graham-Cassidy, funding for the Children’s Health Insurance Program (or CHIP) ended on September 30. Before Graham-Cassidy picked up steam, Congress had been on track to renew it.
  • Why does it matter to Maine? Thankfully, Maine is not one of the states that will run out of money for CHIP right away – both Maine DHHS and MACPAC report that Maine’ program is funded through next summer. But it still adds unwelcome uncertainty to a program that many Maine families – covering 22,310 Maine kids, to be exact – rely on.
  • What’s next? Legislation to refund CHIP got through a Senate committee yesterday, but hit a snag in the House, where House Democrats opposed funding offsets, including a hike in Medicare premiums for people with high incomes. Seems like nothing comes easy for this Congress, even funding this popular program.
Funding expired for Federally Qualified Health Centers.
  • What happened? Add this to the list of things Congress did not act on in time while they were busy debating the future of the ACA. Congress failed to reauthorize funding for community health centers by September 30. Without this legislation, health centers would lose 70% of their funding.
  • Why does it matter to Maine? Nearly 30,000 Mainers go to a community health center for their care. Without this funding, these health centers would face closure. Community health centers are in high need communities that are medically underserved. That means that thousands of people who have few options for their care may have no where else to go.
  • What’s next? Like CHIP, health center funding has broad bi-partisan support. But Congress needs to act fast. If they don’t pass legislation by mid November, it could be tough for the Health Resources and Services Administration (HRSA), the agency that provides this funding, to get money to centers by January 1, when this year’s funding runs out.
The Trump Administration is denying Iowa’s ACA waiver.
  • What happened? Iowa submitted a request to the federal government to sidestep ACA requirements through a 1332 waiver. They argued in their waiver that this will allow them to lower premiums and offer more choices. But reportedly Trump personally directed Seema Verna to deny this request.
  • Why does it matter to Maine? Iowa is a conservative state, and their waiver would have allowed them to implement approaches that are favored by conservatives by getting rid of the exchange, and offering people a tax credit similar to what we’ve seen in federal ACA repeal bills. This would have moved their insurance market further right. Trump’s denial of this request seems to indicate that his administration is more interested in tanking the ACA than giving states flexibility, or allowing them to take steps to stabilize their market. Not a good sign.
  • What’s next?  Again, most experts are interpreting this as an indication of Trump’s commitment to letting the ACA fail – spurred in no small part by his administration’s actions. We’ll be watching closely as we get closer to open enrollment.
And that’s not all. We are also keeping a close eye on a little thing called the Federal budget, which still provides an opportunity for Congress to take up ACA repeal. Don’t forget that Senator Graham and Senator Cassidy continue to make noise about wanting to pass their ACA repeal legislation.

In the midst of all this, we are looking out for for an executive order that will roll back the birth control mandate. This could come out as early as today. We are also looking out for a rumored executive order on association health plans. But we’ll leave those topics for a future Coffee CAHC.

State Level

Let’s start with a corrections corner! Although Anthem is leaving Maine’s Marketplace, they will continue to sell plans off-marketplace throughout the state, and not just in certain counties, as we mistakenly reported last week. Mea culpa, dear readers!

In other Marketplace news, Harvard Pilgrim announced that they are staying in Maine’s Marketplace. That means Marketplace enrollees will be able to choose plans from 2 different companies. But with Anthem leaving the Marketplace, and other carriers making changes to their plans, it’s more important than ever that people actively check out their options. Here’s a message from Maine’s Superintendent of Insurance saying just that.

In non Marketplace news – as we get closer to election day, more Maine groups are coming out in support of Question 2, which will expand Medicaid. In the past week, this includes the Maine Hospital Association and a group of over 150 small business owners.

Would you like to know more?

How else would you spend a three-day weekend? Here’s some health policy reading to keep you busy:

Enjoy the weekend – I’ll be back next Friday!


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