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What some governors want from Obamacare stabilization Centrist Republican governors joined with Democratic governors to testify this morning at the Senate Health, Education Labor and Pensions Committee in favor of Congress agreeing to fund cost-sharing reduction subsidies. It’s unclear whether Senators will agree to appropriate the funds, and if so for how long. Democrats have asked for two years, while HELP Committee Chairman Sen. Lamar Alexander has said he supports a year’s appropriation. Montana Gov. Steve Bullock, a Democrat, said that he would even like to see a CSR package for three years. “You’re sending the message to the market that there is going to be some stability there,” he said. Republican governors also said they wanted more flexibility on essential health benefits, which the range of medical care that insurers are required to cover under Obamacare. The latter is something that Sen. Patty Murray, D-Wash., said in her opening statement she would be unwilling to support, saying that she did not want protections to go away for women seeking maternity care. In addition to Bullock, the committee heard from Democrat Gov. John Hickenlooper of Colorado, and Republican Govs. Charlie Baker of Massachusetts, Gary Herbert of Utah, and Bill Haslam of Tennessee.
Alexander asks why states don’t fund their own reinsurance programs In the HELP Committee hearing this morning Alexander said a discussion needed to occur on how how to address the high cost of care for the sickest population. “Seems to me, senators on both sides of the aisle understand how that discussion is likely to be part of any long-term solution because we’ve got a very small individual insurance market with some exceptionally sick people in it, and finding a way to deal with complex cases helps us reduce rates for everybody else,” Alexander said during his opening remarks. Though he noted that reinsurance was one way to do it, he questioned what a state’s responsibility should be or how the federal government could make it easier for states to set up their own reinsurance plans by asking for an Obamacare innovation waiver as Alaska and Minnesota have done. Under current law the legislature must pass a bill, but Alexander said it might be more efficient to allow a governor or health insurance commissioner to set up such a proposal.
Selling ‘copper’ plans emerges as a discussion point Looking for ways to make cheaper plans available to more individuals on the exchanges, Alexander has floated the idea of offering a “copper” plan alongside the current platinum, gold, silver, and bronze plans. The copper plans would tend to have higher deductibles and offer fewer benefits than more expensive options, but they could be one way to attract individuals into the market who have fewer medical needs. An Avelere study done in 2014, when the idea emerged after the launch of the exchanges, found that such plans would have 18 percent lower premiums than bronze plans. This copper plan proposal is emerging as a trade-off for payments of cost-sharing reduction subsidies.
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Trump promises another try on healthcare: ‘We haven’t given up’ During an event in Bismarck, N.D., that was meant to be a pitch for tax reform, President Trump told the crowd that congressional Republicans are still working to tackle healthcare and may soon try a different approach. “Believe me, we haven’t given up on healthcare. We never give up,” the president said, recalling the narrow 49-51 vote that sunk a Senate GOP measure to repeal President Obama’s signature healthcare law in late July. “One vote, think of it. One vote,” White House officials have continued to weigh various legislative options on healthcare reform that could appeal to both Republicans and Democrats, including an amendment proposed by GOP Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana that would redirect federal spending on Obamacare to the states. “[Trump] is ready with pen-in-hand to sign healthcare reform if, say, Graham-Cassidy moves forward,” White House counselor Kellyanne Conway told Fox News on Wednesday. “People have been working on that very strongly over recess.” Trump has not offered a timeline for when he expects congressional healthcare negotiations to resume, though Conway said Wednesday that changes to the current system “should get done this year.”
McCain indicates some support for block granting healthcare money to the states Sen. John McCain, R-Ariz., made waves in late July by dealing the fatal blow against a “skinny” repeal bill that just gutted some parts of Obamacare. McCain told reporters on Wednesday he thought Graham-Cassidy was a “good proposal and I think we ought to support it.” He later clarified his comments in a statement, saying that he would need to work with Arizona Gov. Doug Ducey on determining its impact. “While I support the concept of the Graham-Cassidy proposal, I want to see the final legislation and understand its impact on the state of Arizona before taking a position,” he said. He repeated that he still believed healthcare legislation needed to occur through open hearings, debates and amendments, the absence of which had led to his vote against the “skinny” Obamacare repeal.
Democrats see opening for Obamacare fix Senate Democrats believe they have an opening to prop up Obamacare’s insurers by passing a bipartisan stabilization package, despite opposition from Republicans. Several Senate Democrats said they were heartened that most insurance regulators at a hearing Wednesday called for Congress to create a new federal reinsurance program, which would pay Obamacare insurers that enroll sicker, more expensive people. That unified industry stance makes Democrats optimistic about passing something, even though Republicans are wary of adding reinsurance to a narrow deal to stabilize Obamacare’s exchanges. “We are in the ballpark for a deal, which is news in and of itself,” said Sen. Chris Murphy, D-Conn., who sits on the Senate Health, Education, Labor and Pensions Committee that held the hearing. He noted that the disagreement appears to be over who should be in charge of the reinsurance program, not whether such a program should exist. Committee Chairman Sen. Lamar Alexander, R-Tenn., floated the idea that states could apply for their own separate reinsurance programs, just like Alaska did for the 2018 Obamacare coverage year. But insurance regulators said at the hearing that a federal program is needed to help get things started. A major problem is getting money from a state legislature for something that would likely bring down Obamacare rates. Some states “cannot get the funds from the legislature for that first year to show there is an impact … that would bring down the rates,” said Lori Wing-Heier, Alaska’s insurance commissioner. Sen. Ron Johnson, R-Wis., chairman of the homeland security committee, said he was open to some type of reinsurance. He offered up examples of Wisconsin’s high-risk pool where the state subsidizes care for the sickest people on the individual market. “I am happy to take a look at different models,” he said.
Anthem scales back by half in Kentucky’s Obamacare market Major healthcare insurer Anthem will only offer Obamacare exchange plans in roughly half of Kentucky’s 120 counties due to mounting policy uncertainty from Washington and a deteriorating market. Anthem had earlier planned to offer individual market plans in every county in Kentucky. However, the insurer said that lingering problems with the market and massive federal uncertainty has forced its hand. Anthem said in a statement there has been “continual changes and uncertainty in federal operations, rules and guidance.” Anthem also highlighted the restoration of taxes on health insurers. Another key factor was “a shrinking and deteriorating individual market.”
McCaskill finds Insys inappropriately pushed opioid to patients Drug company Insys Therapeutics sought to bypass the normal approval process to have its highly addictive and potent fentanyl opioid Subsys provided to patients who didn’t need it, according to a Senate Democratic report. Sen. Claire McCaskill of Missouri, the top Democrat on the Homeland Security and Governmental Affairs Committee, presented the findings during a press conference Wednesday.
Mental health leader in Congress admits to extramarital affair Rep. Tim Murphy, R-Pa., confessed in a statement Wednesday that it was with a personal friend. “This is nobody’s fault but my own, and I offer no excuses,” he said. “To the extent that there should be any blame in this matter, it falls solely upon me. … I ask the media to respect the privacy of my family. They have done nothing wrong and deserve to be left alone.” On Sept. 29, Murphy will be deposed by Jesse Sally, the husband of Shannon Edwards, the woman Murphy had an affair with. Murphy has served eight terms in Congress and is also a practicing psychologist. Edwards is a forensic psychologist. Murphy and Edwards met when Edwards contacted Murphy’s office to assist with a mental health bill, which was signed into law in December. Edwards said her relationship with Murphy was only friendly at first and they worked very hard to pass legislation to help her clients.
RUNDOWN
The Hill Optima’s exit may leave Virginia counties with no Obamacare insurer
STAT News Obamacare’s “guardrails” are crucial issue as Congress debates shoring up law
Roll Call Senate pins healthcare hopes on bipartisan bill
Politico Bid to shore up Obamacare faces time crunch, conservative counter effort
Kaiser Health News Shedding new light on hospice care: No need to wait for “brink of death”
Washington Times State rep: NYC mayor turned a blind eye to mental illness in the city
Bloomberg Opioid use explains 20% of the drop in American men from labor force
Health Affairs Why Medicaid is platform best suited for addressing both healthcare and social needs
Calendar
FRIDAY | Sept. 8
9:15 a.m. AEI. 1789 Massachusetts Avenue NW. Govs. John Hickenlooper and John Kasich discuss bipartisan proposal to stabilize health insurance market. Details.
Noon. G50 Dirksen. Alliance for Health Policy discussion on “Stabilizing the Individual Market in Uncertain Times.” Details.
TUESDAY | Sept. 12
Sept. 12-13. Marriott Wardman Park. 2660 Woodley Rd. NW. 2017 Association for Accessible Medicines Biosimilars Council Conference. Includes keynote by CMS Administrator Seema Verma. Agenda.
8 a.m. Newseum. 555 Pennsylvania Avenue. Discussion hosted by The Hill on “Turning Genes into Medicine: Reimagining Our Healthcare System.” Details.
10 a.m. 420 Dirksen. The Senate Health, Education, Labor and Pensions Committee will hold a third hearing on stabilizing the Obamacare exchanges, with discussions on state flexibility. Details.
10 a.m. 215 Dirksen. Senate Finance Committee hearing on “Health Care: Issues Impacting Cost and Coverage.” Details.
2:30 p.m. Brookings. 1775 Massachusetts Ave. NW. Event on “Inclusive School Environments: Improving Outcomes for Students With and Without Disabilities.” Details.
SUNDAY | Sept. 10
Sept. 10-12. Swissôtel, 323 East Upper Wacker Drive. Chicago. Eighth International Congress on Peer Review and Scientific Publication. Details.
WEDNESDAY | Sept. 13
8 a.m. AJAX. 1011 4th Street NW. Event hosted by The Hill on “America’s Opioid Epidemic: Search for Solutions” with Sen. Rob Portman, R-Ohio, and Rep. Paul Tonko, D-N.Y. Details.
9 a.m. 529 14th Street NW. National Press Club. Event on “Understanding the Value of Innovation in Medicine.” Details.
