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This Week in Health Care Reform: November 17th, 2017

A new nominee is named to head HHS; CSR payments could find their way into an end-of-year spending package, as lawmakers move closer to advancing tax reform; and, a check-in on the status of open enrollment.

Week in Review

HHS Nominee: This week, Alex Azar was nominated to lead the Department of Health & Human Services (HHS).  While some questioned the objectivity of appointing a former pharmaceutical executive to oversee an agency that, amongst other things, regulates prescription drugs, others point to his experience, having also served as deputy HHS Secretary under a previous Administration.  Regardless, Azar has been described as both pragmatic and possessing a deep understanding of the regulatory processes that he would now be in charge of leading at HHS.  While no date has been set, Sen. Lamar Alexander (R-Tennessee), who chairs the Senate HELP Committee, stated that a confirmation hearing would be promptly scheduled.

CSRs and Tax Reform: As lawmakers look to work out the specifics of an end-of-year spending package, at least one Senator thinks that funding for the cost-sharing reduction (CSR) subsidies could eventually make its way into that legislation.  In speaking to reporters on Wednesday, Sen. John Cornyn (R-Texas), the second-ranking Senate Republican, said he thought it was “likely” that CSR payments would be included in the December funding bill.  He went on to say that the bipartisan legislation proposed by Sens. Lamar Alexander (R-Tennessee) and Patty Murray (D-Washington), which, in exchange for added state flexibility, included two years of CSR funding, had merit and could help lower premiums.  However, before they get to that year-end funding package, lawmakers are focusing their efforts on overhauling our tax system.  Yesterday, the House voted on their tax reform bill, which ultimately passed along party lines, with 13 Republicans crossing the aisle to vote with Democrats against the measure.  Meanwhile, debate continues in the Senate on their version of a tax bill, which was only complicated by the decision earlier in the week to include a repeal of the individual mandate as a means of offsetting the proposed tax cuts embedded in their proposed legislation.  In response, Democrats warned their Republican counterparts that the inclusion of that provision in their tax bill would result in Democrats being unable to support the aforementioned Alexander-Murray legislation funding CSRs.  Separately, a growing coalition of stakeholder voices have banded together to caution lawmakers that eliminating the individual mandate without also enacting “a package of reforms to adequately assure a balanced risk pool and prevent extraordinary premium increases” would only serve to further destabilize the already fragile individual and small group markets.

Open Enrollment:
Two weeks into open enrollment and it looks like consumers have been flocking to the health care exchanges in robust numbers, in defiance of gloomy predictions.  As of Wednesday, officials said that nearly 1.5 million people have signed up for coverage.  While those numbers are tracking ahead of last year’s pace at this point in open enrollment, experts point out that we won’t really know what we’re looking at till after open enrollment closes, which historically sees a surge at the end, but has been cut in half from three months previously to just six weeks.      

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