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HEALTH ACTION NETWORK - ADVOCATES FOR BETTER HEALTH CARE SOLUTIONS

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This Week in Health Care Reform - January 13th, 2017

Republican-led efforts to repeal the Affordable Care Act move forward; a new analysis shows Medicare spending increasingly more on specialty drugs; and, stakeholders urge lawmakers to permanently repeal the health insurance tax.

Week in Review

ACA Repeal: After nearly seven hours of largely symbolic votes organized by opponents, the Senate voted early Thursday morning to approve a budget resolution instructing committees in both chambers of Congress to begin work on legislation repealing major components of the Affordable Care Act.  Senators approved the resolution 51-48, for the most part along party lines, with Sen. Rand Paul (Kentucky) representing the lone Republican vote cast against it.  Passage of the resolution allows the budget reconciliation process to begin in earnest.  The measure now moves to the House, where a vote was expected as early as today.  If passed, the next step would be for repeal legislation to be drafted, after which, it could pass both chambers with a simple majority, before heading to the President’s desk for his signature.  For their part, stakeholders across the spectrum are urging lawmakers to exercise caution in advance of repealing the law absent having a replacement plan in place.

Medicare Rx: Last week, a new report was released by the Department of Health & Human Services (HHS) Office of the Inspector General, in which federal payments for the Medicare Part D prescription drug plan’s catastrophic coverage were found to have exceeded $33 billion in 2015.  Under Part D, the catastrophic drug benefit is meant to cover the costs for those beneficiaries with chronic conditions and whose treatments can quickly add up.  That coverage kicks in after the beneficiary spends $4850 out-of-pocket.  The HHS Inspector General’s analysis discovered that in 2015, 3.6 million of the 41 million enrollees in Part D triggered the catastrophic coverage benefit.  That figure represented a 53 percent increase from 2010.  Put another way, federal payments for Part D’s catastrophic benefit essentially tripled over that period.  What accounted for the jump in that number was the prevalence of high-cost specialty drugs.  In 2010, those drugs were responsible for one-third of the total spending in catastrophic coverage.  By 2015, however, specialty drugs had ballooned to two-thirds of total spending.  While the issue of high-cost drugs has become of pressing importance, the Inspector General’s report only serves to emphasize the need to find workable solutions, specifically, by underscoring the threat to the sustainability of the taxpayer-funded Medicare Part D program, upon which so many depend.
 
                                            
HIT:
Legislation offered up last week to repeal the health care law’s health insurance tax (HIT) was immediately praised by stakeholders keen on protecting families, small businesses, and seniors from the tax’s harmful impact.  The bipartisan bill, offered up by Reps. Kristi Noem (R-South Dakota) and Krysten Sinema (D-Arizona), would provide relief for individuals, families, and employers, by as much as $400 per year in health care premium costs.  And, far from being merely a wonky, inside-the-Beltway issue, hard-working voices – such as those of small business owners in Wisconsin – continue to lend their energies to the effort, calling on lawmakers to permanently repeal the HIT.      
                                           
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Looking Ahead

Despite its uncertain future, signups on the health care law’s insurance exchange marketplaces continue to outpace last year’s enrollment numbers.
                                            
                                            

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