This Week in Health Care Reform - March 14th, 2014
A new bipartisan letter from more than 200 House members makes its way to CMS, while a new report details the state-by-state impacts of the agency’s proposed cuts to Medicare Advantage; separately, CMS abandons its proposed changes to the prescription drug program in the face of overwhelming opposition; the numerous tweaks to the health care law leave consumers and insurers in a perpetual state of confusion; and, the Administration releases exchange enrollment data through February.
Health Care Reform
The Sound of Over 200 Congressional Voices: On Wednesday, more than 200 members from the U.S. House of Representatives submitted a bipartisan letter to the Centers for Medicare & Medicaid Services (CMS). The effort, spearheaded by Reps. Bill Cassidy (R-Louisiana) and John Barrow (D-Georgia), implored the agency to keep funding levels flat for Medicare Advantage for next year, maintaining that the program serves their constituents well and that the proposed changes needlessly risk harming seniors. Given the coordinated energies that have already rallied to support the popular program and its beneficiaries, it should come as no surprise that the issue continues to add supporters to its ranks. Just last week, a group of organizations representing business, manufacturing, and retail interests (comprised of the U.S. Chamber of Commerce, the National Association of Manufacturers, the National Retail Federation, the American Benefits Council, the ERISA Industry Committee, and the National Association of Wholesaler-Distributors) came together on behalf of employers to urge CMS to eliminate the proposed cuts. And, also last week, 140 physician organizations signed onto their own letter to CMS, drawing further attention to the risks the proposed changes to Medicare Advantage pose to America’s seniors. Others have, in turn, focused their attention on the politics of the issue. The conservative American Action Network has funneled its resources into a marketing campaign (including mailers and online ads) targeting a handful of vulnerable Democrats in both the House and the Senate, while Republicans are seeking to portray the proposed cuts to Medicare Advantage as just the latest example of the health care law and its supporters being out-of-sync with what matters most to vulnerable seniors. Meanwhile, a new analysis of CMS’ proposed payment reductions to Medicare Advantage for 2015 was released this week detailing just how those cuts could affect beneficiaries across the country. Prepared by management consulting firm, Oliver Wyman, the report charts out geographically the estimated impact of CMS’ proposed changes to the popular program by state, in dollar terms (per member per month), with projections ranging (on average) from $65-$75 worth of reduced benefits and higher out-of-pocket costs for Alabama’s approximately 220,000 Medicare Advantage beneficiaries to $45-$55 for California’s 2 million-plus enrollees, in line with the projected national average faced by the more than 15 million seniors and persons with disabilities currently enrolled in a Medicare Advantage plan. (See the impacts in your state.) Stay on top of what’s happening in the fight to preserve Medicare Advantage by visiting the Coalition for Medicare Choices.
Reprieve for Part D: Unrelated to its proposed changes to Medicare Advantage, CMS had also offered up new rules concerning the Medicare Part D prescription drug program earlier this year. However, given the concerted and vociferous opposition levied against those controversial changes, the agency this week elected, instead, to abandon its proposal, which, critics had argued, would have fundamentally altered the nature of the drug benefit and complicated seniors’ ability to access necessary medicines. While some sought to characterize this latest about-face as merely the most recent incident of the Administration changing course on health care policy to suit its political needs, others wonder what, if anything, this decision portends for the brewing fight to protect Medicare Advantage.
ACA Confusion: It’s no secret that implementation of the Affordable Care Act has not been without its challenges. Beyond the logistics of orchestrating the collective energies and interests of a plurality of stakeholders towards a single goal, merely codifying the moving parts into a cohesive and observable set of rules and regulations requires a unified legislative spirit that’s in short supply. Already we’ve seen critics of the sweeping law introduce and pass dozens of bills aimed at dismantling it. And, that’s not to mention the numerous last-minute changes to the law’s rollout that have only succeeded in leaving consumers confused, insurers increasingly wary, and supporters looking for the panic button. So, observers took note this week when Republicans introduced a trio of bills that were less concerned with upending the law then course-correcting it. Admittedly, the measures offered up had only to do with fixing drafting errors, perceived oversights, or unintended consequences of the law’s implementation. Still, some believe that they hold political significance, all the more so in a time of bipartisan austerity.
4.2M Enrollees: Earlier this week, the Administration released the latest enrollment figures from the insurance exchange marketplaces. And while officials indicated that total enrollment could actually surpass the recalculated 6 million enrollee projection, others aren’t so optimistic. Through February, roughly 4.2 million people had signed up for coverage through the exchanges. Since last fall’s inauspicious launch of the HealthCare.gov portal, the rate of sign-ups has steadily improved. However, despite the enhancements to the website, analysts are predicting that the final tally of enrollees, once open enrollment closes at the end of this month, will be closer to 5.4 million.
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