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This Week in Health Care Reform - March 21st, 2014

Medicare Advantage takes center stage before a powerful House Committee, as supporters continue to close ranks around the endangered program; contrary predictions abound over premium increases for next year; open enrollment heads for the finish line; and, the politics of the Affordable Care Act exert growing influence over the midterm calculus.


Health Care Reform

Medicare Advantage Defense: Late last week, the House Energy & Commerce Committee held a hearing on the impact that recently proposed payment cuts to Medicare Advantage from the Centers for Medicare & Medicaid Services (CMS) would have on the program and its more than 15 million enrollees.  The witness list was made up of two separate panels – the first, comprised of a handful of House members representing beneficiaries from all over the country.  The second panel included practitioners, experts, advocates, and, perhaps most importantly, a Medicare Advantage beneficiary, who was able to provide anecdotal evidence of the good that the program has done for him and his quality of life.  Separately, a recent Op-Ed appearing in The Hill cited further evidence that shows how existing cuts to Medicare Advantage are already impacting the seniors and persons with disabilities that depend on the program.  Penned by Dr. Kavita Patel, a physician and Brookings Institution policy expert, and John Rother, from the National Coalition on Health Care, the authors put forth that the consequences of the proposed cuts to Medicare Advantage not only put the coordinated model of care exemplified by the program at risk, but endanger the next generation of cost-saving and quality-enhancing reforms.  Finally, in last weekend’s GOP address, Republicans warned the President of the dangers the proposed cuts would have on the older Americans enrolled in Medicare Advantage plans.  Keep up with the latest in the fight to protect Medicare Advantage by visiting the Coalition for Medicare Choices

Premium Projections: Refuting earlier attempts by the Administration to downplay concerns over rising premiums, health industry officials this week said that they expected premiums under the Affordable Care Act to as much as double in some parts of the country next year.  Countering claims offered up by Health & Human Services (HHS) Secretary Kathleen Sebelius during testimony before the House Ways & Means Committee last week – which saw the Secretary categorize the projected increases as “far less significant than what they were prior to the Affordable Care Act” – insurance officials were quick to point out that, given the difficulties that have hampered the rollout of the exchanges thus far, premiums are expected to see a significant bump.  And, despite the price control mechanisms engineered into the health care law, experts went on to emphasize that the increases were a consequence of the delays and last-minute changes to the law’s rollout that have become more rule than exception.  As critics continue to parse through the reasons behind the expected premium spike, others were more concerned with how the Administration’s messaging got so off-track.

Final Sprint for Enrollment: As the open enrollment window begins to close on the exchanges, the Administration reasserted that it had no intention of either extending the enrollment period beyond the March 31st deadline or delaying enforcement of the individual mandate.  With two weeks to go, HHS announced this past Monday that, owing to a surge in sign-ups over the weekend, total enrollment on the exchanges has now crested 5 million people.  And, this Tuesday’s slight hiccup (which saw go down for about half an hour) notwithstanding, traffic continues to surge to the web portal.  Whether a direct result of the concerted drive to get people enrolled ahead of the deadline or really just a commentary on folks’ prevailing tendencies to put things off till the last minute, the President, in an interview last week, said he believed that enough people have now signed up to make the health care law work.

Politics of the ACA: Despite the setbacks and delays that have seemed to march in lockstep with the Affordable Care Act’s implementation, public support for the law is growing, at least according to a new survey from CNN and ORC.  While the majority (57 percent) still oppose the law, 39 percent said that they support it, an uptick from December’s 35 percent.  However, polling, much like the people whose opinions it seeks to gauge, can be fickle, as a separate Bloomberg National Poll illustrates.  In that survey, a full 64 percent of respondents said they supported the law outright or were in favor of small changes.  Why does any of this matter?  We need look no further than last week’s special election in Florida for our answer.  The defeat of Democrat candidate Alex Sink by Republican David Jolly in that election heightened concerns on the left regarding turnout, as their candidate led in the polls, but failed to generate enough voters to translate that support into victory.  Republicans were quick to capitalize on the results, hitting Democrats hard on the health care law, pointing to the election as the American public’s first opportunity to vent their frustrations at the voting booth, a strategy they will look to deploy throughout the midterm election season.  Democrats, meanwhile, sought to downplay the result in Florida, while seeking to coalesce around the right messaging regarding the Affordable Care Act – no easy feat, some argue.  Whether the special election serves as a harbinger of things to come, the GOP believes it now has a roadmap to take their health care law alternatives out for a test drive, even as critics maintain that that road leads nowhere.  Regardless, should Republicans regain control of the Senate this November – while also hanging onto the House – some have begun to wonder what that might mean for the divisive health care law.  Others, though, don’t imagine much will change in Washington, either way.        

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Looking Ahead

With CMS expected to make its final determination regarding the proposed changes to Medicare Advantage in just over two weeks, time is running out for beneficiaries and supporters of the popular program to make sure their voices are heard.  This week, we called upon the Health Action Network members of the 40 Senators and 204 Representatives that sent bipartisan letters to CMS urging the agency to protect Medicare Advantage from further, damaging cuts, to let their elected officials know that we appreciate their support.  If you haven’t already – and, if you can count your lawmaker as one of those 40 Senators (check here) or 204 Representatives (check here) – be sure to take action today!

You can keep up with the latest by following the Health Action Network on Twitter and by liking us on Facebook.