This Week in Health Care Reform - February 20th, 2015
Stakeholders brace themselves for the latest proposed changes to the popular Medicare Advantage program; open enrollment (mostly) comes to an end; a new bill is reintroduced to eliminate the tax on health insurance; and, states consider their responses to the Supreme Court ruling.
Week in Review
Preserving MA: The Centers for Medicare & Medicaid Services (CMS) is expected to release its annual proposed changes to how the underlying structure of the popular Medicare Advantage program is, both, funded and administered this afternoon. In recent years, it’s taken a coordinated outreach effort, involving stakeholders from across the health care spectrum, to push back against CMS’ proposed changes and minimize their impact on beneficiaries. Unfortunately, the cumulative effect of the cuts that have ultimately been finalized in recent years, on top of those enacted under the Affordable Care Act, have degraded the benefits that 16 million seniors and persons with disabilities enrolled in the program have come to rely on. As mentioned last week, though, a bipartisan push in the Senate resulted in a letter being sent to CMS Administrator Marilyn Tavennner, urging her to protect Medicare Advantage from further, harmful cuts. (Health Action Network members stepped up, sending hundreds of emails to their Senators asking them to add their names to the letter, too.) While we won’t immediately know what CMS will propose or how those changes will impact beneficiaries, we do know that it will take a sustained effort, from as many voices as possible, raised in unison on behalf of the millions of vulnerable Americans enrolled in Medicare Advantage, to preserve this important program and its proven model of coordinated care for future generations. Be on the lookout for ways you can engage in the effort to protect Medicare Advantage.
Open Enrollment Ends: As scheduled, the second open enrollment period closed this past weekend. Despite some last-minute hiccups, once the dust had settled, the Administration was able to announce that 11.4 million Americans had enrolled in coverage through the federal and state exchange marketplaces, exceeding their original goal. However, the final moments of open enrollment were not without complication. While consumers were largely spared a repeat of the technical glitches that hamstrung last year’s rollout, behind-the-scenes issues continue to be an area of concern. But, that didn’t stop consumers from flooding to the online marketplaces in the days leading up to the end of the open enrollment period. Given the last-minute surge of traffic, officials today announced a special enrollment period to coincide with tax-filing season. This extension would be on top of the one already granted to consumers who had difficulty enrolling this past weekend, making some experts more than a little anxious.
Health Insurer Fee: The health insurer fee found its way back onto the legislative docket last week after a bipartisan bill aimed at repealing it was reintroduced in the House. Sponsored by Reps. Charles Boustany (R-Louisiana) and Kyrsten Sinema (D-Arizona), the bill seeks to eliminate the tax which, Rep. Boustany went on to say, “hurts individuals and businesses by increasing premiums and out-of-pocket costs.” Imposed under the health care law, the tax is larger than all other health industry-specific taxes – such as those on prescription drugs and medical devices – combined, and will exceed $145 billion over the next decade. Most alarmingly, however, is the impact that the tax will have on individuals, families, small businesses, and seniors, with each segment having to shoulder the weight of these increased costs in the form of higher premiums.
States' SCOTUS Response: As anxiety builds ahead of the Supreme Court hearing arguments next month in the case challenging the tax subsidies extended to consumers via the federal exchange, stakeholders continue to weigh their options. For the 34 states that elected not to set up their own exchanges, the potential response has been decidedly mixed, with some already engaged in contingency-planning, while others have outright declared that they will not step in with a solution should the Court rule in favor of the plaintiffs. While the more practical aspects of what would happen next continue to play out, some are focusing their attention on the merits of the case, offering up reasons why the challenge might fail and why the challenge might win.
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As highlighted, the push to protect Medicare Advantage from further, harmful cuts begins now. Keep up with the latest as the industry and stakeholders digest, interpret, and react to CMS’ latest proposed changes to the Medicare Advantage program.
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