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This Week in Health Care Reform - February 3rd, 2017

Stakeholders anxiously await this year’s round of proposed changes to the popular Medicare Advantage program; GOP lawmakers continue their march towards repealing the health care law; voices call for the permanent elimination of the harmful health insurance tax; and, telehealth broadens its reach into schools.

Week in Review

Medicare Advantage: With 18 million seniors and persons with disabilities enrolled in Medicare Advantage plans – approximately 30 percent of all Medicare beneficiaries, in fact – chances are pretty good that each of us knows someone who depends on this important program for their comprehensive health care needs.  Given its track record of connecting beneficiaries with the kind of coordinated and chronic care management that leads to better outcomes, while also helping to lower costs, it’s not hard to see why the program enjoys such high levels of satisfaction amongst its enrollees.  However, in recent years, Medicare Advantage’s comprehensive blanket of care has slowly been undermined by annual changes to its underlying funding structure, exacted every year through the Centers for Medicare & Medicaid Services' (CMS) annual Advance Notice.  But, with the number of enrollees now flocking to the program on the rise, stakeholders have been successful in helping to mitigate some of the impacts of CMS’ annual funding cuts through outreach and by giving beneficiaries a voice in the debate.  Prior to CMS announcing this year’s proposed changes (released earlier this week) a bipartisan group of Senators, in a record-breaking show of support, sent a letter to CMS.  Sens. Mike Crapo (R-Idaho) and Bill Nelson (D-Florida) led the effort and were joined by 63 of their Senate colleagues in calling upon the agency to protect Medicare Advantage and its millions of beneficiaries.  As stakeholders work to determine what this year’s changes could mean for the program going forward, it’s vital that decision-makers hear from beneficiaries and those impacted by those cuts about the important role Medicare Advantage plays in their lives.  Learn more and be ready to add your voice to the efforts to protect the millions of Americans who depend on this program.

GOP Repeal Efforts: Open enrollment on the Affordable Care Act’s insurance exchange marketplaces came to an end this week, but not without a little controversy, as outreach efforts to communicate the impending deadline to consumers were prematurely halted late last week.  Against this backdrop, Republicans continue to work mapping out next steps in their ongoing efforts to repeal the health care law, seeking to dismantle the intricate regulatory framework upon which our health care system has spent the past seven years reshaping itself.  While the GOP must now grapple with the monumental realities of determining a better way forward, there’s mounting concern that whatever form those proposals might take could be problematic for the states, not to mention setting up a potential showdown with the White House.
HIT Repeal:
On a separate but related track, many Republicans have stated that any efforts to repeal the Affordable Care Act must include elimination of all the taxes that were enacted under it.  One of those taxes, the health insurance tax (HIT), has long been the target of opponents’ energies, who argue that the onerous fee only takes our health care system further away from the law’s titular goal by raising costs for hard-working families, seniors, and small business owners in the form of higher premiums.  From Utah to Wisconsin to Kentucky, across the country, stakeholders continue to call for the HIT’s permanent repeal. 
Telehealth in Schools:
As has been covered, telehealth continues to establish itself as an integral component of our evolving health care system.  Given our growing comfort with its application, it stands to reason that we’d also be open to exploring how and where it can help us overcome traditional barriers to care, such as proximity and convenience.  With that in mind, a growing number of school systems have begun utilizing telehealth for their student populations.  For example, three new telehealth clinics have opened in rural Indiana, in an effort to increase children’s access to health care.  And, in NorthCarolina, a school-based pilot has since grown into a national model, growing from three rural schools to 33 across four counties.      

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After meeting with pharmaceutical company executives this week, the new Administration pledges to work with drugmakers to lower prices.

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