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This Week in Health Care Reform: September 29th, 2017

Lawmakers pivot back to searching for bipartisan market stabilization solutions; employers bear the burden of rising drug costs; a new bill looks to expand telehealth’s reach; an extension for the delay of an unpopular tax is introduced; and, stakeholders continue to press for CHIP reauthorization.

Week in Review

Bipartisan Solutions: In the wake of the GOP’s latest effort to repeal the Affordable Care Act (ACA) collapsing, Senate HELP Committee Chairman Lamar Alexander (R-Tennessee) signaled that he was ready to resume bipartisan talks aimed at bringing much-needed stability to the shaky individual market.  Following up on the series of hearings he and Ranking Member Patty Murray (D-Washington) had convened earlier this month, Sen. Alexander released a statement late Tuesday afternoon saying he would “consult with Sen. Murray and with other senators, both Republicans and Democrats, to see if senators can find consensus on a limited bipartisan plan” that would help lower premiums and increase access to the millions of Americans enrolled in the individual market in 2018 and 2019.  On a separate track, Senate Majority Whip John Cornyn (R-Texas) also floated the possibility this week of tying structural reforms for the ACA favored by Republicans to any bipartisan deal.

Employers' Rx Costs: Employers project average per-employee health costs to increase by 4.3 percent next year, much higher than the average 3 percent increase seen over the past five years, and the highest since 2011.  These findings, the result of a new national survey from Mercer, also show that employers are struggling to contain out-of-control drug costs, which are expected to rise more than 7 percent in 2018.  There’s growing concern that spending on specialty drugs, which had risen by about 15 percent compared to the prices that had been factored into this year’s health plans, will only continue to push up the overall cost of prescription drugs.  As it’s anticipated that as many as 50 new specialty drugs are expected to hit the market each of the next five years, increasing costs $25 billion annually, those worries would seem to be justified.

Telehealth Bill: Earlier this month, a new bipartisan bill was introduced in the House Ways & Means Committee that would boost telehealth coverage in Medicare Advantage (MA) plans.  Proposed by Reps. Diane Black (R-Tennessee), Mike Thompson (D-California), Susan Brooks (R-Indiana), and Doris Matsui (D-California), the legislation would make telehealth services a core benefit in MA.  The bill met with broad support from lawmakers before passing unanimously out of Committee.  In speaking to what the bill would help achieve, Rep. Black spoke to its ability to connect seniors to the “best health care possible, while also working to address those skyrocketing health care costs." 

HIT Delay: Also this week, Senate Republicans offered up a bill that would delay the reintroduction of the health insurance tax (HIT) before it goes back into effect next year.  The HIT, which is a fee levied against health insurers, would result in increased costs to seniors, small business owners, and working class families.  Initially implemented under the ACA in 2014, a moratorium was enacted by Congress for 2017.  If reintroduced, analysts predict that the HIT will increase premiums by an average of 2.6 percent next year.  The bill, co-sponsored by 11 GOP Senators, would delay the HIT for another year.      

CHIP Reauthorization: With 9 million low-income children enrolled in the Children’s Health Insurance Program (CHIP), it’s understandable that there’s growing alarm surrounding the fact that the program’s funding expires on Saturday.  Owing to technical reasons, though, the money wouldn’t just run out the next day, still, stakeholders have rallied to CHIP’s defense, urging lawmakers to quickly reauthorize funding.  According to estimates, as many as ten states are projected to face a funding shortfall by the end of this year unless Congress renews federal funding to the program, with more than half of the states swelling those ranks by late March.  But, there are signs of progress, as the outlines of a deal were finally announced earlier this month.  Nonetheless, the timing puts CHIP on perilous financial footing.

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