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This Week in Health Care Reform: September 8th, 2017

Senators waste no time in seeking bipartisan fixes for the troubled exchanges; meanwhile, Congress faces a looming deadline on another critical program; the possible reinstitution of a harmful tax casts a long shadow; and, insurers look to tackle the opioid epidemic.

Week in Review

Bipartisan Efforts: This week, the Senate Health, Education, Labor, & Pensions (HELP) Committee held the first two of four planned hearings exploring what can be done in the near-term to bring much-needed stability to the troubled individual insurance market.  On Wednesday, insurance commissioners from five states appeared before the Committee, offering up their recommendations.  And, yesterday, five governors shared their states’ experiences grappling with the challenges currently undermining the exchanges.  Both groups’ testimonies only add to the litany of voices already pressing federal lawmakers to stabilize the individual market.  Despite the political and policy obstacles in front of them, HELP Committee Chairman Lamar Alexander (R-Tennessee) has set an ambitious timetable for the Senate to break through years of rancorous stalemate and advance bipartisan health care reform solutions.

CHIP Deadline: As previously covered, federal funding for the Children’s Health Insurance Program (CHIP) is set to expire at the end of this month absent Congressional reauthorization.  CHIP currently provides health coverage to more than 9 million low- and middle-income children.  With so much at stake, many have expressed concern over the critical program’s uncertain future, especially as legislative focus on reforming the health care law has largely overshadowed the tight deadline bearing down on CHIP.  Earlier this week, though, lawmakers signaled their intent to focus their attention on the issue, as the Senate Finance Committee held a hearing on the program’s future.

Return of the HIT:
Slated to return after the end of this year, the health insurance tax (HIT) threatens to increase health care costs for individuals, working families, and seniors.  A new analysis seeks to highlight how the HIT will also impact Medicaid.  Prepared by health care consulting firm, Health Management Associates (HMA), the study expands on a previous report from a separate consulting firm, Oliver Wyman, in which it was estimated that the reinstitution of the HIT would increase premiums by as much as $22 billion next year – and $267 billion over the next decade.  In their analysis, HMA attributed $5.5 billion of next year’s projected burden as being shouldered by the Medicaid program.

Combatting Opioids:
The opioid epidemic has become a national crisis, devastating families and communities across the country.  Drug overdoses have become the leading cause of accidental death in the U.S., exceeding car crashes and guns.  From 2014 to 2015, deaths from drug overdoses increased 11.4 percent, signifying the continuation of a worsening trend that’s been observed since 1999, according to the Centers for Disease Control and Prevention (CDC).  With so much at stake, health care organizations from across the spectrum have pledged themselves to addressing the issue causing so much harm to so many, like health insurers, who are seeking to leverage their role in facilitating connections between consumers and caregivers in order to help combat this epidemic.  In fact, one of these companies, Anthem, Inc., which, earlier this year, set an organizational goal of reducing the amount of opioids prescribed to members across its affiliated health plans by 30 percent by the end of 2019, announced last month that it had achieved its goal more than two years early.  In setting prescribing limits, the company sought to prevent accidental addiction and opioid use disorder, while also ensuring clinically appropriate use of these painkillers that was consistent with the guidelines established by the CDC.  Anthem has now updated its goal to achieve a 35 percent reduction by the end of 2019.  These efforts further the growing trend reshaping the health care industry’s approach to combatting the issue, which includes using data to counter opioid over-prescribing and exploring enhanced use of alternative pain management treatments.      

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With lawmakers back in Washington, here’s a quick run-through of their crammed September to-do list.                       

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