CHIP funding crisis remains unresolved

Congressional authorization of federal funds for the Children’s Health Insurance Program (CHIP), which Nine million children depend on, expired on September 30, 2017. States are now operating CHIP on carryover and redistribution payments from prior years. The Centers for Medicare and Medicaid Services (CMS) estimates that at least one state will exhaust such funding in November 2017 and most will by March 2018. [More]

American Hospital Association files lawsuit against the Department of Health and Human Services

On November 13, 2017, the American Hospital Association (AHS) and associated entities filed a lawsuit in the U.S. District Court for the District of Columbia challenging certain provisions of a final rule issued on November 1, 2017 by the Department of Health and Human Services (DHHS), which would reduce by nearly 30% Medicare outpatient reimbursements to certain public and not-for-profit hospitals and clinics for prescription drugs purchased on a discounted basis under section 340B of the Public Health Service (PHS) Act. [More]

CBO releases report on bipartisan ACA stabilization plan

On October 25, 2017, the Congressional Budget Office (CBO) released a report on the Bipartisan Health Care Stabilization Act of 2017, which is now under consideration within the Senate Committee on Health, Education, Labor, and Pensions. The new legislation would offer additional flexibility under the state innovation waiver process, appropriate funding for cost-sharing reductions (CSRs), require some insurers to pay rebates on premiums for 2018, allow more individuals to purchase high-deductible plans, and require Federal support for outreach and enrollment activities. [More]

Recent Federal health policy developments

There were several significant health policy developments at the Federal level this month, including a Presidential Executive Order, the announcement that the administration will no longer fund Cost Sharing Reductions (CSRs) and the release of the bipartisan effort to stabilize health insurance markets known as the Alexander-Murray bill. In follow-up to our post on these developments earlier this month, below, we share further updates and details regarding these developments, and share our analysis of their potential impacts. [More]

Insights from the annual National Academy for State Health Policy (#NASHPCONF17)

PCG subject matter experts were in Portland, Oregon last week at the 30th annual #NASHPCONF17. With a focus on guiding state policy makers though the changing health policy landscape, #NASHPCONF17 provided a break from the day to day, reactionary work to adjust to federal policy. The conference served as an opportunity for state health policy leaders to learn from their colleagues and collaborate on problem solving the tough issues facing health policy; rising prescription drug costs, the opioid epidemic, providing affordable health care and measuring and improving public health. [More]

Major Health Policy Developments coming out of the Federal Administration

While Congressional efforts to change or repeal the Patient Protection and Affordable Care Act (ACA) continue to be stalled, the federal administration announced two significant health policy developments at the end of last week – an Executive Order aimed at promoting access to plans not subject to the full range of ACA protections as well as the decision to stop making cost-sharing reduction payments immediately. [More]

Congress takes steps to reauthorize CHIP

On October 4, 2017, the U.S. Senate Finance Committee approved a bill that would reauthorize federal funding through FFY 2022 for the Children’s Health Insurance Program (CHIP), a program that currently serves over nine million low-income children. New funding authorization for CHIP expired on September 30, 2017. For now, states are operating CHIP on federal allotments left over from prior years. Those reserves vary widely from state to state. [More]

Balance billing – a new report on recent efforts by state

PCG subject matter experts recently completed a survey report entitled “Balance Billing: Report of Recent Efforts to Protect Consumers.” The practice of balance billing is historically commonplace, but increased scrutiny on rising out of pocket health care costs is driving efforts to provide greater transparency into the practice.

For those states contemplating crafting consumer balance billing protections, this paper aims to provide a landscape of the options available, with national models from organizations like the National Association of Insurance Commissioners and the National Conference of Insurance Legislators outlined. Additionally, our report includes a comprehensive list that outlines enacted and pending balance billing legislation in a variety of states. [More]