Charles Gaba's blog

Tuesday, December 10th, is gonna be a pretty big day for federal healthcare policy, especially in the U.S. House of Representatives.

For one thing, it's my understanding that the big Prescription Drug Bill (H.R. 3, the Lower Drug Costs Now Act) is scheduled for a floor vote on Tuesday, although it's possible that it'll be bumped until later in the week given the grumbling by the Congressional Progressive Caucus.

For another, the House Energy & Commerce Committee is holding what I'm assuming are all-day hearings on not one, not two, but nine different Universal Coverage bills, including the Big Ones: Medicare for All and Medicare for America:

HEARING ON "PROPOSALS TO ACHIEVE UNIVERSAL HEALTH CARE COVERAGE"

Date: Tuesday, December 10, 2019 - 10:30am

(h/t @CarenaAK via Twitter)

The hits just keep on coming for CMS Administrator Seema Verma:

Medicare chief asked taxpayers to cover stolen jewelry

A top Trump health appointee sought to have taxpayers reimburse her for the costs of jewelry, clothing and other possessions, including a $5,900 Ivanka Trump-brand pendant, that were stolen while in her luggage during a work-related trip, according to documents obtained by POLITICO.

Seema Verma, who runs the Centers for Medicare and Medicaid Services, filed a $47,000 claim for lost property on Aug. 20, 2018, after her bags were stolen while she was giving a speech in San Francisco the prior month. The property was not insured, Verma wrote in her filing to the Health and Human Services department.

The federal health department ultimately reimbursed Verma $2,852.40 for her claim, a CMS spokesperson said.

via email from the House Energy & Commerce Committee:

Bipartisan House and Senate Committee Leaders Announce Agreement on Legislation to Lower Health Care Costs

• Legislation ends surprise medical bills; funds Community Health Centers for five years; increases the purchasing age of tobacco to 21; lowers prescription drug and other medical costs by requiring more transparency and competition

WASHINGTON, December 8, 2019 — Senate Health Committee Chairman Lamar Alexander (R-Tenn.) and House Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-N.J.) along with Ranking Member Greg Walden (R-Ore.) today announced they have reached a bipartisan, bicameral agreement on legislation to lower what Americans pay out of pocket for their health care.

Whether it actually makes it through both the House and Senate and gets signed by Trump or not, just getting this type of announcement itself is pretty unheard of these days for any significant policy.

As noted a few days ago, House Democrats have officially scheduled a floor vote on H.R. 3, the Lower Drug Costs Act of 2019, for next week:

Pelosi, Hoyer, Pallone, Neal and Scott Joint Statement Announcing Floor Vote on H.R. 3

Washington, D.C. – Speaker Nancy Pelosi, Majority Leader Steny Hoyer, Energy & Commerce Committee Chairman Frank Pallone Jr., Ways & Means Committee Chairman Richard E. Neal and Education & Labor Committee Chairman Bobby Scott released the following joint statement:

“Next week, the House of Representatives will pass the Elijah E. Cummings Lower Drug Costs Now Act.

“We have now received enough guidance from CBO to bring the Lower Drug Costs Now Act to the Floor and to reinvest its savings in one of the most transformational improvements to Medicare since its creation.

via the Washington Health Benefit Exchange:

Washington Health Benefit Exchange Issues Statement on Approval of Cascade Care Plan Designs

Washington Health Benefit Exchange (Exchange) board approved the design for Cascade Care plans today. Cascade Care plans are qualified health plans that have a standard health benefit design across health insurance carriers making it easier to understand and offer more value for Washington Healthplanfinder consumers.

Today, Pam MacEwan, CEO of the Washington Health Benefit Exchange, and Ron Sims, the Exchange’s Board Chair, issued the following statement regarding the approval of the designs as a step in implementing Senate Bill 5526 (Cascade Care):

via HealthSource RI:

The clock is ticking on picking the best health insurance plan for 2020. High quality and affordable health coverage is available through HealthSource RI, and Rhode Islanders have until December 23rd to purchase coverage that starts on January 1st.
 
Getting health insurance is even more important this year because coverage is now required in the state of Rhode Island. As of January 1st, residents who don’t have health insurance will pay a tax penalty when filing for the prior year.

AGAIN: The federal shared responsibility requirement (aka the individual mandate penalty) may have been zeroed out by Congressional Republicans, but in addition to the District of Columbia, four states (Massachusetts, New Jersey, California and Rhode Island) have reinstated it at the state level.

A few weeks ago, I did a write-up about a concerning development at HealthCare.Gov: The growing push under the Trump Administration to not only partner with 3rd-party web brokers (which has been done since the first days of the ACA under the Obama Administration), but to actively promote those third-party brokers over HealthCare.Gov itself.

In and of itself, this wouldn't be too problematic as long as people are still ultimately enrolling in fully ACA-compliant policies and receiving ACA subsidies if they're eligible for them. Hell, one of these 3rd-party authorized web brokers even has a banner ad at the top of my website...which I only allow because this particular one only sells on-exchange ACA-compliant policies.

Your Health Idaho doesn't post presse release very often, but when they do it's usually helpful info:

Open Enrollment for Idaho is coming to a close, don’t miss out on enrolling in an affordable health insurance plan! You can set up an account, shop for plans, and apply for coverage online. Visit Apply and Enroll for more information. No computer? No problem. To apply over the phone or to request a paper application, call Your Health Idaho at 1-855-944-3246.

We’re Here to Help!

Your Health Idaho will have extended hours throughout December*:

• December 1 – 6: 7am – 7pm
• December 9 – 13: 7am – 8pm
• December 14 (Saturday): 10am – 4pm
• December 16 – 20: 7am – 8pm
• December 21 (Saturday): 10am – 4pm

This is the perfect opportunity for those Idahoans who were unable to reach us during the busy work week.
*All times are in Mountain Time Zone.

What is an Open Enrollment Period?

This just in from MNsure, the Minnesota ACA exchange:

All private health plans offered on the MNsure marketplace limit the out-of-pocket cost to enrollees for insulin prescriptions in 2020. Each of MNsure's four insurers are offering either low-cost or free insulin benefits, meaning consumers purchasing plans through MNsure will pay no more than 25 dollars per month for insulin.

"The rising cost of insulin has put a huge financial burden on many families across Minnesota," said Nate Clark, MNsure CEO. "It’s so important to have access to insulin at an affordable price. We encourage all those looking for prescription insulin coverage to check out the plan options at MNsure.org."

Just another quick update from AccessHealthCT:

This year, their press release page states the following:

Stats as of December 6, 2019:

Qualified Health Plans (QHP):

• Net Total QHP Enrollment: 99,322
• 2020 OE Acquisition Summary: 10,281

Overall Volume

• Unique Website Visitors: 128,886
• Calls Handled: 119,089

Medicaid: Completed applications/redeterminations processed through the integrated eligibility system: 29,692

I'm assuming this means that they've joined several other state exchanges and are front-loading their auto-renewals of everyone currently enrolled. I'm further assuming that of those 99,322 people, 10,281 of them are new enrollees. If so, that means they'll have to enroll just 11,744 more people over the next four weeks to beat last year's 111,066 total.