So much crazy healthcare policy/legal news is happening this week I'm having trouble keeping up.

This happened yesterday:

BREAKING: federal judge strikes down Kentucky's Medicaid work requirements. Again. Remands them back to HHS

— Nathaniel Weixel (@NateWeixel) March 27, 2019

Same judge also strikes down work requirements in Arkansas

— Nathaniel Weixel (@NateWeixel) March 27, 2019

And since I was too swamped with other stuff, I didn't have a chance to write about it until now. A bunch of other outlets have already posted the details, so here's Dylan Scott of Vox.com to save me the trouble:

A federal district judge has blocked Medicaid work requirements approved by the Trump administration in Arkansas and Kentucky.

There's been so many Big Important Breaking News stories about healthcare this week I haven't been able to keep up. On top of the ACA 2.0 rollout and Trump's kamikaze #TexasFoldEm maneuver via the Dept. of Justice memo and the release of the 2019 Open Enrollment Period report and a major judicial ruling which torpedoed Medicaid expansion work requirements in Kentucky (again) and Arkansas which also had immediate implications for Idaho and Iowa...and potentially other states as well!!

And then, this evening, THIS just happened:

It's been a long time since I last wrote a piece for healthinsurance.org, but the latest chapter in the neverending "GOP attack on the ACA" drama compelled me to do so yesterday.

I left out one tidbit in my latest post, however: There's been a lot of speculation the past two days about the timing of both Trump's DOJ memo formally asking the 5th Circuit Court of Appeals to repeal the entire Affordable Care Act on Monday the 25th and the timing of the House Democrats' ACA 2.0 press conference/bill rollout the very next day on March 26th.

The House Dems announced on Saturday the 23rd that they were scheduling their big ACA 2.0 rollout on Tuesday the 26th.

 

As I'm typing this, the House Energy & Commerce Health Subcommittee is holding markup hearings regarding twelve different healthcare-related bills. The first six relate to prescription drug pricing and regulation, and some of them appear to have genuine bipartisan support.

The other six are directly related to the ACA...these are the six "mini ACA 2.0" bills which cover six of the eleven ACA repairs & improvement provisions included the the larger ACA 2.0 bill introduced yesterday. Here's summaries of all twelve bills being debated today:

 

Most people know that over the past three years, I've gone from being a fan of Vermont U.S. Senator Bernie Sanders to...well, not being a fan; let's just leave it at that. They also know that while I support an eventual move towards a single payer-based healthcare system, I simply feel that it will have to be achieved via incremental steps (preferably large steps, not baby ones).

However, for the past year, I've repeatedly made sure to temper my concerns and criticisms of Sen. Sanders views by making sure to note that Bernie himself cosponsored the Senate version of ACA 2.0 introduced by Sen. Elizabeth Warren, aka the Consumer Health Insurance Protection Act, or CHIPA.

I addressed this point at the time in response to earlier attacks on me by MFA purists:

I need to take a moment here to call out progressives who badmouthed and scolded me last week for promoting the House ACA 2.0 bill by insisting that ONLY Bernie's M4A bill will do, and ANYTHING short of that--even in the short term--is unacceptable.

OK, the House Democrats just wrapped up their press conference at which they officially introduced...The Protecting Pre-Existing Conditions and Making Healthcare More Affordable Act, or #PPECMHMAA.

Just rolls off the tongue, huh?

(sigh) Naming-wise, this is actually worse than the title of last year's ACA upgrade bill ("The Undo Sabotage and Expand Affordability of Health Insurance Act", or #USEAHIA), H.R.5155, which I didn't think was possible.

In any event, last year I went with simply calling it "ACA 2.0", which seems even more appropriate today. Others seem to agree:

The bill Democrats are rolling out to shore up Obamacare is called the Protecting Pre-Existing Conditions and Making Healthcare More Affordable Act. I think @charles_gaba calling it ACA 2.0 is going to catch on pretty quickly.

— Kimberly Leonard (@leonardkl) March 26, 2019

(sigh) I was planning on writing up an in-depth analysis of the 2019 ACA Open Enrollment Period report which was just released by CMS a few hours ago.

Instead, in a bit of sick irony, I have to spend the evening writing about this (via Nicholas Bagley):

The Trump Administration Now Thinks the Entire ACA Should Fall

In a stunning, two-sentence letter submitted to the Fifth Circuit today, the Justice Department announced that it now thinks the entire Affordable Care Act should be enjoined. That’s an even more extreme position than the one it advanced at the district court in Texas v. Azar, when it argued that the court should “only” zero out the protections for people with preexisting conditions.

UPDATE 3/26/19: In light of last night's bombshell announcement that the Trump DOJ is now officially calling for the entire ACA to be repealed in the #TexasFoldEm lawsuit, the wording of yesterday's press release from Trump's CMS division is straight out of 1984 territory:

CMS Issues the 2019 Exchange Open Enrollment Period Final Report
Agency also extends the policy allowing issuers to continue “grandmothered” plans

The Centers for Medicare & Medicaid Services (CMS) today released the Health Insurance Exchanges 2019 Open Enrollment Report. With the Trump Administration’s focus on making healthcare more affordable, the report confirms another successful open enrollment period coinciding with a stabilization of premiums after years of substantial increases. Specifically, the report shows plan selections in Exchange plans in the 50 states and D.C. remained steady at 11.4 million. This represents a minimal decline of around 300,000 plan selections from the same time last year. Also, as outlined in the report, average total premiums for plans selected through HealthCare.gov dropped by 1.5 percent from the prior year, the first decline since the Exchanges began operations in 2014.

A couple of weeks ago, I noted that Colorado is joining over a half-dozen other states in moving forward with their own ACA reinsurance program 1332 waiver request. At the time, I was a bit vague as to just how much the program, if approved, would actually lower unsubsidized premiums, especially since the wording of the bill differentiates between different rating areas:

The Commissioner shall set the payment parameters at amounts to achieve:

NOTE: This was originally posted just before H.R. 1868 was introduced, and was based on a prior version of the legislation from 2018 called H.R.5155. Everything below has been updated to reflect the 2019 version of the legislation in question.

On Saturday, the 9th Anniversary of the Patient Protection and Affordable Care Act being signed into law, the news broke that on Tuesday, House Speaker Nancy Pelosi and other House Democratic leaders will be formally rolling out some sort of major "ACA 2.0" legislation:

Pelosi, House Democrats to Unveil Sweeping Legislation to Protect People with Pre-Existing Conditions and Lower Health Costs

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