DFA Round Up – April 7, 2017

 TAKE ACTION

Though discussions between the White House, the House Freedom Caucus and centrist Republicans continued this past week in an attempt to revive support for the American Health Care Act, the GOP health bill is still in shambles as the House commences a two-week spring recess. Following the cancelled vote, momentum for the AHCA stalled given discordance between different factions within the Republican party. Yesterday, House Republicans introduced an amendment that creates a federal “invisible risk-sharing program,” to reduce premiums in the individual insurance market. The $15B amendment is a form of re-insurance, designed to help states reduce premiums by reimbursing insurers for individuals with high-cost medical conditions. The proposal passed the House Committee on a party line vote; however, it leaves out specific details regarding enrollee eligibility and state funding qualifications. The White House is reportedly working on additional amendments to the billthat would allow states to request waivers to opt out of certain Obamacare insurance regulations, like essential health benefits— a move that the Freedom Caucus has viewed favorably. Discussions are expected to continue during the two-week break, in order to rally enough support for the bill to pass the House thereafter.

Efforts in two states to expand Medicaid were also stalled this week. The Kansas state legislature were unable to override the governor’s veto of Medicaid expansion. And in Virginia, the Republican-controlled House rejected a budget amendment to expand Medicaid, despite significant effort from Democratic governor Terry McAuliffe. Maine, North Carolina and Georgia are among those GOP-led states that are reconsidering their decision to not expand Medicaid. In other state-related news, new Centers for Medicare & Medicaid Services administrator Seema Verma has stated that she will recluse herself from the decision to grant Kentucky a waiver request that would allow the state to remake its Medicaid program, which is modeled closely to the plan Verma designed for Indiana. The decision could make Kentucky the first state in the country to require Medicaid recipients to work in order to qualify for health coverage.

As the deadline for insurers to submit exchange participation applications approaches, AHIP and other insurance industry groups remain concerned about the future of the Obamacare cost-sharing subsidies. This funding issued to insurers to subsidize exchange customers’ out-of-pocket costs are not guaranteed next year, as the administration decides how to handle the House Republican’s court case challenging the legality of cost-sharing subsidies. House Speaker Paul Ryan has stated that he expects the funding to continue; however, some advisers believe that funding should cease. Meanwhile, insurers are still wavering on their participating in the individual market. Aetna has announced that it will exit from the Iowa individual exchange marketplace. This decision came soon after Wellmark Blue Cross and Blue Shield, Iowa’s dominant insurer, also retreated from the individual marketplace, leaving many Iowa counties with only one insurance option.

Lastly in the pharmaceutical sector, companies learned of a new effort by the Medicare Payment Advisory Commission to change the way in which drugs are paid for under Medicare Part B. The Commission voted 15-0 to recommend that Congress enact new drug reimbursement lawsthrough several proposals that would decrease Medicare spending by as much as $750M in the first year of implementation, and $5B over five years. Pharmceutical companies and providers have previously succeeded in lobbying against a similar attempt to change reimbursement laws under the Obama administration.

MEMBERS IN ACTION

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March for Health

New York

Dr. Bruce Rector, New York State Director and Co-chair of the DFA Drug Pricing, Value, and Affordability Campaign, shares that on Saturday, April 1st, DFA-NY members marched with other physicians from our New York physician advocacy coalition, nurses, patients and union members to deliver a strong, unified message on the need for equitable and affordable access to high-quality healthcare for all. Speakers shared powerful stories on how the ACA benefited them as women, people with disabilities, people with mental health problems, LBGTQ members, freelance employees, veterans and more. Local politicians joined them on stage to speak about the need for equitable health care for all and DFA-NY member, Kamini Doobay, passionately spoke about the need to dismantle racism in healthcare.

Washington

Dr. Lisa Playmate, Washington State Director, also spoke at a March for Health rally in Washington. During her remarks she said, “When we moved to Seattle 10 years ago, I decided to follow my passion and go where I was most needed.  I first went to eastern WA, to work with migrant workers in a federally funded community clinic; we did not ask for citizenship papers, and most of patients were in subsidized programs.  I then worked for a special clinic in Rainier Valley, where our patients were frail, elderly, complex and poor – eligible for both Medicare and Medicaid.  I cannot imagine how any of the patients I saw in either of those places could have been seen under the repeal plan.”

KEY ARTICLES

New York Times: Neil Gorsuch confirmed to the United States Supreme Court