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Policy and Regulation News

Revised Tax Policies Needed to Reduce Individual Market Premiums

March 8, 2019 - Policymakers should revise current tax policies and work to eliminate financial barriers to health insurance in order to reduce individual market premiums, says a new brief from the Blue Cross Blue Shield Association (BCBSA). Over 14 million people buy health insurance in the individual market, BCBSA noted, including individuals without job-based insurance, workers who aren’t...


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House Joins Senate in Urging Delay of Health Insurance Tax

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Democrats and Republicans from the House of Representatives have joined their Senate colleagues in introducing legislation to delay the ACA Health Insurance Tax for several years. Representatives Ami Bera (D-CA), Josh Gottheimer...

Noncitizens, Lawful Immigrants Much More Likely to Be Uninsured

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Non-US citizens, including immigrants lawfully present in the country, are significantly more likely than citizens to be uninsured, according to new data from the Kaiser Family Foundation (KFF). The uninsured rate for adult undocumented...

Payers, Trade Groups Defend Silver-Loading in Comments to CMS

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Major health payers and representative trade groups are urging CMS not to eliminate the practice of silver-loading, which has been used to stabilize premiums in a volatile and unpredictable market. In response to a request for comments...

Senators Request Payer, Provider Data on Surprise Medical Billing

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Senators from both sides of the aisle have requested information from providers and payers regarding surprise medical billing. In a recently released letter, Senators Bill Cassidy (R-LA), Michael Bennet (D-CO), Todd Young (R-IN), Tom...

Marketing for Short-Term Health Plans May Mislead Consumers

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Websites and brokers that sell short-term health plans as a replacement for ACA-compliant coverage often fail to give consumers the detailed plan information necessary to inform their purchase, according to a study conducted by the Urban...

Price of Insulin Doubles, Increasing Spending for Members, Payers

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Dramatic increases in the price of insulin are driving a rapid uptick in overall spending for diabetes care, according to new data from the Health Care Cost Institute (HCCI). Between 2012 and 2016, the point of sale price for insulin...

CMS Approves Arizona Medicaid Community Engagement Requirement

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CMS has approved Arizona’s request to add a community engagement requirement to its section 1115 Medicaid demonstration project, called “Arizona Health Care Cost Containment System” (AHCCCS). After consulting with Native...

CMS Mulls End of Auto-Reenrollment, Silver Loading in ACA Market

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CMS has issued its proposed Payment Notice for the 2020 plan year, which contains provisions that would significantly alter the operations and structure of the ACA individual marketplace. Continuing a pattern of using CMS regulatory...

NYC Mayor Announces Plan to Guarantee Health Coverage for All Residents

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Mayor Bill de Blasio has announced the launch of a comprehensive, universal healthcare coverage plan that will guarantee benefits for every New Yorker. “Healthcare is a right, not a privilege reserved for those who can afford...

Verma: Price Transparency Rule a “First Step” for Consumerism

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The hospital price transparency mandate that went into effect on January 1 is still ruffling feathers among healthcare providers, leading CMS Administrator Seema Verma to reiterate the importance of giving consumers access to pricing...

CA Governor Addresses Prescription Drug Costs, Healthcare Access

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California Governor Gavin Newsom has announced a series of major executive actions and budget proposals to reduce prescription drug costs and move California closer to the goal of healthcare coverage for all. Newsom’s healthcare...

Hospital Price Transparency Rule Takes Effect January 1, 2019

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Starting January 1, 2019, hospitals will be required to post their price lists online in an effort to increase price transparency and empower consumers to make informed choices about their care. The mandate stems from the 2019 inpatient...

HHS Signals End to Health Plan Identifiers in New Proposed Rule

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Years of pushback from industry stakeholders has motivated an HHS proposal to eliminate a federal requirement for identifying health plans in HIPAA transactions. As everyone prepares to break for the holidays, the federal agency formally...

Better State Policy Needed to Address Social Determinants of Health

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A report on social determinants of health (SDOH) has five recommendations for addressing these important but often overlooked health factors with effective policymaking. The Center for Health Care Strategies (CHCS) recently published...

Coalition of State AGs Challenge Ruling of Unconstitutional ACA

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Following a December 14 ruling stating the Affordable Care Act to be unconstitutional without its individual mandate, attorney generals from 16 states and the District of Columbia filed an expedited motion to bring clarity to the...

TX Judge Rules ACA Unconstitutional in Highly Charged Court Case

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In a highly politically court case brought by a number of Republican officials, US District Judge Reed O'Connor has issued a ruling stating that the Affordable Care Act as a whole is unconstitutional. The ruling stems from the notion...

Trump Administration Touts IPI Model for Reining In Drug Prices

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On average, Americans pay 80 percent more for the costliest physician-administered drugs than patients in other developed countries, according to a key HHS advisor. “Free market advocates and those who have philosophical concerns...

High-Deductible Plans Lead Diabetics to Forgo, Delay Treatment

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Workers with diabetes who switched to high-deductible health plans requiring additional out-of-pocket expenses are more apt to put off necessary check-ups, a new Annals of Internal Medicine study finds. A growing proportion of Americans...

Proposed Rule Seeks Lower Medicare Advantage, Part D Drug Prices

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CMS has opened comments on a proposed rule with the purpose of lowering the cost of prescription drugs and out-of-pocket expenses under Medicare Part C (Medicare Advantage) and Part D. The proposed rule aligns with the Trump...

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