Efforts to shift to a value-based health care system create an opportunity to improve the quality of care and health outcomes, save money for consumers and the health care system as a whole, and drive reductions in health disparities. But such positive outcomes from payment and delivery reform efforts are not guaranteed. There are some elements of this proposed rule that can help reduce health disparities, but a real commitment to health equity requires additional steps from CMS.
Recently, there’s been news coverage of the Trump Administration’s latest attempts to undercut enrollment in the exchanges by cutting many of the outreach, education, and enrollment activities that took place during prior open enrollment periods. But these are merely new tactics in the administration’s ongoing effort to sabotage the Affordable Care Act (ACA). These tactics—some questionable in their legality—are unlikely to stop before the next open enrollment period.
Connecticut just took an important step toward improving health outcomes for its most vulnerable residents. Earlier this summer, the governor signed a law that lays the foundation for the broader use and support of community health workers (CHWs).
Community health workers play a valuable role in helping people achieve better health. Because they are trusted community members, they are uniquely effective at connecting underserved communities to the health care system and helping people navigate social factors that pose barriers to good health. In doing so, CHWs help to improve health outcomes and narrow health disparities.
After the most recent collapse of Senate efforts to repeal the Affordable Care Act (ACA), many in Congress, on both sides of the aisle, see an opening for bipartisan health reform. Rather than take insurance away from tens of millions of Americans through sweeping legislation rushed through on a straight party-line vote, some lawmakers now propose to stabilize health insurance markets through careful, bipartisan policymaking.
To help people who currently receive health coverage through the individual insurance market, a well-constructed stabilization package could slow the rise of premiums, guarantee financial assistance, and increase the availability of meaningful health insurance options.
For months, President Trump has been threatening to cancel so-called called “cost-sharing reduction” payments, or CSRs. This is apparently part of his brazen strategy to “implode” health insurance marketplaces and force Democrats to negotiate about the Affordable Care Act’s (ACA) future. CSR payments cover insurers’ cost of lowering deductibles and other out-of-pocket costs for almost 6 million marketplace enrollees in low-wage, working families.
On August 15, the Congressional Budget Office (CBO) released its analysis of what would happen if CSR payments were eliminated.
Iowa has asked the federal government to approve a proposal to make troubling changes to its marketplace that will increase coverage costs for low- and middle-income Iowans. It essentially takes federal funds intended to help people afford the cost of health insurance and uses them to pay insurance companies and to offer subsidies to relatively high-income people. The risky and harmful proposal fails to meet key requirements and should be rejected.
Several states are now pursuing 1332 waivers. We have heard about several helpful proposals, and at least one that is troubling.
On the positive side, Alaska’s reinsurance waiver was recently approved. This waiver will allow Alaska to pass through federal savings resulting from the state’s reinsurance system. Partly as a result of this system, Alaska’s individual market insurer has proposed a 22 percent reduction in premium rates for next year.
Congress has left D.C. for the summer without passing legislation to repeal the Affordable Care Act (ACA) or cut Medicaid. Leadership and rank-and-file representatives and senators on both sides of the aisle appear to be looking past the repeal fight that has embattled Congress for the past year and looking ahead toward efforts to stabilize the insurance market. Are these overtures of bipartisanship to be believed? Are the ACA and Medicaid finally safe? As always, it’s complicated.
Coming off the Senate failure to repeal the Affordable Care Act (ACA) last week, President Trump has threatened an immediate cutoff of payments to insurance companies that support the reductions in the amount lower-income people must pay out of their own pockets for their marketplace plans. The president threatened to stop these cost-sharing reduction (“CSR”) payments both personally via Twitter and through multiple administration representatives.
We always believed in our hearts that it would not be possible for Congress to pass repeal—that we could stop these harmful efforts because too many people rely on the Affordable Care Act and Medicaid for it to be so easy to rip coverage away through a sweeping piece of legislation.