While Congress wrestles with budget reconciliation and takes another swipe at the Affordable Care Act, most state lawmakers are back at their day jobs and finished with legislative business for the year. The 2015 sessions produced a few highlights, and some lowlights, for health care advocates. Lawmakers continued to grapple with full implementation of the ACA, but some looked beyond the health care law to move their states toward a health reform 2.0 agenda. Below we note some of the significant work this year in state capitals.
The activity around payment and system reform creates an opportunity to develop interventions that directly address racial and ethnic health disparities. However, some reforms could inadvertently make disparities worse. For example, they could discourage providers from treating sicker, more complex patients, or undermine the financial viability of struggling safety net providers.
Fortunately, some communities are implementing delivery system reforms that reduce health disparities and bend the cost curve. The effective models we describe in this blog series share several features in common.
A new report released last week confirms the findings that enrollment experts emphasized on our teleconference with reporters last Wednesday: We still have a ways to go in getting “hard-to-reach” populations enrolled in health coverage.
Yesterday, two major proposals that would have rolled back the Affordable Care Act’s progress in expanding coverage were defeated by bipartisan majorities, Senate leadership is now pulling together a so-called “skinny” bill, which they hope will attract the 50 votes needed to pass the chamber and move to a conference committee with the House.
The “skinny” bill would likely end selected ACA provisions—the requirement that individuals have health coverage, the employer coverage requirement, and the tax on medical device manufacturers. No legislative language has been released, so we do not know the bill’s precise contents. But the CBO produced a score showing that, if passed, such a bill would immediately cause 14 million Americans to lose their health insurance in 2018 by destabilizing the individual insurance market and sharply increasing marketplace premiums.
Yesterday, President Obama and Department of Health and Human Services Secretary Burwell kicked off the Health Care Payment Learning and Action Network (Network), a network of cross-sector stakeholders focused on quality and costs in the health care system. The network aims to transform our entire health care system—beyond Medicare and Medicaid—from a system that pays for volume to one that pays for quality and value and that actively engages consumers in their own care. More than 2,800 payers, providers, employers, and consumer groups (including Families USA) have registered to participate in the Network.
Health information technology (HealthIT) offers many powerful tools in the fight to eliminate disparities in the delivery of care and health outcomes. From identifying variation in care delivery and outcomes by demographic group to harnessing the power of mobile devices to collect and share health data, the opportunities to leverage HealthIT in the promotion of health equity are plentiful.
Last week, the federal government, for the first time, announced far-reaching regulations banning discrimination in health care. With this historic action, the government is prohibiting discrimination in the provision of health care services based on sex and gender identity. The new regulations announced by the Office of Civil Rights (OCR) in the Department of Health and Human Services (HHS) also expand existing discrimination bans on the basis of disability or health status, race, national origin, age, or language spoken.
With last month’s Supreme Court ruling affirming that the Affordable Care Act (ACA) is here to stay, advocates and decisionmakers can turn to building on the law’s success, such as closing the Medicaid gap, improving the value of care, and eliminating the “family glitch.” Another top priority in this next phase of health reform is making good on the promise of health care for all, regardless of immigration status. Last month, California, the state with the most undocumented immigrants, took a momentous leap in that direction.
At least for the next few months, Congress has shelved its attempts to take health insurance away from tens of millions of people through severe and partisan cuts to the ACA and Medicaid. This extraordinary result is a tribute to consumers and advocates who raised their voices all across the country, in phone calls to Senate and House offices, town-hall meetings, letters to the editor, rallies, and more.
This accomplishment is worth celebrating, but the fight continues. Vital health care priorities are currently up for grabs, in five main areas.
Idaho’s governor wants to roll back insurance coverage in the Gem State to the days when it was more expensive to get health care if you had a pre-existing condition.
Governor Butch Otter and Lt. Governor Brad Little signed an executive order on January 5, directing the Idaho Department of Insurance to create new guidelines for health insurance carriers to sell lower-priced, less-comprehensive coverage plans in the state. The Idaho plan will be getting a lot of attention from other governors across the country who want to get around the requirements of the Affordable Care Act.