On April 18, 2019, the Trump Administration finalized the Notice of Benefit and Payment Parameters for 2020 (NBPP). This rule will govern health insurance marketplaces and set the framework for insurance companies to propose plans and premium rates for 2020. Consumer advocates achieved several important victories in the final 2020 NBPP. Contrarily, the final rule also establishes harmful changes that will decrease access to high-quality, affordable coverage and care for families across the country.
On May 16th, the Centers for Medicare and Medicaid Services announced a final regulation for Medicare’s Part D drug benefit for 2020. The regulation backed off of a proposal that would have created significant exceptions to requirements that Part D plans cover all drugs in six “protected classes”.
High and rising drug prices jeopardize consumers’ health and well-being.1 To address the harms of high drug prices, families across America want and deserve meaningful reforms that target and reduce the underlying “list” prices of drugs. Polling shows that nine out of 10 voters support allowing the government to negotiate lower drug prices in Medicare.2
The Utah Department of Medicaid released its much-anticipated proposal for a Section 1115 Medicaid waiver seeking a “per capita cap” – or a limit on federal spending – on major portions of its Medicaid program. If approved by the Trump administration, it would set a new precedent that could have catastrophic effects for state budgets and Medicaid programs in the future.
The U.S. Department of Health and Human Services has proposed a new rule to severely weaken the Affordable Care Act’s prohibitions against discrimination in health care, and to erase references to protections against discrimination by health care programs on the basis of gender identity or sex stereotype in regulations. These protections are provided under Section 1557 of the Affordable Care Act and its regulations.
On July 9, 2019, the Fifth Circuit Court of Appeals in New Orleans will hear oral arguments in the case Texas v. United States. This case threatens access to health care and financial security for millions of Americans. In December 2018, U.S. District Court Judge Reed O’Connor issued a dangerous ruling that would strike down the entire Affordable Care Act (ACA), including provisions that:
If the Texas vs. United States lawsuit overturns the Affordable Care Act, the veterans who become completely uninsured as a result will outnumber the entire U.S. Army and Marine Corps combined.
Oral Health Coverage in the 2019 State Legislatures: Victories, Budget Cuts, and Opportunities for Future Progress
Comprehensive oral health coverage allows us all to have better oral health, better overall health, and improved quality of life. Yet oral health coverage and care remain out of reach for millions of people in America — particularly adults who rely on Medicare and Medicaid for their health coverage. Many states, however, are realizing and elevating the importance of oral health as they improve dental coverage for adult Medicaid participants.
This brief summarizes 2019 state legislative activity on surprise medical bills.
This summary outlines significant policies that advanced in 2019 addressing prescription drug prices in states all over the country. Advocates and lawmakers can gain a sense of what has been made possible this legislative session, and gain insight into what could come next to tackle high drug prices.