LAST WEEK IN REVIEW: Monday, Nov. 6th – Friday, Nov. 10th
From legal battles to administrative rules to elections, the heat was all the way up last week in health policy. Following up on the Trump Administration’s roll backs of the Affordable Care Act’s (ACA) birth control mandate, attorneys general in five states (including Virginia) filed an injunction last Thursday to halt the implementation of the new rules. All five states were recently on the losing end of another lawsuit two weeks ago, where they filed suit to compel the Administration to continue making the cost-sharing subsidy payments for low-income enrollees through the ACA health insurance exchanges.
Speaking of the exchanges, we made it through the first week of the six-week open enrollment period, and the results were surprising to many. Rather than the predicted decreases in enrollment due to a reduced healthcare.gov marketing budget and uncertainty surrounding the marketplace, Americans actually showed up to sign up for coverage en force. With approximately 600,000 people enrolling in the first week, it was the biggest start to open enrollment to date.
Among the more controversial matters this week, the Centers for Medicare and Medicaid Services (CMS) published its 2018 Medicare Outpatient Prospective Payment System (OPPS) final rule. In addition to increasing payment rates to providers and updating hospital quality reporting measures, the rule notably reduces payments to hospitals for certain Medicare Part B drugs purchased through the 340B drug program—an estimated $1.6 billion cut. Created in 1992 to provide outpatient drugs to eligible health care entities at discounted prices, the changes to the 340B program would result in payments to providers that are 22.5 percent less than the average sales price (ASP) for drugs, rather than the current rate of ASP plus 6 percent. While the Medicare Payment Advisory Commission (MedPAC) has long proposed this rate change, a strong coalition of health care organizations is coalescing to fight the rule. Led by the American Hospital Association and the Association of American Medical Colleges, opponents of the rule fear that it will threaten access to healthcare for many patients.
Finally, last week’s election yielded some exciting developments with implications for the future of American healthcare. First, exit polls from the Virginia election—which resulted in the election of Democrat Ralph Northam as Governor—found that four out of 10 Virginians felt healthcare was their top issue. Also, Maine voters became the first state to successfully use a ballot referendum to expand their Medicaid program. This last development leads us to our focus for tomorrow’s Spotlight: the prospects for Medicaid’s future.
Student Contributors on this Article:
Marissa Alvarez, Chad Fletcher, Shaina Haque