THIS WEEK IN REVIEW: Monday, Jan. 15th – Friday, Jan. 19th
At midnight tonight, the government has the potential to shutdown for the first time since 2013. It is still unclear whether GOP leaders will include funding for the Children’s Health Insurance Program as part of the new funding bill which is one main point of contention. The Committee Chairman, Orrin Hatch (R-Utah) has begged Senate Democrats to “stop holding CHIP hostage.” Currently there are 16 states (including Virginia) that are projected to run out of federal funding for CHIP by the end of this month.
Continuing on the state level, a recent statewide poll revealed that 83% of Virginians are in favor of expanding Medicaid. This support comes after years of opposition from a Republican-controlled legislature. After November’s elections left control of the house too close to call, Republican David Yancey eventually won the seat after his name was drawn out of a bowl to end the tie, maintaining control of the legislature in favor of Republicans. So, despite the widespread support, it remains unlikely that Virginia will expand its program as of yet.
Nine states are also in the midst of awaiting approval for requiring community engagement activities in order for able-bodied beneficiaries to be considered eligible for Medicaid. The Trump Administration’s decision to approve these “work requirements” for Kentucky’s Medicaid program has sparked concern that the program will leave behind Medicaid beneficiaries who are unable to find or keep work. While these “work requirements” may also impose administrative burdens that can cause Medicaid recipients to lose coverage, Kentucky officials argue that the changes will give beneficiaries “more dignity and promote personal responsibility.” However, current Senate Democrats are questioning the legality of these requirements.
Yesterday, the Department of Health and Human Services announced a new policy that will protect the religious and moral freedoms of health workers. This includes a new division under the Office of Civil Rights that will investigate complaints pertaining to acts that violate employee’s religious rights or if the individual felt discrimination from their refusal of services. This decision to protect religious freedom is a big win for Trump’s Republican base, but reverses an Obama-era policy that allowed healthcare workers to refuse to treat people seeking abortions or transgender individuals. Following the recent contraception mandate, it is clear that the conversation surrounding the relationship between religious freedom and health will continue to be on the forefront of health policy legislation.
Finally, late last week, the Medicare Payment Advisory Commission (MedPAC) voted in favor of recommending Congress eliminate the Merit-based Incentive Payment System (MIPS). MIPS—one of two new Medicare payment models under the Medicare Access and CHIP Reauthorization Act (MACRA)—is an individual clinician-level payment adjustment based on quality, cost, advancing care information, and clinical practice improvement activities. MedPAC outlined concerns for MIPS stating it is “burdensome and complex” and “replicates flaws of prior value-based purchasing programs.” Instead MedPAC recommend the Voluntary Value Program (VVP), which would include an across-the-board withhold for fee schedule payments and performance assessment rooted in three specific categories. Be on the lookout for the CMS response to MedPAC’s recommendation.
With MIPS hanging in the balance, check out this week’s Viewpoints guest blog where Dr. Rick Mayes, Professor and Chair of the Healthcare Studies Program at the University of Richmond, discusses MACRA and its influence on physicians.
Student Contributors on this Article:
Marissa Alvarez, Chad Fletcher, Shaina Haque, Virginia Wright