THIS WEEK IN REVIEW: Monday, September 3rd – Friday, September 7th
From quite a few different angles, the biggest news in health policy this week all seemed to touch and concern the Affordable Care Act (ACA). Sure, some major health care mergers and disruptive generic drug start-ups made waves as well, but everywhere we looked this week we saw Obamacare either making the headlines or serving as the subtext. We’re going to unpack all of the details for you in under 1,000 words. Ready…go!
First, health insurance premiums were back in the news after the Associated Press and the consulting group Avalere Health dropped the latest insurance marketplace predictions this week. Based on their estimates, it looks like health insurance marketplace premiums are forecast to see only a modest increase, much less than in recent years. The report projects an average increase of 3.6 percent in proposed or approved premiums for 2019. More than that, the report suggested that the trend of insurers leaving the ACA marketplaces has somewhat reversed, offering more options to consumers for 2019. Still, with the average total premium for individuals covered under the ACA still hovering around $600 per month (before subsidies), there remains a ways to go before the bend in the cost curve spells real insurance premium relief for consumers.
Next, the fight over the ACA’s Medicaid expansion continued in the Mountain States this week. A newly formed Political Action Committee (PAC) called “Work, Not Obamacare PAC” endeavors to convince Idahoans to vote against Proposition 2—the state’s Medicaid expansion ballot initiative. With both supporters and opponents of the ballot initiative spending significant sums of money to influence voters, it looks like the prospects of Idaho becoming the nation’s 34th state to expand Medicaid are unlikely to be determined until the last ballot is cast on November 6th.
In stark contrast to efforts to expand Medicaid, we also received an update this week on the impact of the nation’s first implemented Medicaid work requirements program. In Arkansas, reports emerged that as many as 4,600 individuals lost their Medicaid coverage for the rest of this year after failing to meet the state’s new work requirements. While Governor Asa Hutchinson stood firm in calling on the importance of individual responsibility among Medicaid beneficiaries, these findings only stoked the fire among the three consumer groups (the National Health Law Program, Legal Aid of Arkansas, and Southern Poverty Law Center) who have filed suit against the Trump Administration contending that the Arkansas program runs afoul of Medicaid’s legislative intent.
Speaking of lawsuits, the health care case making the most news this week hails from the state where everything is bigger. Down in the U.S. District Court for the Northern District of Texas, Federal Judge Reed O’Connor heard oral arguments in Texas v. United States—the latest legal effort to invalidate the ACA. In the case, 18 Republican state attorneys general have requested a preliminary injunction to pause ACA operations on the grounds that the recent repeal of the individual mandate—the linchpin of the ACA—renders the entire law unconstitutional. After the Trump administration’s Department of Justice (DOJ) declined to defend the law in court earlier this summer, Democratic attorneys general from 16 states (and the District of Columbia) stepped in to argue that the ACA remains valid. With Wednesday’s oral arguments completed, Judge O’Connor could render his decision any day now—a decision that will almost certainly be appealed all the way up to the United States Supreme Court.
That brings us to our health policy story of the week: the Senate confirmation hearings for Supreme Court nominee, Judge Brett Kavanaugh. While no Supreme Court nomination is entirely focused on any single issue, Judge Kavanaugh’s confirmation hearings have been contentious, dramatic, and packed with health policy implications. With the Texas v. United States case in the pipeline, many Democrats are convinced that Judge Kavanaugh’s confirmation to the Supreme Court would be the death knell for the ACA. Additionally, advocates for women’s reproductive rights contend that Kavanaugh would work to overturn Roe v. Wade—sentiments that intensified after the Judge’s private emails were disclosed on Thursday shedding light on his personal beliefs on abortion and birth control (among other things). With confirmation hearings concluding this afternoon, the Senate Judiciary Committee is likely to vote on the appointment as early as next week. Senate Democrats would need to unanimously vote against Kavanaugh’s confirmation and get the help of two Republican Senators to derail the confirmation and prevent Judge Kavanaugh from being seated before the next session of the Supreme Court begins on October 1st.
Looking to next week, we expect that there is plenty more chatter to be heard about Judge Kavanaugh before the full Senate vote in a few weeks. Additionally, the Senate is set to vote next week on the STOP Act—a bill that focuses on treatment and prevention to combat the Opioid Epidemic. The last two weeks of “summer” are sure to be exciting, so be sure to tune in next week for more Viewpoints!
Student Contributors on this Article:
Marissa Alvarez, Chad Fletcher, Shaina Haque, Virginia Wright