THIS WEEK IN REVIEW: Monday, Oct. 29th – Friday, Nov. 2nd

November 2, 2018 by B. Cameron Webb, MD, JD

THIS WEEK IN REVIEW: Monday, October 29th – Friday, November 2nd

Welcome back for another edition of Viewpoints! November is coming in hot, so we wanted to jump into your inbox to give you all the latest and greatest health policy news from around the nation! Let’s jump right in….

The 2019 Affordable Care Act (ACA) enrollment season kicked off yesterday with the new twist of stable premiums and increased insurer participation in the ACA exchanges for 2019. Despite those encouraging factors, though, enrollment numbers are expected to stay about the same this year. Several factors likely explain the flat enrollment predictions, such as the removal of the individual mandate penalty, funding cuts for enrollment programs and the availability of cheaper plans not meeting ACA requirements (i.e., short term, limited duration insurance). We should know soon enough if the predictions are accurate, with the weekly enrollment numbers likely to fill headlines in the weeks to come.

In big news out of the Trump Administration, the Centers for Medicare and Medicaid Services (CMS) put the finishing touches on the controversial Patients over Paperwork initiative championed by Administrator Seema Verma. The finalized rule touts immediate relief for clinician burnout by “addressing excessive paperwork and outdated billing practices.” The rule touches on issues ranging from the Physician Fee Schedule to the Quality Payment Program (QPP), and also aims to improve access to care for patients by promoting virtual care. Champions of the rule highlight its potential to improve health information interoperability, and bring down the cost of prescription drugs for Medicare Part B enrollees, as well as revisions that preserve access to care for complex patients and equalize certain payments for primary and specialty care. Much of the earlier controversy surrounding the initiative centered around a proposed evaluation and management (E&M) “payment collapse” for office visit services, but the final rule delayed implementation on these reforms until 2021, allowing time for continued stakeholder engagement. The rule goes into effect on January 1st, but the conversation will continue in months to come.

Also out of CMS this week, the Trump Administration on Wednesday approved Wisconsin’s proposal to impose work requirements. With this latest approval, Wisconsin became the fifth state with approved work requirements, with several more states in line. Of note, Wisconsin is also the first state to compel certain poor residents to disclose behavior such as drinking and exercise to qualify for Medicaid. The state is also looking to charge more to people whose behavior is deemed “risky”. We’ll see if this trend toward health risk assessments catches on as the administration continues to encourage states across the country to innovate in Medicaid.

Insurance exchanges and Medicare reforms notwithstanding, let’s be honest…elections are dominating the public consciousness this week. The stakes are high across the states, as nearly 2.5 million able-bodied, low income Americans could gain access to Medicaid coverage if Democrats win gubernatorial elections in six states (Florida, Georgia, Kansas, South Dakota, Maine, and Wisconsin) on Tuesday. Additionally, voters in Idaho, Nebraska, and Utah also have the chance to approve Medicaid expansion next Tuesday, adding as many as 325,000 more adults to Medicaid rolls across those three states. In Idaho, Republican Governor Butch Otter also endorsed the state’s grassroots-led ballot initiative that would expand Medicaid eligibility to up to 91,000 Idahoans. Meanwhile, Montana’s Medicaid expansion hangs in the balance next week, with big tobacco shelling out big bucks to oppose a ballot initiative that would use a $2 per pack tobacco tax to pay for the expansion beyond 2019.

In elections for the House and Senate all over the country, the healthcare implications are enormous. According to a recent survey, health care is top of mind for many voters heading into the polls. While many Democrats are focusing on access to health care and delivery system reform, Republican candidates have tended to focus more on immigration and the economy. No matter the talking points, the public emphasis on the need for affordable health care is sure to resonate at the polls next week. Democrats are growing increasingly confident in heralding a blue wave that will see them taking control of the House of Representatives in January, while Republicans remain hopeful that they’ll maintain the majority. Heading into the 116th Congress—whether red, blue or purple—health care again looks to be front and center. No matter who takes the reins, we’ll be here….watching.

Thanks for tuning in this week. Don’t forget to get out and vote!

 


Student Contributors on this Article:
Marissa Alvarez, Chad Fletcher, Shaina Haque, Virginia Wright


 

Filed Under: Viewpoints - Week in Review, Viewpoints: Health Policy Blog