Supreme Court Will Hear Challenge to Affordable Care Act
The U.S. Supreme Court decided to review Texas v. United States, the court case challenging the constitutionality of the Affordable Care Act (ACA). A ruling in favor of the plaintiffs would invalidate the entire law, leaving an estimated 20 million people uninsured. It is unclear how the timing will align with the November elections.
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Update on ACA Legal Status
The U.S. Supreme Court is set to decide whether to expedite a review of Texas v. United States, the court case challenging the constitutionality of the Affordable Care Act (ACA). A ruling in favor of the plaintiffs would invalidate the entire law, leaving an estimated 20 million people uninsured ahead of the November 2020 elections. […]
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Court Rules in Favor of Limited Coverage Plans
Late last month, a federal judge upheld a Trump Administration regulation to allow the sale of bare-bones, short-term health plans that are exempt from critical health coverage provisions in the Affordable Care Act (ACA). The 2018 regulation, which went into effect in August that year, promotes the sale and allows for an extended duration of these short-term plans. These plans will continue to be sold in direct competition with ACA-compliant marketplace plans.
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GAO Report: Congress Can Undo Trump Administration ACA Waiver Guidance
Congress has the authority to review and overturn Trump Administration guidance on state innovation waivers according to a report released this week by the Government Accountability Office (GAO). The guidance from the Department of Health and Human Services (HHS), issued last October, relaxed requirements around Section 1332 waivers, the Affordable Care Act’s (ACA) vehicle for states to make changes to their individual insurance markets. GAO’s opinion states that the guidance is subject to review by Congress and can be overruled with a simple majority vote in both chambers.
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Federal Judge Rules Against Association Health Plans
A final rule released last year that allowed for the proliferation of association health plans (AHPs) that do not comply with requirements in the Affordable Care Act (ACA) was ruled illegal by a District Judge last week. AHPs allow small businesses and trade groups to band together to purchase health insurance plans that are exempt from many critical ACA consumer protections, such as the requirement to provide certain health benefits which include mental health and substance use disorder treatment, and to do so at parity with physical and surgical health benefits. The National Council applauds U.S. District Judge John D. Bates for reversing these harmful AHPs.
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Court Ruling Creates Uncertainty for ACA
Late last week, Judge Reed O’Connor found the Affordable Care Act (ACA) to be unconstitutional following Congress’ repeal of the individual mandate penalty in 2017. Most importantly, the law remains in effect pending what is likely to be a lengthy appeals process. Nonetheless, the ruling will likely have significant impacts on the health care debate in Washington and around the country. The decision is expected to be appealed to the Court of Appeals for the Fifth Circuit, which will likely consider it at some point in 2019, and the case could eventually be heard by the Supreme Court.
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Trump Administration Unveils More Options for States to Bypass ACA
Late last week, the Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced four new Section 1332 state innovation waiver concepts for states to make changes to their individual insurance markets (fact sheet). The new waiver concepts build on the recently issued CMS guidance on Section 1332 waivers, under which CMS aims to strengthen states’ authority to shape their health insurance markets. The Administrator stated in her keynote address at the States and Nation Policy Summit of the American Legislative Exchange Council (ALEC) that it was a mistake to federalize so much of health care policy under the Affordable Care Act (ACA), and that the new concepts are “designed to illustrate how states can waive certain ACA provisions under section 1332 of the law and develop alternatives to the ACA’s otherwise one-size-fits-all approach.”
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Health Care Emerges as Top Issue in Midterms
With historic levels of voter turnout, Tuesday’s midterm election results saw Democrats regain control of the House of Representatives, while Republicans strengthened their majority in the Senate. Health care emerged as a clear priority for voters and Medicaid expansion proved to be a big winner on election night. With power now divided in Congress, the next two years could feature intense political gridlock or force bipartisan compromise. Right now, one thing is clear – the 2018 midterms will send one of the largest classes of freshmen Members to Washington in recent history – and with them come new advocacy opportunities for the National Council and its members.
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Final Rule Expands Health Plans Exempt from Affordable Care Act
Beginning in October, bare-bones, short-term health plans that are exempt from critical coverage provisions of the Affordable Care Act (ACA), will become more widespread in the insurance market. A final rule issued this week by the Departments of Health and Human Services (HHS), Labor and Treasury would permit the sale of limited health coverage plans that expose consumers to more risks and potentially larger medical bills when seeking critical care. The National Council strongly opposes any moves that undermine the availability of comprehensive coverage, including mental health and addiction benefits offered at parity.
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Administration Continues Pushing for Medicaid Work Requirements
The Trump Administration intends to continue approving states’ requests to institute work requirements on Medicaid enrollees, despite a recent court ruling that set such efforts back. In an address last week, Health and Human Services (HHS) Secretary Alex Azar said the administration is ‘undeterred’ after a federal judge blocked Kentucky’s Medicaid work requirements last month. This move invalidated the Centers for Medicare and Medicaid Services’ (CMS) approval of an 1115 Medicaid waiver to redefine eligibility for the public program in Kentucky.
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Trump Administration Finalizes Association Health Plan Rule
This week, the Trump Administration released a final rule that would allow small businesses and trade groups to band together to purchase health insurance, known as “association health plans”. This move is strongly opposed by the National Council because it will expose more consumers to limited coverage health plans, including plans that lack mental health and substance use disorder (SUD) benefits. This final rule is the result of a 2017 executive order President Trump signed that directed federal agencies to loosen restrictions on association health plans (AHPs) and short-term health insurance to create less comprehensive coverage options.
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New Report Shows Mental Health/SUD Parity At Risk
The National Alliance on Mental Illness (NAMI) recently released a report “Mental Health Parity at Risk” highlighting disparities in health coverage for behavioral health services. Parity ensures that patients have access to health plans that cover mental health and substance use disorder treatment, in addition to medical/surgical services, and that they are not charged more for using such services. The report finds that parity was very weak prior to the passage of the Affordable Care Act’s (ACA) consumer protections, which limited consumers’ access to treatment. The report underscores how current efforts to weaken the individual insurance market could mean returning to a time when Americans with behavioral health conditions could be denied coverage or offered coverage that excludes services they need.
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Trump Administration Declines to Defend ACA, Urges Repeal of Pre-existing Conditions Protections
The Department of Justice (DOJ) has declined to defend the Affordable Care Act (ACA) from a challenge by 20 GOP-led states, and instead asked a Texas court to invalidate many of the law’s key insurance reforms, including its prohibition against discriminating against persons with pre-existing conditions. The Texas court will likely render a decision in the coming months. Legal experts suggest that this decision does not put the law into immediate jeopardy as any decision handed down by the court will likely be challenged and appealed to the Supreme Court.
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Marketplace Stabilization Package Stalls Amid Rising Premiums
After seven months of bipartisan negotiation, Senate Health, Education, Labor and Pensions Committee leaders abandoned efforts to stabilize the individual insurance market for this year. Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) had been working since the fall on legislation to restore cost-sharing reduction payments to insurers – key payments that lower the cost of health insurance on the individual market.
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Budget Update: FY2018 Budget Not Finalized Yet, Deadline Looms
As the March 23rd government funding deadline inches closer, members of the House and Senate continue their slow move toward a bipartisan agreement on spending levels for the remainder of Fiscal Year 2018. At the time of this writing, text of the spending bill is not expected until next week and lawmakers are likely to leave town for the weekend. Congress has until March 23rd to approve a budget deal to avert another government shutdown.
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HHS Releases Rule on Short-Term Health Plans
This week, the Trump Administration issued a proposed rule to expand the availability of short-term health insurance coverage. This move would expose more consumers to limited coverage health plans, including plans that lack mental health and substance use disorder benefits. The proposed rule comes from an executive order President Trump signed in October 2017 that directed federal agencies to loosen restrictions on short-term health insurance and association health plans to create less comprehensive coverage options.
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Trump Talks ACA, Drug Prices and Opioids During SOTU
Tuesday evening, President Donald Trump used his first State of the Union address to tout repeal of the Affordable Care Act’s (ACA) individual mandate, reiterate his promise to reduce prescription drug prices and vow to address the opioid epidemic with an enhanced focus on criminal justice. Although the speech lacked health care specifics, the address did serve to highlight President Trump’s most pressing health care priorities heading into his second year as Commander-In-Chief.
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Senate Approves Azar as HHS Secretary
The Senate voted to confirm former pharmaceutical executive Alex Azar as the new Secretary of Health and Human Services (HHS) on Wednesday. Six Democrats and Independent Sen. Angus King (I-ME) joined all but one Republican Senator in supporting Azar. As the nation’s top health official, Azar will oversee critical health programs like Medicaid and Medicare and take over the implementation of the Affordable Care Act (ACA). Azar’s confirmation gives HHS its first permanent leader since September, when former Secretary Tom Price resigned due to a scandal regarding his use of public funds for travel.
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Congress Set to Pass Another Funding Extension To Avoid Shutdown
For the fourth time in as many months, Congress is faced with another government funding deadline. With a potential shutdown looming, Congress is expected to pass another short-term spending bill today that would keep the government open until mid-February. On the health care front, the spending deal would renew funding for the Children’s Health Insurance Program (CHIP) for six years and delay some Affordable Care Act (ACA) taxes. The stopgap spending bill has passed the House, but faces an uncertain future in the Senate.
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Leaked Memo Details Trump Administration’s ACA Plans
A Trump Administration memo detailing plans to dismantle provisions of the Affordable Care Act (ACA) through executive action was made public last week. Released by Senate Democrats, the one-page document lists ten possible points of action to follow up on the President’s 2017 Executive Order to reduce the “economic burden” of the ACA. A number of the initiatives have already been enacted, while others, including weakening the essential health benefits requirement, are currently being considered.
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