Weekly Health Policy Update: CBO Released Revised Estimates, CHGME Funding Got a Boost, and CMS Announced a New Co-Op
Weekly Health Care Wrap-Up.
CBO Releases Revised Estimates Following Supreme Court Ruling
The Congressional Budget Office (CBO) released revised cost and coverage estimates of the Affordable Care Act (ACA) this week in light of the Supreme Court’s ruling. As expected, the CBO predicts the health law will cover approximately 3 million fewer people than before the Court made the Medicaid expansion optional for states. Specifically, the CBO finds, “In 2022, for example, Medicaid and the Children’s Health Insurance Program are expected to cover about 6 million fewer people than previously estimated, about 3 million more people will be enrolled in exchanges, and about 3 million more people will be uninsured.” In total, the law’s cost was also reduced by approximately $84 billion by the Court’s decision. Read the CBO’s findings here and reactions from the White House and American Action Forum.
House Appropriations Bill Includes Boost for CHGME Funding
In the midst of legislation that cut funding to several HHS programs and eliminated the Agency for Healthcare Research and Quality (AHRQ) entirely, House appropriators tagged $275 million for the Children’s Graduate Medical Education (CHGME) program, $10 million above the Senate level. It is still unclear when or if the full House Appropriations Committee will consider the legislation. Additional information about efforts to fund and reauthorize CHGME is available here.
CMS Announces Latest Co-Op
The Centers for Medicare and Medicaid Services (CMS) announced today that it will loan $69 million to Colorado Health Insurance Cooperative, Inc. to initiate a private non-profit, consumer-governed health insurance company. This announcement marks the latest Consumer Owned and Operated Plan (Co-Op) funded under the ACA. A complete list of Co-Ops can be found here.
From the States
For full coverage of state exchange activities, check out this week’s State of the States: Health Insurance Exchange Developments here.
On Monday, the Republican Governors Public Policy Committee (RGPPC) released a letter seeking specific answers to the 30 questions from their July 10letter to HHS following the Supreme Court ruling. The questions revolve mostly around the implementation of exchanges and the Medicaid expansion. CMS Acting Administrator Marilyn Tavenner responded to the original letter, but did not address many of the questions posed by the RGPPC. In the latest letter, Governor McDonnell urges the Obama administration to consider a report released last summer by the RGPPC, A New Medicaid: A Flexible, Innovative and Accountable Future.
The Patient Centered Outcomes Research Institute released a draft Methodology Report and will accept public comments until September 14. The report outlines the 60 standards for research that the agency will fund.
A new report from the Government Accountability Office examines the IRS “affordability test” used to determine whether or not employer coverage is affordable under the ACA.
Deloitte is out with a new study showing that one in 10 employers will discontinue health insurance for employees under the ACA. Read the story here.
AHIP examines Health Savings Accounts (HSAs) in a new research report, finding that enrollment increased to 13.5 million people in January 2012, with large-group coverage being the fastest growing market. Read the report here.
The New England Journal of Medicine finds that expanded adult Medicaid coverage has lowered death rates in the three states studied, New York, Maine, and Arizona, as compared to three that did not expand. Find more information here.
The Commonwealth Fund announced that David Blumenthal will succeed Karen Davis as the group’s new president, effective January 1. Blumenthal previously served as National Coordinator for Health Information Technology under President Obama.
According to a new GAO report, 16 percent of eligible hospitals and 9 percent of eligible professionals claimed electronic health record incentive payments in 2011. Read the report here.
Health Insurance Exchanges: State of the States update.
This week was relatively slow for exchange watchers as states continue to evaluate whether or not they will establish exchanges and/or expand Medicaid.
Of note this week, Idaho Governor Butch Otter appointed two working groups under the Idaho Health Care Council to evaluate questions related to the Affordable Care Act (ACA). The 26 public and private stakeholders will consider both the Medicaid expansion and the exchange – with Idaho Department of Health and Welfare Director Dick Armstrong leading the Medicaid workgroup and Idaho Department of Insurance Director Bill Deal leading the exchange team. Recommendations are due to the Governor this fall.
In Indiana, Governor Mitch Daniels indicated he would consult his potential successors before making a decision on an exchange, saying, “I don’t consider it right for me or my administration to make such a decision that the next administration then has to implement. So I’m going to have to find some way to get input from the next governor.” Governor Daniels’s second term as governor comes to a close this year. Current candidates for the top spot in the Hoosier state include Republican Mike Pence, Democrat John Gregg and Libertarian Rupert Boneham.
While Nebraska is still undecided on the exchange front, with little exchange action in the state to date, the Department of Insurance this week did post ananalysis by Mercer examining potential essential health benefits options. For a state by state recap of the essential health benefits selection process, check out the chart on the statereforum blog.
Finally, on the private exchange front, Arthur J. Gallagher & Co. announced this week that its benefit consulting division, Gallagher Benefit Services, Inc. (GBS), is partnering with Liazon to offer the Bright Choices Exchange to customers. In his statement, GBS President James Durkin offered his thoughts on the private exchange opportunity, “There will be many different private exchange models and organizations will be interested in them for different reasons. Some organizations may be focused on simplifying a complex benefits administration process, while for others this may be a key piece in helping execute their Total Rewards strategy.” Arthur J. Gallagher & Co. is an international insurance brokerage and risk management services firm with operations in 17 countries.