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Politics, Law and Policy Blog

Bipartisan policy insights and political intelligence

Health Insurance Exchanges: State of the States

Posted in Health Policy

By Cindy Gillespie

Health Insurance Exchanges: State of the States update is our weekly report on Health Insurance Exchange developments.

This week, HHS released additional guidance extending the Transitional Policy that gives states and insurers the option of extending non-ACA complaint health plans for an additional two years while Cover Oregon and Oracle signed a 60-day agreement to continue IT work on the Cover Oregon online portal.

Weekly Health Care Wrap-Up

Posted in Health Policy

By Cindy Gillespie

Weekly Health Care Wrap-Up is our weekly look at developments affecting health care at the federal and state levels.

This week, HHS released the final 2015 Notice of Benefit and Payment Parameters rule while the Obama Administration released its proposed budget for HHS, requesting over $1 billion in funding. In it, funding for Medicare and Medicaid alone account for 85% of total HHS spending.

Exempt Organization Attorneys Raise Comments and Concerns to IRS

Posted in Campaign Finance

By Stefan Passantino

Last week, we reported on the bipartisan coalition of lawyers representing tax-exempt 501(c)(4) social welfare organizations that issued joint comments to the Internal Revenue Service (IRS) commending the IRS for attempting to bring additional clarity to political activities by tax-exempt organizations. The comments also highlight the key ways in which current proposed regulatory rulemaking falls short. Among the concerns raised by the bipartisan coalition, the lawyers recommended the following:

Whatever rules are crafted defining political activity should apply as universally as possible throughout the tax code, applying not only to 501(c)(4)s, but also to other 501(c)s, and also applying, to the degree possible, to other matters, including the proxy tax paid by some 501(c) entities under 6033(e) and the denial of a business expense deduction under 162(e)(1)(B).

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Health Insurance Exchanges: State of the States

Posted in Health Policy

By Cindy Gillespie

Health Insurance Exchanges: State of the States update is our weekly report on Health Insurance Exchange developments.

This week, CMS released a bulletin outlining policies that will allow applicants to gain insurance subsidies and retroactive QHP coverage despite the faulty operations of some exchanges and the board for the Maryland Health Benefit Exchange voted to sever its contract with its exchange IT vendor.

Weekly Health Care Wrap-Up

Posted in Health Policy

By Cindy Gillespie

Weekly Health Care Wrap-Up is our weekly look at developments affecting health care at the federal and state levels.

This week, CMS Administrator Marilyn Tavenner announced that CMS will not delay its implementation of the ICD-10 coding system and the Congressional Budget Office released its projection that the bicameral, bipartisan “Doc Fix” bill will cost $138.4 billion from 2014 through 2024.

Recent Treasury and DOJ Marijuana Advisories Likely Not to Result in Increased Activity by Financial Industry

Posted in Colorado, Congress, Legislation (Federal), Legislatures (State)

By David Fine

Twenty states and the District of Columbia currently permit the use of medical marijuana; of those, Colorado and Washington recently legalized its recreational use. Colorado has projected $578.1 million a year in combined wholesale and retail marijuana sales yielding $67 million in tax revenues. Yet, the marijuana business is almost exclusively a cash business because banking services are not available. This is not a surprise as marijuana is still a Schedule I controlled substance (along with heroin and LSD, among others) under the federal Controlled Substances Act (“CSA”), but the cash nature of the business raises significant security and public safety concerns at the very least, and certainly inhibits the growth of the industry from a business perspective.

The marijuana industry and government officials, including Colorado Governor John Hickenlooper and Senator Michael Bennet have pushed for regulations allowing banks to service the marijuana industry. Recently eighteen members of Congress called upon President Obama to instruct Attorney General Eric Holder to delist or reclassify marijuana under the CSA.

On February 14, 2014, the United States Treasury Department Financial Crimes Enforcement Center (“FinCEN”) and the Department of Justice (“DOJ”) issued separate advisories directed at the issue. The FinCen advisory  stated that its purpose was to “enhance the availability of financial services for, and the financial transparency of, marijuana-related businesses.” The advisory focuses mainly on banks’ reporting obligations under the Bank Secrecy Act (“BSA”), including the obligation to file “suspicious activity reports” related to marijuana industry transactions. Continue Reading

The Long Term View: An MLA Public Policy Update on Long-Term Services and Supports

Posted in Health Policy

By Dennis Smith

Dennis Smith previously served as Secretary of the Department of Health Services for the State of Wisconsin and as Director of the Center for Medicaid and State Operations at the Centers for Medicare and Medicaid Services (CMS).

Thomas Jefferson is so well known for his many talents and contributions to the early days of the Republic, it would be difficult to find where to begin to describe them all. February 27 marks an anniversary of one of his most important, but perhaps also one of his least known contributions. On that date in 1801, Jefferson received his newly printed book, A Manual of Parliamentary Practice for the Use of the Senate of the United States. His compilation of parliamentary rulings and guidance for maintaining order and decorum were eventually adopted by the House of Representatives as well.

Congress has grown dramatically since Jefferson presided over the Senate as Vice President, adding staff members to now equal in size the population of many county seats spread across the country. One of those important staff resources is the Government Accountability Office (GAO), an agency that provides Congress with research on every imaginable topic. GAO also provides technical assistance when requested to analyze policy options such as funding formulae. Recently, the agency published a study, Medicaid: Demographics and Service Usage of Certain High-Expenditure Beneficiaries,[1] that provides some eye-opening data on the relatively small number of people who account for a disproportionately large share of Medicaid spending.

One conclusion from the GAO study: narrowly focused cost-saving efforts in Medicaid responsibly aimed at where the preponderance of resources are being spent may yield outsized savings.

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