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Featured Content

Insurance Coverage: Waivers

Tennessee Block Grant Waiver Summary

December 03, 2019

On November 20, 2019, Tennessee submitted a Section 1115 waiver application to CMS, which, if approved, would implement a block grant for the state’s Medicaid program, TennCare.

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Recently Approved 1332 Waivers

Insurance Coverage: Waivers

Recently Approved 1332 Waivers

October 16, 2019

Section 1332 of the ACA allows states apply for waivers requesting authority to amend ACA provisions in the individual and small group market place.  A 1332 wavier grants the states flexibility in ensuring the stability of fragile insurance markets and address unique state insurance issues. As of October 2019, 13 states received approval to implement…

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Idaho 1115 Waiver Application

Insurance Coverage: Waivers

Idaho 1115 Waiver Application

October 11, 2019

On September 27, 2019, Idaho submitted a new section 1115 waiver application to CMS. Please find our summary of key points of the waiver.

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Tennessee 1115 Waiver Application

Insurance Coverage: Waivers

Tennessee 1115 Waiver Application

September 20, 2019

On September 17th, 2019, Tennessee released its proposal to implement a black grant for Tennessee’s Medicaid program, otherwise known as TennCare.  This 1115 waiver, referred to as “Amendment 42,” would convert the federal share of the state’s Medicaid funding for most services into a block grant.

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Insurance Coverage: Waivers

Montana 1115 Waiver Application Summary

September 17, 2019

Montana submitted a new 1115 waiver application to CMS on August 30, 2019. The waiver is pending approval.

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Insurance Coverage: Regulation

Recent State Action Relating to Medicaid Expansion

September 12, 2019

We have highlighted recent state grassroots, legislative and executive action to expand Medicaid.

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Utah Medicaid Waivers

Insurance Coverage: Waivers

Utah Medicaid Waivers

August 28, 2019

CMS has approved Utah’s 1115 waiver, implementing a “bridge plan” while the state submits additional waivers.

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New York 1115 Waiver Application Summary

Insurance Coverage: Waivers

New York 1115 Waiver Application Summary

August 15, 2019

On August 9, 2019, New York announced it will submit a Section 1115 Medicaid Demonstration waiver application to CMS to provide Medicaid services to certain incarcerated individuals about to be released from county jails and New York State prisons.

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CMS Approves Colorado and North Dakota 1332 Waiver Applications

Insurance Coverage: Waivers

CMS Approves Colorado and North Dakota 1332 Waiver Applications

August 12, 2019

On July 31, 2019, the Centers for Medicare and Medicaid Services (CMS) approved Section 1332 waiver applications for Colorado and North Dakota to implement state reinsurance programs. Below is a summary of the waivers.

ORIGINAL ANALYSIS

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Insurance Coverage: Congress

House E&C Committee Holds Markup of Surprise Billing Bills

July 12, 2019

The House E&C Health Subcommittee held a markup of several bills, including the No Surprises Act (H.R. 3630), which addresses surprise billing.

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Insurance Coverage: Legislation

HELP Committee Moved Forward with Cost Containment Bill

June 20, 2019

A day after a hearing on the HELP Committee’s cost containment discussion draft, the Lower Health Care Costs Act, committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) released an updated version of the bill (S. 1895) along with a notice that the committee will hold a markup of the legislation on June…

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Insurance Coverage: Regulation

Final Rule Issued on Health Reimbursement Arrangements

June 14, 2019

The Departments of the Treasury, Health and Human Services (HHS), and Labor published the final rule Health Reimbursement Arrangements and Other Account-Based Group Health Plans. This rule expands health reimbursement arrangements (HRAs). Under the rule, employers can provide employees with tax-preferred funds to purchase coverage on the individual market through individual coverage HRAs. Additionally, the…

EXTERNAL LINK

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Insurance Coverage: Congress

Ways and Means Holds Hearing on Medicare for All

June 13, 2019

The House Ways and Means Committee held a hearing on Medicare for All, the first time a committee with health care jurisdiction has considered the policy. In addition to voicing support for the Medicare for All Act, many Democrats also brought up other proposals to expand coverage, such as lowering the Medicare eligibility age, creating…

EXTERNAL LINK

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South Carolina 1115 Waiver Application Summary

Insurance Coverage: Waivers

South Carolina 1115 Waiver Application Summary

June 11, 2019

On May 8, 2019, South Carolina submitted a new 1115 waiver application to the Centers for Medicare and Medicaid Services (CMS). The waiver includes work requirements, expands coverage for children, pregnant women and parents, and expands coverage for certain individuals with substance use disorders, who are chronically homeless or who are involved in the justice…

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Utah Per Capita Cap 1115 Waiver Summary

Insurance Coverage: Waivers

Utah Per Capita Cap 1115 Waiver Summary

June 06, 2019

On May 31, 2019, Utah released its 1115 waiver proposal, “Per Capita Cap.” This waiver requests authority to implement the provisions of Senate Bill 96 “Medicaid Expansion Adjustments”, which passed during the 2019 Utah legislative session.  Provisions of the waiver include implementing a per capita cap, seeking enhanced Federal Medical Assistance Percentages (FMAP) for the…

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Insurance Coverage: Legislation

Senate Dems Introduce Choose Medicare Act, Public Option

May 01, 2019

Senators Jeff Merkley (D-OR), Chris Murphy (D-CT), and Dianne Feinstein (D-CA) introduced the Choose Medicare Act, which would allow for any individual who is not already enrolled in Medicare or Medicaid to enroll in Medicare as an individual. This would be known as Medicare Part E and would be offered on all state and federal…

EXTERNAL LINK

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Insurance Coverage: Legislation

House Dems Introduce Medicare for America Act, Expanding Coverage in Medicare and Medicaid

May 01, 2019

Representatives Rosa DeLauro (D-CT) and Jan Schakowsky (D-IL) introduced the Medicare for America Act. The bill would expand coverage in Medicare and Medicaid to include prescription drugs, dental, vision, hearing, and long-term support services. Those who are uninsured or do not have employer-sponsored health insurance, including those in the individual marketplace, would be auto-enrolled into…

EXTERNAL LINK

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Insurance Coverage: Legislation

Montana Passes Bill to Continue Medicaid Expansion

May 01, 2019

The Montana state legislature passed a bill to continue Medicaid expansion in the state, adding new community engagement requirements. Montana’s expansion, which was first passed in 2015, extends Medicaid coverage to those earning up to 138 percent of the federal poverty level. Beginning July 1, 2020, qualifying beneficiaries age 19 to 55 will be required to complete…

EXTERNAL LINK

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Insurance Coverage: Congress

Senate HELP Committee Holds Second Hearing on Electronic Health Information Implementation

May 01, 2019

The Senate HELP Committee will hold its second hearing on implementing the electronic health information provisions of the 21st Century Cures Act. Don Rucker, National Coordinator for Health Information Technology at the Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) Chief Medical Officer Kate Goodrich will be testifying.

EXTERNAL LINK

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Insurance Coverage: Legislation

House Appropriations Committee Holds First Subcommittee Markup

May 01, 2019

The House Appropriations Committee will hold the first subcommittee markup of the year next week: Labor-HHS-Education.

EXTERNAL LINK

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Insurance Coverage: Legislation

House Rules Committee to Hold Medicare for All Hearing

May 01, 2019

The House Rules Committee will hold a hearing on Medicare for All proposals, the first time this concept will be in the spotlight.

EXTERNAL LINK

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Insurance Coverage: Budget Information

CBO Releases Single Payer Analysis

May 01, 2019

The Congressional Budget Office has released an analysis of single payer policy approaches.

EXTERNAL LINK

The First 100 Days: House Health Policy Recap

Insight: original analysis

The First 100 Days: House Health Policy Recap

April 15, 2019

Let me count the ways to 100. 1. Affordable Care Act. 2. Insurance Expansion. 3. Drug Pricing. 4. Surprise Billing. 5… Ok, maybe let me count to four.

ORIGINAL ANALYSIS

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Insurance Coverage: Legislation

Democratic Senators Introduce the Medicare Choice Act

April 08, 2019

This legislation would allow anyone to buy Medicare plans, an option they say is more realistic than Medicare for All.

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Insurance Coverage: Waivers

Utah Medicaid 1115 Waiver Summary

April 03, 2019

On June 22, 2018, Utah submitted an 1115 waiver amendment to CMS seeking to implement a partial and capped Medicaid expansion, as well as Medicaid work requirements for certain populations. Following that waiver amendment, on February 6, 2019, Utah submitted an additional 1115 waiver amendment lifting the Medicaid Institution for Mental Disease (IMD) exclusion for…

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Insurance Coverage: Waivers

Kentucky and Arkansas Work Requirements Blocked

March 29, 2019

U.S. District Judge James Boasberg ruled that the federal government failed to justify adding work requirements to Kentucky and Arkansas’ Medicaid program. Both decisions remand the Arkansas and Kentucky waivers back to HHS.

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Insurance Coverage: Litigation

Judge Strikes Down Association Health Plans

March 29, 2019

On Thursday, a federal judge blocked the Trump Administration’s final rule to expand Association Health Plans (AHP). The judge noted that the “Final Rule exceeds the statutory authority delegated by Congress in ERISA.”

EXTERNAL LINK

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Insurance Coverage: Waivers

Ohio Section 1115 Waiver Approval

March 19, 2019

On March 15, 2019, CMS approved Ohio’s Medicaid 1115 waiver, allowing the state to implement work requirements for certain Medicaid recipients.

ORIGINAL ANALYSIS

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Democrats Launch Investigation on STLDI

Insurance Coverage: Congress

Democrats Launch Investigation on STLDI

March 15, 2019

House Committee on Energy and Commerce Democrats have launched an investigation into Short-Term, Limited Duration Insurance plans.

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Section 1115 Guidance

Insurance Coverage: Waivers

Section 1115 Guidance

March 15, 2019

On March 14th CMS published tools and guidance for states on how to monitor and evaluate 1115 waivers that implement work requirements, require monthly premiums, implement premium assistance programs, waive retroactive eligibility, or implement non-eligibility periods for failing to meet requirements. Additionally, CMS published monitoring and evaluation guidance and tools for states that are implementing…

EXTERNAL LINK

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Insurance Coverage: CMS

State Innovation Waivers for ACA

March 06, 2019

EXTERNAL LINK

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Section 1115 State Waivers List

Insurance Coverage: CMS

Section 1115 State Waivers List

March 06, 2019

The Centers for Medicare and Medicaid Services Section 1115 demonstration waiver portal.

EXTERNAL LINK

Five Unanswered Questions on the Medicare for All Act

Insight: original analysis

Five Unanswered Questions on the Medicare for All Act

March 06, 2019

On February 27, 2019, Representative Pramila Jayapal (D-WA) and more than 100 co-sponsors in the House of Representatives introduced the Medicare for All Act (HR 1384). The bill, like its predecessors, creates a single payer, government-funded health care program. The new program would cover enumerated medical benefits, prescription drugs, vision, dental, mental health and substance…

ORIGINAL ANALYSIS

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Actuaries Weigh in on Expanding Public Insurance

Insurance Coverage: Stakeholder Engagement

Actuaries Weigh in on Expanding Public Insurance

March 04, 2019

An American Academy of Actuaries report out today breaks down criteria and implications for “Medicare for All” and less sweeping approaches, including Medicare and Medicaid buy-ins.

POST

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Medicaid Expansion Bill Introduced

Insurance Coverage: Legislation

Medicaid Expansion Bill Introduced

February 14, 2019

On February 14, 2019, Senator Brian Schatz (D-HI) introduced the State Public Option Act (S. 489) which allows states to provide a public option through Medicaid for individuals not otherwise covered under Medicaid or enrolled in other insurance.

EXTERNAL LINK

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Medicare Buy-in Bill Introduced

Insurance Coverage: Legislation

Medicare Buy-in Bill Introduced

February 13, 2019

On February 13, 2019, Senator Debbie Stabenow (D-MI) introduced the Medicare at 50 Act (S. 470) which lowers the eligibility age for Medicare coverage to age 50.

EXTERNAL LINK

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Bill Introduced to Reverse STLDI Plan Expansion

Insurance Coverage: Legislation

Bill Introduced to Reverse STLDI Plan Expansion

February 06, 2019

On February 6, 2019, Representative Kathy Castor (D-FL) introduced H.R. 1010 which would rollback the Administration’s short-term limited duration regulation.

EXTERNAL LINK

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Administration Releases Marketplace Proposed Rule

Insurance Coverage: Regulation

Administration Releases Marketplace Proposed Rule

January 24, 2019

On January 24, 2019, the Centers for Medicare and Medicaid Services issued a proposed rule on payment parameters for the Health Insurance Marketplaces.

EXTERNAL LINK

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Medicaid Extenders Act of 2019

Insurance Coverage: Legislation

Medicaid Extenders Act of 2019

January 24, 2019

On January 24, 2019, the Medicaid Extenders Act of 2019 (H.R. 259) was signed into law. This law extends the Money Follows the Person program, among other things.

EXTERNAL LINK

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DelBene Leads Letter to CMS to Delay MSSP Application Timeline

Insurance Coverage: Congress

DelBene Leads Letter to CMS to Delay MSSP Application Timeline

January 23, 2019

On January 23, 2019, Representative Suzan DelBene led a letter to to the Centers for Medicare and Medicaid Services Administrator, Seema Verma, expressing concern related to the deadlines for the Medicare Shared Savings Program.

EXTERNAL LINK

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Congressional Inquiry on Insurance Fee Spending

Insurance Coverage: Congress

Congressional Inquiry on Insurance Fee Spending

January 20, 2019

EXTERNAL LINK

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Pre-existing Conditions Protection Act of 2019

Insurance Coverage: Legislation

Pre-existing Conditions Protection Act of 2019

January 19, 2019

On January 18, 2019, Representative Greg Walden introduced the Pre-existing Conditions Protection Act of 2019 (H.R. 692) which would prohibit pre-existing conditions exclusion in the individual and group health insurance markets.

EXTERNAL LINK

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Insurance Coverage: CMS

CMS Releases Final Weekly ACA Enrollment for the 2019

January 06, 2019

CMS releases final weekly ACA Enrollment for the 2019 enrollment period.

EXTERNAL LINK

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Federal District Court Invalidates Affordable Care Act

Insurance Coverage: Original Analysis

Federal District Court Invalidates Affordable Care Act

December 17, 2018

Late on Friday, December 14, 2018, a federal district judge in Texas struck down the Affordable Care Act (ACA) in its entirety. The district court did not, however, issue an injunction requiring immediate compliance. The decision and the ensuing developments are nonetheless potentially significant and merit attention by health care stakeholders.

ORIGINAL ANALYSIS

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Exchange Program Integrity Proposed Rule

Insurance Coverage: Regulation

Exchange Program Integrity Proposed Rule

November 09, 2018

The Centers for Medicare and Medicaid Services issued a proposed rule on the Health Insurance Exchanges.

EXTERNAL LINK

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Administration Announces State Relief and Empowerment Waivers

Insurance Coverage: Administration

Administration Announces State Relief and Empowerment Waivers

October 23, 2018

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Insurance Coverage: Litigation

Texas Judge Hears Arguments in ACA Case

September 07, 2018

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Insurance Coverage: Legislation

Senate Republicans Introduce Pre-existing Conditions Protection Bill

August 28, 2018

The Ensuring Coverage for Patients with Pre-Existing Conditions Act (S. 3388) was introduced on August 23rd by Senate Republicans in an effort to protect pre-existing conditions.

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CMS Awards $8.6 Million to Strengthen States Insurance Markets

Insurance Coverage: Administration

CMS Awards $8.6 Million to Strengthen States Insurance Markets

August 21, 2018

Administration announces State Flexibility to Stabilize the Market Grant Program which will provide funding to 30 states and the District of Columbia for state exchanges.

POST

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Administration Finalizes Rule Expanding Availability of Short Term Plans

Insurance Coverage: Administration

Administration Finalizes Rule Expanding Availability of Short Term Plans

August 01, 2018

The Trump Administration released a final rule amending the definition of short-term, limited duration insurance. The rule lengthens the maximum duration of short-term, limited duration insurance and is intended to provide more affordable consumer choices for health care coverage.

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Short-term Plans Final Rule

Insurance Coverage: Regulation

Short-term Plans Final Rule

August 01, 2018

The Centers for Medicare and Medicaid Services issued a final rule on short-term limited duration plans.

EXTERNAL LINK

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Insurance Coverage: Budget Information

House GOP Proposes 2019 Budget Plan

June 20, 2018

The Republican House Budget Committee released a FY 2019 budget roadmap, The Budget for A Brighter American Future, on June 19.

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Congressional Inquiry on Section 1332 Guidance

Insurance Coverage: Congress

Congressional Inquiry on Section 1332 Guidance

June 19, 2018

On June 19, 2018 Republican leaders of the Senate Budget Committee sent a letter to the Secretary of Health and Human Services, Alex Azar, inquiring on improper payments made in the Medicare and Medicaid programs.

EXTERNAL LINK

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Insurance Coverage: Budget Information

2018 Medicare Solvency Report Released

June 11, 2018

On June 5, 2018, the Board of Trustees released the 2018 annual report on solvency of the Medicare trust funds (the Hospital Insurance Trust Fund and the Supplementary Medical Insurance Trust Fund).

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Insurance Coverage: Budget Information

CBO Provides Updated Estimates for Uninsured; Small and Non-Group Market Coverage

May 25, 2018

POST

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Insurance Coverage: Stakeholder Engagement

Urban Institute Unveils ‘Healthy America’ Plan

May 16, 2018

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Insurance Coverage: Administration

President-Elect Trump Announces Additions to Health Policy Team

May 09, 2018

On January 5, 2017, the President-elect’s transition team announced that Andrew Bremberg will serve as Director of the White House Domestic Policy Council and Katy Talento will lead Healthcare Policy.

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Insurance Coverage: Administration

2016 Republican Party Platform

May 09, 2018

2016 Republican Party Platform – Downloadable pdf.

PDF DOWNLOAD

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Insurance Coverage: Administration

President-Elect Trump’s Transition Website

May 09, 2018

President-Elect Trump’s Transition Website  

EXTERNAL LINK

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GOP Releases Legislation Intended to Stabilize Exchange Markets

Insurance Coverage: Congress

GOP Releases Legislation Intended to Stabilize Exchange Markets

March 21, 2018

Republican congressional health leaders introduced legislation to stabilize individual federal insurance exchange markets on March 19th.

ORIGINAL ANALYSIS

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Bipartisan Efforts from Various Stakeholder Groups to Kickstart Health Reform efforts

Insurance Coverage: Stakeholder Engagement

Bipartisan Efforts from Various Stakeholder Groups to Kickstart Health Reform efforts

March 07, 2018

ORIGINAL ANALYSIS

Insight: original analysis

Five Key Takeaways on Healthcare Priorities from the President’s Budget

February 27, 2018

ORIGINAL ANALYSIS

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State Lawsuits Against Medicaid Expansion

Insurance Coverage: Litigation

State Lawsuits Against Medicaid Expansion

February 26, 2018

EXTERNAL LINK

Insight: original analysis

Bipartisan Budget Act of 2018 Includes Significant Changes in Medicare, Other Federal Health Programs

February 09, 2018

ORIGINAL ANALYSIS

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Insurance Coverage: Regulation

Association Health Plans Proposed Rule

January 05, 2018

The Centers for Medicare and Medicaid Services issued a proposed rule on Association Health Plans.

EXTERNAL LINK

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Insurance Coverage

Republicans Face Difficult Post-Election Healthcare Decisions (Managed Healthcare Executive)

November 14, 2017

Piper Su provides additional election-related health care insights.

ORIGINAL ANALYSIS

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Insurance Coverage: Budget Information

CBO Scores Alexander Murray Legislation

October 26, 2017

ORIGINAL ANALYSIS

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Insurance Coverage

CBO Scores Bipartisan Health Care Stabilization Act, Introduced by Sens. Alexander and Murray

October 26, 2017

On October 25 the Congressional Budget Office (CBO) released its score for the Alexander Murray bill.

ORIGINAL ANALYSIS

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Insurance Coverage: Congress

Senate HELP Committee Releases Bipartisan Bill to Stabilize Markets

October 18, 2017

Yesterday, Senate HELP Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) announced a bipartisan agreement to provide for short-term stabilization of the individual health insurance market following President Trump’s recent decision to end distribution of cost sharing reduction payments (CSRs) previously available under the Affordable Care Act (ACA).

ORIGINAL ANALYSIS

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Insurance Coverage: Budget Information

Governors Weigh-in on Graham-Cassidy Healthcare Proposal

September 22, 2017

ORIGINAL ANALYSIS

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Insurance Coverage: Congress

Senate Releases Bipartisan Legislation Reauthorizing CHIP Through 2022

September 21, 2017

ORIGINAL ANALYSIS

Insight: original analysis

Senate Republicans and Democrats Introduce Competing Visions for Health Reform Beyond the ACA

September 15, 2017

ORIGINAL ANALYSIS

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Insurance Coverage: Congress

Senators Graham (R-SC), Cassidy (R-LA), Heller (R-NV), and Johnson (R-WI) Release Revised ACA Overhaul Proposal (September 13, 2017)

September 13, 2017

ORIGINAL ANALYSIS

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Insurance Coverage: Congress

Senator Bernie Sanders (I-VT) Releases Medicare For All Proposal (September 13, 2017)

September 13, 2017

ORIGINAL ANALYSIS

Insight: original analysis

September Health Care Round-up: Legislative Activities and Deadlines of Note

September 05, 2017

PDF DOWNLOAD

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Insurance Coverage: Budget Information

CBO Estimates Impact of Ending CSR Payments

August 16, 2017

On August 15, the Congressional Budget Office (CBO) released its report estimating the impact of ending the cost-sharing reduction payments (CSRs) currently paid by the federal government to offset the cost of insurance in the public exchange market for individuals with income between 100-250% of the federal poverty level (FPL).  The payments are administered by…

ORIGINAL ANALYSIS

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Insurance Coverage: Congress

Senate GOP Fails to Pass ACA Repeal and Replace Bills

July 28, 2017

This week, Republican leadership brought three separate proposals to repeal the Affordable Care Act (ACA) to the Senate floor for consideration but were unable to find consensus within their caucus, and all three measures failed to pass.  Majority Leader McConnell now must decide how to move forward with their efforts to repeal and/or replace the…

ORIGINAL ANALYSIS

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Insurance Coverage: Budget Information

Senate Republicans and CBO Explore Both Options

July 21, 2017

This week, Senate Republican leadership released two potential plans for moving forward with its effort to repeal and/or replace the portions of the Affordable Care Act (ACA) that are appropriate to address in the reconciliation process.

ORIGINAL ANALYSIS

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Insurance Coverage: Congress

Repeal and Replace: Senate Republicans and CBO Explore Both Options

July 21, 2017

This week, Senate Republican leadership released two potential plans for moving forward with its effort to repeal and/or replace the portions of the Affordable Care Act (ACA) that are appropriate to address in the reconciliation process.

ORIGINAL ANALYSIS

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Insurance Coverage: Budget Information

CBO Releases Budget Impact Estimate for Better Care Reconciliation Act

June 27, 2017

CBO released its budget impact estimate for the draft Better Care Reconciliation Act on June 26, 2017.  The report reflects the updated version of the discussion draft released by the Senate Budget Committee on June 26, including the addition of a six month lockout period for individuals purchasing insurance after experiencing a lapse in coverage.

ORIGINAL ANALYSIS

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Insurance Coverage: Congress

Better Care Reconciliation Act

June 26, 2017

PDF DOWNLOAD

Insight: original analysis

Senate Republicans Released an ACA Repeal and Replace Bill Discussion Draft, the “Better Care Reconciliation Act of 2017,” on June 22, 2017

June 26, 2017

A McDermottPlus side-by-side comparison table reflecting the draft’s major proposals compared to the AHCA and the ACA is now available

ORIGINAL ANALYSIS

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Insurance Coverage: Regulation

CMS Actuary Report Differs from CBO; 13M Still Uninsured Under AHCA

June 13, 2017

Today the Centers for Medicare and Medicaid Services’ Office of the Actuary released its report estimating the “financial effect of the ‘American Health Care Act of 2017”, legislation that would repeal and replace portions of the Affordable Care Act.

ORIGINAL ANALYSIS

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Insurance Coverage: Regulation

CMS seeks public input on reducing the regulatory burdens of the Patient Protection and Affordable Care Act (PPACA)

June 09, 2017

ORIGINAL ANALYSIS

Insight: original analysis

FY 2018 President’s Budget May Signal Challenges for Health Programs on the Horizon

May 25, 2017

ORIGINAL ANALYSIS

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Insurance Coverage: Budget Information

CBO Releases Revised Estimate of the American Health Care Act

May 24, 2017

The Congressional Budget Office (CBO) today released a new assessment of H.R. 1628, American Health Care Act of 2017 (AHCA), as passed by the U.S. House of Representatives on May 4, 2017.

ORIGINAL ANALYSIS

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Insurance Coverage: Budget Information

A New Foundation for American Greatness

May 23, 2017

ORIGINAL ANALYSIS

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Insurance Coverage: Stakeholder Engagement

Freedom Partners and Americans for Prosperity Letter to Senate

May 22, 2017

In a May 22, 2017 letter, two conservative advocacy groups lay out their principals for the Senate’s health reform bill.

PDF DOWNLOAD

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Insurance Coverage: Stakeholder Engagement

Health Care Groups Request Senate Fund CSRs

May 19, 2017

In a May 19, 2017 sign-on letter, major health care groups request the Senate take action to guarantee CSR funding through 2018.

PDF DOWNLOAD

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Insurance Coverage: Congress

Draft Legislative Text of McArthur Amendment Offers More Details on Proposed AHCA Changes

April 26, 2017

On Tuesday, House Republican leaders circulated draft legislative language offering more details about the AHCA amendment developed by Reps. McArthur and Meadows.

ORIGINAL ANALYSIS

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Insurance Coverage: Stakeholder Engagement

National Governors Association Asks Congress to Fund ACA Subsidies

April 24, 2017

April 24, 2017 letter requesting funding for ACA subsidies in the FY2017 spending negotiations and 2018 budget.

EXTERNAL LINK

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Insurance Coverage: Congress

Leaked AHCA Amendment Would Allow States to Seek Waivers from Federal Standards Established under the ACA

April 04, 2017

ORIGINAL ANALYSIS

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Insurance Coverage: Budget Information

CBO Releases New Assessment of House’s AHCA

March 24, 2017

ORIGINAL ANALYSIS

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Insurance Coverage: Congress , Original Analysis

Republicans Revise AHCA Before Floor Vote

March 21, 2017

House Republican leaders unveiled amendments to the American Health Act Monday night in anticipation of a floor vote Thursday.

ORIGINAL ANALYSIS

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Insurance Coverage: Regulation

Secretary Price and CMS Director Verma Detail Plan for Medicaid Reform in Letter to Governors

March 16, 2017

ORIGINAL ANALYSIS

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Insurance Coverage: Budget Information

American First: A Budget Blueprint to Make American Great Again

March 15, 2017

President Trump’s proposed budget for FY 2018

PDF DOWNLOAD

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Insurance Coverage: Budget Information

CBO Cost Estimate for the American Health Care Act

March 13, 2017

PDF DOWNLOAD

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Insurance Coverage: Stakeholder Engagement

America’s Health Insurance Plans (AHIP) Recommendations for the American Health Care Act

March 08, 2017

PDF DOWNLOAD

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Insurance Coverage: Stakeholder Engagement

Blue Cross Blue Shield Association Key Recommendations for the American Health Care Act

March 07, 2017

AHA and AMA Letters to Congress Opposing Newly Unveiled American Health Care Act

ORIGINAL ANALYSIS

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Insurance Coverage: Stakeholder Engagement

Republican Governors Criticize American Health Care Act

March 06, 2017

On March 16, 2017, four Republican governors (John Kasich of Ohio, Rick Snyder of Michigan, Brian Sandoval of Nevada and Asa Hutchison of Arkansas) sent congressional leaders a letter criticizing the American Health Care Act and proposing an alternative framework for reforming the Medicaid program. The four governors endorse per capita caps and block grants,…

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Insurance Coverage: Congress

American Health Care Act

March 06, 2017

On March 6, 2017 House Republicans unveiled the American Health Care Act, their Repeal and Replacement legislation for the Affordable Care Act.

ORIGINAL ANALYSIS

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Insurance Coverage: Stakeholder Engagement

Congressional Research Service Posts Summary of the American Health Care Act

March 04, 2017

On March 14, 2017, the Congressional Research Service posted a summary of the American Health Care Act. This summary includes references to actions taken by the House Ways & Means and Energy and Commerce Committees on March 6th, and the analysis issued by Congressional Budget Office on March 13th, but predates action by the House…

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Insurance Coverage: Congress

Obamacare Repeal and Replace: Policy Brief and Resources

February 16, 2017

Summary of the Republican ACA Repeal and Replace Proposal prepared by House Republican leadership.

PDF DOWNLOAD

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Insurance Coverage: Stakeholder Engagement

Committee for a Responsible Federal Budget: The Cost of Full Repeal of the Affordable Care Act

February 04, 2017

January 4, 2017 report released by the Committee for a Responsible Federal Budget, which currently estimates that the repeal and replacement of the ACA in its entirety would cost roughly $350 billion through 2027 under conventional scoring and $150 billion using dynamic scoring.

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Insurance Coverage

Episode One: Governing Health Podcast Series

January 31, 2017

In this inaugural episode, McDermott governance partner Michael Peregrine interviews Eric Zimmerman, a Washington-based McDermott partner, and Chip Falahee, Senior Vice President for Legal and Legislative Affairs at Bronson Healthcare Group, to discuss how boards can prepare for the changes ahead – particularly with regard to the Affordable Care Act.

EXTERNAL LINK

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Insurance Coverage: Administration

Executive Order on Reducing Regulation and Controlling Regulatory Costs

January 30, 2017

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Insurance Coverage: Congress

H.R. Bill Protecting Patients with Pre-Existing Conditions

January 26, 2017

Energy and Commerce Committee Chairman Greg Walden (R-OR) proposes legislation that would require insurance companies to accept everyone who applies, as long as they sign up during certain enrollment periods or certain life events like getting married.

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Insurance Coverage: Stakeholder Engagement

Healthcare Stakeholders Urge President Trump and Congress to Back Value-Based Care

January 25, 2017

January 25, 2017 letter addressed to President Trump and congress to continue to move forward with value-based payment models.

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Insurance Coverage: Congress

S.222 The Obamacare Replacement Act

January 25, 2017

On January 25, 2017 U.S. Senator Rand Paul, M.D. (R-KY) introduced the Obamacare Replacement Act. Senator Paul’s plan offers some limited protections for those with pre-existing conditions, and seeks to address the cost of health care through expanded health savings accounts and tax credits. While legislative text is not yet available, a summary is available.

ORIGINAL ANALYSIS

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Insurance Coverage: Administration

Executive Order Freezing the Hiring of Civilian Employees

January 24, 2017

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health-reform-20

Insurance Coverage: Stakeholder Engagement

NGA Response to Request for Feedback on Changes to ACA

January 24, 2017

January 24, 2017 National Governors Association (NGA) response to the December 2, 2016 letter from House Leadership request input on changes to the Affordable Care Act.

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Insurance Coverage: Congress

Patient Freedom Act of 2017

January 23, 2017

On January 23, 2017 U.S. Senators Susan Collins (R-ME), Bill Cassidy, M.D. (R-LA), Shelley Moore Capito (R-WV) and Johnny Isakson (R-GA) released the legislative text for the Patient Freedom Act of 2017, a replacement plan for the Affordable Care Act that proposes a compromise to repeal – offering states the option to keep the Affordable…

ORIGINAL ANALYSIS

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Insurance Coverage: Administration

Executive Order Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal

January 20, 2017

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Insurance Coverage: Stakeholder Engagement

The Commonwealth Fund: Medicaid’s Future: What Might ACA Repeal Mean?

January 12, 2017

January 12, 2017 report examining how repeal legislation could affect Medicaid.

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Insurance Coverage: Stakeholder Engagement

Urban Institute: The Impact on Health Care Providers of Partial ACA Repeal Through Reconciliation

January 05, 2017

January 2017 examining the repeal of the Affordable Care Act if conducted through the budget reconciliation process used in Jan. 2016 legislation vetoed by President Obama.

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Insurance Coverage: Stakeholder Engagement

Healthcare Leadership Council Letter to President-elect Trump

January 04, 2017

January 4, 2017 letter to President-elect Trump detailing actions specific steps that should be taken to stabilize the health insurance marketplace both short-and long-term.

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health-reform-20

Insurance Coverage: Congress

The American Health Care Reform Act of 2017

January 04, 2017

On January 4, 2017 the House Republican Study Committee released a new plan for the repeal and replacement of the Affordable Care Act (ACA).

ORIGINAL ANALYSIS

health-reform-20

Insurance Coverage: Stakeholder Engagement

American Medical Association (AMA) Letter to Congressional Leaders on Reform of Health Care System

January 03, 2017

January 3, 2017: AMA letter to congress requesting replacement policies in place prior to the repeal of the ACA.

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Insurance Coverage: Budget Information

CBO Report: How Repealing Portions of the Affordable Care Act Would Affect Health Insurance Coverage and Premiums

January 01, 2017

The Congressional Budget Office and Joint Committee on Taxation released an updated report on the projected impact of H.R. 3762, the Restoring Americans’ Healthcare Freedom Act of 2015, if enacted. The report, prepared at the request of the House Minority Leader and the Ranking Member of the Senate Committee on Finance, would result in a…

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health-reform-20

Insurance Coverage: Congress

Senate Finance Committee Letter to RGA on Jan 2017 Medicaid Roundtable

December 13, 2016

In a letter to the Republican Governors Association dated December 13, 2016, the Senate Finance Committee announced that it will convene a Governor Roundtable in January 2017 to discuss the sustainability and future of the Medicaid program.

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Insurance Coverage: Stakeholder Engagement

America’s Health Insurance Plans (AHIP) Memo to Transition Team

December 09, 2016

Memo to transition team and congressional leadership identifying priority legislative and administrative changes

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Insurance Coverage: Stakeholder Engagement

Health Care Transformation Task Force Letter to Transition Team

December 06, 2016

Letter addressed to President-elect, transition team and congressional leadership

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Insurance Coverage: Stakeholder Engagement

American Hospital Association (AHA) Memo to Transition Team

December 02, 2016

Memo to transition team and congressional leadership identifying priority legislative and administrative changes

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health-reform-20

Insurance Coverage: Congress

House Letter to Governors and State Insurance Commissioners

December 02, 2016

December 2, 2016 letter from the House Republican Leadership to Governors and State Insurance Commissioners requesting input on specific questions concerning repealing and replacing the Affordable Care Act.

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Insurance Coverage: Budget Information

CBO Options for Reducing the Deficit: 2017-2026

December 01, 2016

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Insurance Coverage: Congress

The World’s Greatest Healthcare Plan (Congressman Sessions and Senator Cassidy)

December 01, 2016

ORIGINAL ANALYSIS

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Insurance Coverage: Stakeholder Engagement

Brookings Report: Repeal and Replace Obamacare: What Could it Mean?

November 30, 2016

November 30, 2016 report from Brookings on what would happen if the Affordable Care Act were to be repealed on the first day, and a suggested stepby-step approach.

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Insurance Coverage: Regulation

Rep. Tom Price Nominated as Secretary of Health & Human Services

November 29, 2016

ORIGINAL ANALYSIS

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Insurance Coverage: Regulation

President Trump Selects Seema Verma to Serve as CMS Administrator

November 29, 2016

ORIGINAL ANALYSIS

health-reform-20

Insurance Coverage: Stakeholder Engagement

Heritage Foundation Issue Brief

November 22, 2016

Memo outlining steps for a smooth transition for the repeal of the Affordable Care Act

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Insurance Coverage: Stakeholder Engagement

What Would Block Grants or Limits on Per Capita Spending Mean for Medicaid?

November 18, 2016

November 18, 2016 report from the Commonwealth Fund examining the President-elect Trump and some congressional leaders’ calls for absolute limits on the federal government’s spending on Medicaid.  This report explores the two most common proposals for reengineering federal funding of Medicaid: block grants that set limits on total annual spending, regardless of enrollment; and caps…

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Insurance Coverage: Stakeholder Engagement

American Medical Association (AMA) Vision on Health Reform

November 15, 2016

Summary of the AMA’s current policy on health reform

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Briefing Points for the Board  – The Election and the 2017 Health Policy Agenda

Insight: original analysis

Briefing Points for the Board – The Election and the 2017 Health Policy Agenda

November 14, 2016

It is vitally important for the health system board, as well as certain of its key committees, to receive an introductory briefing as soon as possible on the health policy implications of last week’s Presidential and Congressional elections, as they are currently understood.

ORIGINAL ANALYSIS

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Insurance Coverage

How Congress, President-Elect Trump Might Proceed on Promise to Repeal, Replace ACA

November 11, 2016

EXTERNAL LINK

Insight: original analysis

WEBCAST: The Election and the 2017 Health Policy Agenda

November 10, 2016

An Election Breakdown and What It Means for the Health Care Industry

ORIGINAL ANALYSIS

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Insurance Coverage: Regulation

Republican Leadership Letter Directing Agencies to Halt Rulemaking

November 05, 2016

ORIGINAL ANALYSIS

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Insurance Coverage: Regulation

House Republicans Call on CMS to Halt Future CMMI Models

September 29, 2016

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Insurance Coverage: Congress

H.R. 3100 (Congressman Tom Price, M.D.)

July 16, 2016

Prohibits HHS and States from requiring physicians to participate in certain health plans or the Meaningful Use program as a condition of licensure

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Insurance Coverage: Congress

Better Way Plan (Speaker Paul Ryan)

June 22, 2016

ORIGINAL ANALYSIS

health-reform-20

Insurance Coverage: Congress

H.R. 4848 (Congressman Tom Price, M.D.)

March 23, 2016

Would delay implementation of the Medicare Comprehensive Care for Joint Replacement (CJR) payment model

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health-reform-20

Insurance Coverage: Congress

H.R.3762 Budget Reconciliation Bill

December 03, 2015

Approved by Congress and vetoed by President Obama in January 2016

ORIGINAL ANALYSIS

health-reform-20

Insurance Coverage: Stakeholder Engagement

Improving Health and Health Care: An Agenda for Reform

December 01, 2015

2015 Paper laying out ACA alternative authored by 10 Republican thought leaders

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Insurance Coverage: Congress

H.R. 2300 Empowering Patients First Act of 2015 (Congressman Tom Price, M.D.)

May 13, 2015

ORIGINAL ANALYSIS

health-reform-20

Insurance Coverage: Congress

H.R. 1650 (Congressman Tom Price, M.D.)

March 26, 2015

Expands Medicare beneficiary-physician private contracting rights

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Insurance Coverage: Congress

H.R. 1234 (Congressman Tom Price, M.D.)

March 04, 2015

Repeals select aspects of the Affordable Care Act

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health-reform-20

Insurance Coverage: Stakeholder Engagement

New England Journal of Medicine: Medicare at 50 – Origins and Evolution

January 29, 2015

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Insurance Coverage: Budget Information

CBO Options for Reducing the Deficit: 2015 to 2024

November 01, 2014

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Insurance Coverage: Budget Information

CBO Options for Reducing the Deficit: 2014 to 2023

November 01, 2013

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Insurance Coverage: Budget Information

CBO Budget Options Volume I: Health Care

December 01, 2008

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