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Policy Update-Wks of Oct. 20 & 27

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In the Health Reform Update for the past two weeks, Republican lawmakers plot new strategies to derail the Affordable Care Act (ACA) as polls show them likely to gain control of the U.S. Senate. Meanwhile, Democrats focus on key governorships in ACA-resistant states.

The Centers for Medicare and Medicaid Services (CMS) notifies federal Marketplace insurers that they can opt-out of their contracts should the U.S. Supreme Court invalidate ACA premium subsidies. The agency also delays another provision of the ACA, this time relating to transparency provisions requiring insurers to disclose of enrollment data, claims denials, and cost-sharing designs.

State Medicaid directors urge Congress to take immediate action to curb specialty drug costs, including price controls or mandatory discounts. Small business Marketplaces operated by the federal government begin a “soft launch” in five states, while Washington expands their version so that it is offered statewide. Utah becomes the sixth state with a federally-approved alternative to the Medicaid expansion under the ACA.

Alabama and New Hampshire join the list of states expecting Marketplace premiums to remain largely the same for 2015, while North Carolina becomes the third to project double-digit rate hikes.

You can find the full Health Reform Update here! If you’re interested in Advocacy, please join the PSI Patient Coalition.

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