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In the Health Reform Update for the past week, the new Congress immediately resurrects stalled legislation to increase the threshold for the employer mandate under the Affordable Care Act (ACA), as well as repeal payments to insurers that serve a costlier mix of patients.
Marketplace enrollment continues to climb, exceeding 7.1 million sign-ups for the 2015 open enrollment period, as another study confirms that premiums for the qualified health plans have remained stable overall. A new notice from the Centers for Medicare and Medicaid Services (CMS) pledges to investigate whether Marketplace benefit designs are unlawfully discriminating by moving all or most drugs for a costly condition into specialty tiers that require prohibitive coinsurance.
CMS lets Arkansas and Iowa impose additional premiums and cost-sharing for their Medicaid expansion alternatives, while the Tennessee governor proposes a similar model for his state. The Arizona Supreme Court rules that Republican legislators have standing to challenge whether that state’s traditional Medicaid expansion is constitutional.