In the Health Reform Update for this week, Senate leaders revise their bill to repeal and replace key Affordable Care Act (ACA) provisions in an effort to woo conservative holdouts. However, key moderates remain opposed to the dramatic increases in consumer out-of-pocket costs and severe Medicaid cuts that remain unchanged.
The Senate Majority Leader pushes for quick vote on the revised bill, with or without a cost estimate from the Congressional Budget Office. Republicans and Democrats put forward more limited alternatives in the event the legislation fails. House appropriators seek to separately attack the ACA by barring funding for Marketplaces, navigators, and enforcement of the individual mandate.
A Kaiser Family Foundation study finds that insurer participation in ACA Marketplaces is down by 38 percent, due largely to uncertainty over if and how Congress will repeal the ACA. Opportunistic insurers agree to cover counties in Missouri and Washington left unserved by departing Marketplace carriers.
The Trump Administration grants Alaska a federal ACA waiver allowing the federal government to fund most of its previously state-funded reinsurance program that dramatically brought down Marketplace premium increases. Oregon becomes the third state behind Alaska and Minnesota to create such a reinsurance program.
Ohio’s Republican governor successfully vetoes a freeze on that state’s Medicaid expansion, while Kentucky’s Republican governor asks for a federal waiver to impose strict work requirements on all “able-bodied” Medicaid enrollees.