Federal Healthcare Reform

Virginia Legislature Votes for Expansion

On May 30, the Virginia Senate voted, with 4 Republicans supporting the measure, to expand Medicaid eligibility to all individuals with income at or below 138 percent of the federal poverty line, according to the Washington Post. Later in the day, the House of Delegates approved the bill by 67 to 31. Gov. Northam, a pediatrician who campaigned in 2017 on expanding Medicaid, is expected to sign the bill.

Both chambers in Wisconsin have passed a $200 million reinsurance plan that would provide funds to insurers for high-cost patients’ expenses to prevent ACA marketplace premium increases in 2019. The Governor has come out in support of the program and is expected to sign the bill, according to the Journal Sentinel.

Open enrollment for health insurance policies sold under the Affordable Care Act marketplaces ran for 6 weeks the end of 2017. Enrollment was down from 2017 – by 3.7 percent – but nonetheless 11,760,533 Americans selected a health insurance plan for 2018.

President Trump signed an executive order today that will allow businesses and individuals to buy association health plans that will not have to comply with the Affordable Care Act. See the official White House release about the provisions of the executive order here

The Georgetown University Center on Health Insurance Reforms has released a...

President Trump signed an executive order today that will allow businesses and individuals to buy association health plans that will not have to comply with the Affordable Care Act. See a video of the signing ceremony at the White House here. Read Washington Post coverage...

Today, NBC news published a report that President Trump has said he is about to sign an executive order to allow Americans to purchase health insurance policies across state lines. The ACA already has a provision for selling insurance across state lines so long as the plans meet certain minimum standards of coverage and five states have such laws on the books already. However, no insurer currently sells such policies.

Remember that after the Affordable Care Act passed, numerous commentators predicted that increased insurance coverage, achieved through purchase of individual plans through the ACA marketplace or expanded Medicaid coverage, would precipitate a primary care shortage? Experts feared that those with new coverage would not actually have access to care and those previously insured might experience decreased access to primary care. Studies have shown that primary care availability hasn’t suffered as expected.

Remember that after the Affordable Care Act passed, numerous commentators predicted that increased insurance coverage, achieved through purchase of individual plans through the ACA marketplace or expanded Medicaid coverage, would precipitate a primary care shortage? Experts feared that those with new coverage would not actually have access to care and those previously insured might experience decreased access to primary care. Studies have shown that primary care availability hasn’t suffered as expected.

The bill proposed this week by Senators Graham and Cassidy would repeal many provisions of the  Affordable Care Act and redesign the Medicaid program. Through 2026 the federal government would  provide each state a block grant in lieu of funding for Medicaid expansion and subsidies for health insurance purchased through the ACA marketplaces. Federal funding for Medicaid, absent the expansion, would be converted to a per capita cap basis, reducing federal expenditures over time. After 2026, the block grant would disappear. The bill would also eliminate consumer insurance protections of the ACA including prohibitions against annual and lifetime limits and underwriting practices related to pre-existing conditions.  

Proceedings of the Medicaid 201 Leadership Policy Academy, Sept. 13-15, 2017

 

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