Congress moves forward on key healthcare appointments; the Administration takes steps to shore up the Marketplaces; and Governors prepare to gather in Washington as new reports document the ACA's impacts on states. Read on for more details.

Federal Health Reform Activity

House Republicans Release New Repeal and Replace Plan House Republican leadership released the outline of their new repeal and replace plan, which would provide age-rated tax credits for individuals without access to employer-sponsored coverage, repeal the Medicaid expansion in its current form, implement capped financing in Medicaid, eliminate ACA taxes and mandates, expand access to health savings accounts, and prohibit the use of tax credits on any plan that covers abortion services. Read more

Verma Testifies Before Senate Finance Committee; Mulvaney Confirmed as OMB Director President Trump's nominee for CMS Administrator Seema Verma testified before the Senate Finance Committee on Thursday; a full Senate confirmation vote is expected in the coming weeks. Read more

Trump Administration and House Republicans Ask Court to Continue Hold on Cost-Sharing Reduction Suit House Republicans and the Justice Department have filed a joint motion asking the D.C. Circuit Court of Appeals to continue a temporary hold on the House v. Price suit to allow more time for a legislative resolution to the case. Read more

Proposed Market Stabilization Rule Released; QHP Certification and Rate Filing Deadlines Extended CMS released a proposed rule, intended to stabilize the individual market, that would shorten the annual open enrollment period, tighten special enrollment period requirements, and allow insurers to require payment of past‐due premiums as a condition of enrollment. Read more

Healthcare Reform on the Agenda for National Governors Association Meeting The National Governors Association's (NGA) 2017 Winter Meeting (February 24-27) will include several healthcare-related activities, including a governors-only session on healthcare reform, an exhibition from the NGA Center for Best Practices Health Division, and briefings on healthcare reform with Congressional Republicans and Democrats. Read more

Federal and State Reports on Health Spending and Reform

National Health Spending Projected to Grow 6% Annually Between 2016 and 2025 CMS's Office of the Actuary projects annual health spending will increase an average of 5.6% between 2016 and 2025—1.2 percentage points faster than GDP—driven primarily by economic growth and an aging population. Read more

Medicaid Has Lowest Projected Growth Rate Among Means-Tested Healthcare Programs, CBO Report Finds A CBO analysis of January 2017 baseline spending projections for 2018-2027 found that the projected annual growth rate for means-tested programs, including Medicaid, CHIP, and the Marketplace subsidies, is lower than the projected annual growth rate for non-means-tested programs such as Social Security and Medicare (4.3% versus 6%). Read more

ACA Had No Impact on Employment Rates and Hours Worked, Report Finds An Urban Institute report found the ACA had little to no effect on employment rates or total hours worked per week, indicating that few employers have switched full-time employees to part-time status to avoid paying penalties under the ACA's employer mandate. Read more

Stronger Collaboration Between Medicaid Agencies and Insurance Departments Would Improve the Coverage Continuum A new Commonwealth Fund brief, prepared by Manatt Health, identifies competing priorities and cultural differences between state Medicaid agencies and insurance departments as a potential barrier to continuity of coverage. Read more

Changes to Essential Health Benefits Possible Under New Administration A Health Affairs blog post written by Manatt Health explores potential changes to the essential health benefits (EHBs) requirement that Congress and the Trump Administration might pursue, including eliminating the requirement to cover maternity care, treatment for mental health and substance use disorders, and habilitative services. Read more

Kaiser Publishes Issue Briefs on Children's Insurance Coverage, Medicaid-Medicare Enrollees, and the Future of 1115 Waivers A new issue brief from the Kaiser Family Foundation reviews the state of health insurance coverage for children and the potential implications if the ACA is repealed and Medicaid funding is capped. Read more

State-Specific Studies Examine Impact and Benefits of the ACA Several new studies were released this week on the state-specific impacts of the ACA, and the Commonwealth Fund separately released a series of state-specific fact sheets highlighting the impact of Medicaid and the ACA, including effects on enrollment levels, access to care, patient-reported experiences, and job growth. Read more

State Medicaid Expansion Updates

Arizona: Appeals Court Hears Arguments in Medicaid Expansion Lawsuit A three-judge State Appeals Court panel heard an appeal of the Maricopa County Superior Court's decision that Arizona's Medicaid expansion plan was passed legally, reports the Arizona Republic. Read more

Maine: Measure to Expand Medicaid Qualifies for November 2017 Ballot A voter petition effort to expand Medicaid in Maine successfully submitted 66,434 valid signatures, qualifying for placement on the November 2017 referendum ballot. Read more

New Jersey and Ohio: Governors Support Continuation of Medicaid Expansion New Jersey Governor Chris Christie (R) and Ohio Governor John Kasich (R) have expressed their support for continuing coverage of the Medicaid expansion population, regardless of ACA repeal. Read more

State Medicaid and Health Reform Activity

Idaho: Lawmakers Considering Measure to Provide Limited Coverage to Some Uninsured Residents The House Health and Welfare Committee voted unanimously to introduce legislation that would create a "Health Care Assistance Program" to provide limited primary care and some prescription drug coverage to 78,000 adults earning below the poverty level. Read more

Massachusetts: Commission Makes Recommendations in Response to Missed Healthcare Spending Benchmark In its annual report, the Massachusetts Health Policy Commission recommended measures to reduce healthcare spending in response to the State's failure to meet its goal of keeping per capita healthcare spending growth across all payers at or below 3.6% between 2014 and 2015. Read more

Oregon: Legislature Considering Medicaid Coverage for Undocumented Children The House Health Care Committee held a hearing on Monday to discuss HB 2726, which would extend Medicaid coverage to an estimated 17,600 undocumented children and has the support of Governor Kate Brown (D), House Speaker Tina Kotek (D), other Republican and Democratic legislators and healthcare providers. Read more

State Staffing Update

Rhode Island: Former Medicaid Director Appointed Interim Secretary of Health and Human Services Agency Former Medicaid Director, Ana Rader Wallack was appointed Acting Secretary of the Executive Office of Health and Human Services following Elizabeth Roberts's resignation. Read more

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