A pledge made to US Senator Susan Collins (R-ME) to support funding for cost-sharing reductions (CSRs) in exchange for her yes vote on the GOP tax bill fell apart Wednesday, apparently because House Speaker Paul Ryan refused to allow the funding to be included in this year’s spending package, slated to be voted on Friday.
A pledge made to US Senator Susan Collins (R-ME) to support funding for cost-sharing reductions (CSRs) in exchange for her yes vote on the GOP tax bill fell apart Wednesday, apparently because House Speaker Paul Ryan refused to allow the funding to be included in this year’s spending package, slated to be voted on Friday.
The loss was the result of a feud between Ryan (R-WI) and Senate Majority Leader Mitch McConnell, according to press reports. McConnell (R-KY) made the promise to Collins in order to get her to sign on to the tax bill, celebrated by Republicans Wednesday at the White House. During the GOP gathering, President Trump said, "We have essentially repealed Obamacare."
CSRs help insurers afford the lower prices they charge for those with the lowest incomes under the Affordable Care Act (ACA).
This would be the second blow to the ACA this year. The tax bill headed to President Trump’s desk ends the individual mandate, which required everyone to have health insurance or pay a penalty.
Wednesday afternoon, Collins and US Senator Lamar Alexander (R-TN) released a joint statement, saying, “Rather than considering a broad year-end funding agreement as we expected, it has become clear that Congress will only be able to pass another short-term extension to prevent a government shutdown and to continue a few essential programs.”
“For this reason, we have asked Senator McConnell not to offer this week our legislation which independent analysts Avalere and Oliver-Wyman say would reduce premiums by about 20% for the 9 million Americans who have no government subsidies to help them buy insurance in the individual market. Instead, we will offer it after the first of the year when the Senate will consider the omnibus spending bill, the Children’s Health Insurance Program reauthorization, funding for Community Health Centers, and other legislation that was to have been enacted this week. "
They said they believe that McConnell will "uphold his committment" to bring the Bipartisan Health Care Stabilization Act of 2017, sponsored by Alexander and US Senator Patty Murray, (D-WA), up for a vote.
The ACA requires those whose incomes qualify them for premium tax credits to get subsidized rates, CSRs or not. Amid uncertainty and with few options, regulators in some states had allowed insurers to build a CSR loss into 2018 rates, and to load the premium increase onto the benchmark silver tier, causing the cost of these plans to soar.
Trump spent much of 2017 threatening to end the CSRs, while declaring the ACA a failure and calling for Congress to repeal it. He finally canceled CSRs on October 12.
Under the ACA, subsidies are set as a percentage of the value of a second-lowest cost silver plan.
Standard Criteria for Loss of Ambulation Needed in DMD
April 19th 2024A recent study suggests the differences between ambulation definitions for patients with Duchenne muscular dystrophy (DMD) can impact the identification of ambulant vs nonambulant individuals, and standard criteria across settings are needed.
Read More
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
An Overview of Health Care and Pharmaceutical Trends, 2023-2024
April 19th 2024Douglas M. Long, BA, MBA, was featured as the keynote speaker on the closing day of The Academy of Managed Care Pharmacy 2024 annual meeting, with a session dedicated to surveying the health care and pharmaceutical trends of the last year.
Read More
Drs Raymond Thertulien, Joseph Mikhael on Racial Disparities in Multiple Myeloma Care Access
December 28th 2023In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.
Listen
Real-World Study Reveals Key Insights Into DLBCL Treatment Patterns, Outcomes
April 18th 2024A recent study offers valuable insights into the characteristics, treatment patterns, and outcomes of diffuse large B-cell lymphoma (DLBCL) in patients across different lines of therapy, providing a look into the landscape of DLBCL management.
Read More