One of the principal achievements of the Affordable Care Act was its prohibition on denying insurance coverage to patients with pre-existing conditions. Under the ACA, insurance companies must sell polices to people with chronic diseases and charge the same premiums paid by healthy people.
But patients with pre-existing conditions in fact are being denied coverage when their insurance plans don’t allow for medically recommended treatments or place significant obstacles in the way of getting them. Many plans impose “utilization management” rules restricting access to drugs by requiring prior authorization, quantity limits and so-called step therapy—making patients try a cheaper drug before taking a “step” up to a more expensive treatment.
. . .
Ohio Gov. John Kasich (R) and Colorado Gov. John Hickenlooper (D) are working on a bipartisan proposal to stabilize ObamaCare that they say could be unveiled as soon as a week from now.
“We’re getting very close,” Kasich said in a joint interview with Hickenlooper on Colorado Public Radio. “I just talked to my guys today, and men and women who are working on this with John’s people, and we think we’ll have some specifics here. John, I actually think we could have it within a week.”
. . .
Democrats are ready to go on the health care offensive. And Sen. Brian Schatz (D-HI) may have a new plan for them to do it.
In an interview with Vox, Schatz revealed that he’s preparing a new bill that could grant more Americans the opportunity to enroll in Medicaid by giving states the option to offer a “buy-in” to the government program on Obamacare’s exchanges.
His proposal would expand the public health insurance program from one that covers only low-income Americans to one open to anyone seeking coverage, depending on what each state does.
. . .
Andy Thorburn, a health insurance executive who is plugging $2 million into a bid to replace Rep. Edward R. Royce (R-Calif.), is the latest Democrat pushing the party to embrace single-payer health care — even in swing districts. In a video announcement, Thorburn paints the contest as a referendum on health care, between a Republican who voted for the repeal of the Affordable Care Act and a Democrat who wants to move, eventually, to “Medicare for all.”
. . .
Iowa on Tuesday submitted to the federal government a final request to make changes to try to shore up its struggling ObamaCare insurance marketplace.
The plan from the Iowa Insurance Division is intended to be a short-term market stabilization solution to entice more insurers into the marketplace. The state is facing what it calls a “collapse” of its ObamaCare marketplace after all but one insurer declined to offer plans for 2018.
. . .
Ohio Gov. John Kasich said he and Colorado Gov. John Hickenlooper are planning to release proposals as early as next week on how to repair Obamacare’s exchanges.
“We’re getting very close,” Kasich, a Republican, said in a joint interview with Hickenlooper on Colorado Public Radio on Monday. “I just talked to my guys today, men and women who are working on this with John’s people, and we think we’ll have some specifics here … I think we could have it within a week.”
. . .
Senators looking for ways to stabilize the individual health insurance market will hear from governors and state health insurance commissioners at their first bipartisan hearings next month.
The hearings, set for Sept. 6-7, will focus on stabilizing premiums and helping people in the individual market in light of Congress’ failure to repeal and replace the Affordable Care Act, or Obamacare.
“Eighteen million Americans, including 350,000 Tennesseans – songwriters, farmers, and the self-employed – do not get their health insurance from the government or on the job, which means they must buy insurance in the individual market,” said Sen. Lamar Alexander, the Tennessee Republican who chairs the Senate Health, Education, Labor and Pensions Committee.
. . .
A fast-approaching deadline for insurers to commit to selling health plans next year under the Affordable Care Act is pressuring Republican lawmakers to decide quickly whether to shore up the law and ease the path for insurers or continue efforts to roll it back.
Lawmakers returning to the Capitol from recess on Sept. 5 will have only 12 legislative days to decide whether to pass a bipartisan bill aimed at bolstering the ACA’s markets before insurers must commit to participating in the law’s exchanges in 2018. At the same time, a plan from Sens. Lindsey Graham (R., S.C.) and Bill Cassidy (R., La.) that would largely topple most of the ACA is gaining traction among Republicans.
. . .
For all the attention on various ways to improve Medicaid’s finances and sustainability in recent months, another key area of Medicaid policy that deserves focus is improving the state waiver process. With all the recent calls for bipartisanship, this should be an area where Democrats and Republicans can work together to improve the program.
Medicaid is a state-federal partnership and a critically-important safety net for millions of our nation’s most vulnerable patients. The program dates back to the Great Society era and will cover up to 98 million people and cost taxpayers more than $600 billion this year alone.
. . .