Reforming Medicaid does not have to be an all-or-nothing approach, where millions of people are thrown off of the program to reduce the budget. The states, which administer Medicaid, are closest to the problem and also are in the best position to develop solutions for Medicaid. With leeway to innovate and the pressure to achieve savings, the circumstances are ideal for change.

Since the program’s inception, the federal government has had regulations in place that mandate certain services be provided and that also set rules around eligibility. Those states seeking to innovate have had to secure a waiver from those rules.

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Senate Republicans said Tuesday that President Donald Trump was open to their suggestions about how to stabilize the Obamacare exchanges, but did not give any clear policy updates, leaving insurers hanging.

Health and Human Services Secretary Tom Price also highlighted the individual and small group markets as one of the “toughest challenges” for his employees, without providing specific steps that HHS would take. The focus on stabilizing the Affordable Care Act’s individual marketplace comes even as Senate Republicans are struggling to reach consensus on a bill that would overhaul major parts of the ACA.

. . .

Americans view Humana Inc. and Aetna Inc. no less favorably after the industry giants announced their plans to pull out of the Affordable Care Act’s individual exchanges in 2018, according to Morning Consult Brand Intelligence data.

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More than a dozen states and the District of Columbia filed a motion on Thursday to intervene in the appeal of a lawsuit targeting the ACA’s cost-sharing reduction (CSR) subsidies. The lawsuit was originally brought by the U.S. House of Representatives against the Obama administration, which the Trump administration must now deal with. The Kaiser Family Foundation has estimated that the average premiums for silver plans sold on the ACA exchanges would increase by about 19% to compensate for insurers’ lack of funding without the CSR payments. The Trump administration and the House are set to update the court on Monday on how they plan to proceed with the case.

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The Trump administration plans to let small businesses bypass the Affordable Care Act’s online marketplace to get health insurance for their employees.

Obamacare was meant to offer better insurance options for small businesses through the Small Business Health Options Program while rewarding companies with tax credits for offering insurance to their employees. But enrollment in SHOP plans fell drastically below expectations. Just 230,000 Americans were insured in the plans as of January, less than one-tenth of the Congressional Budget Office’s estimate of 4 million covered by this year.

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Years of promising to repeal and replace the Affordable Care Act took a major step last week with the House passing the American Health Care Act. The years of rancorous debate leading to this vote have highlighted the profound divisions in our political system. But, it has also obscured the encouraging reality that most Democrats and Republicans actually share a common goal – the creation of a high quality, high-performance, high-value health care system. We cannot continue to spend more than $3 trillion a year on health care, yet lag behind much of the developed world in overall health outcomes.

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House GOP leaders and Trump administration officials on Wednesday agreed to pour an additional $8 billion into the latest version of their health care bill, part of a last-minute effort aimed at garnering enough support for a potential floor vote before a week-long recess starts on Friday.

The revision won over at least two moderates who had previously opposed the legislation, but it remains unclear whether House Republican leaders, who can afford to lose only 22 GOP lawmakers, have the support needed to send the bill to the Senate before legislators face their constituents next week. A House floor vote has not been scheduled.

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Forty-nine percent of registered voters say congressional Republicans should continue with their efforts to replace Obamacare, up from 37 percent in March immediately after the GOP canceled a House floor vote on its legislation, a Morning Consult/POLITICO survey shows.

Insurance executives, as well as the head of the trade group America’s Health Insurance Plans, met with Seema Verma, administrator of the Centers for Medicare and Medicaid Services, on Tuesday. Insurers have been pressuring administration officials and lawmakers to fund the ACA’s cost-sharing reduction payments. Insurers have struggled to adjust to the individual marketplaces since the ACA created the exchanges, and the ACA’s uncertain political future has only added to the questions they face as they approach the June 21 deadline for filing their 2018 premium rate requests. That will be the first indication of how the individual exchanges fare next year.

. . .

The Trump administration on Thursday released a final rule that slashes the open enrollment period for Affordable Care Act coverage in 2018 in half, among other changes, in its first major regulatory change affecting Obamacare.

The regulation, which aims to stabilize the ACA exchanges, could have a significant impact on the marketplace, but it leaves unanswered insurers’ biggest question: whether the government would continue funding the ACA’s cost-sharing subsidies, which help lower-income consumers afford out-of-pocket health costs.

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