Health and Human Services Secretary Alex Azar told lawmakers Tuesday that he wants to preserve access to affordable insurance for Americans with preexisting medical conditions, but he declined to disclose his view of an administration move that could undercut such consumer protections.

Calling it “a constitutional position . . . not a policy position,” Azar sidestepped grilling on whether he agreed with a legal brief filed last week by Justice Department attorneys stating they would not defend the Affordable Care Act in a federal lawsuit by Texas and 19 other Republican-led states.

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The latest plan is being forged by leaders at the conservative think tanks Heritage Foundation and the Galen Institute, along with former senator Rick Santorum and Yuval Levin of the Ethics and Public Policy Center. They’ve been meeting regularly over the past eight months to craft a recommendation for Congress to repeal much of the ACA’s coverage requirements and taxes, turn over some of its spending to states through block grants and expand the use of tax-free health savings accounts.

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Insurers are proposing double-digit premium increases in Maryland’s individual-health-plan market, a consequence of what the state’s health insurance commissioner called a “death spiral.”

CareFirst BlueCross BlueShield requested an 18.5 percent increase on the HMO plans used by the vast majority of its individual-plan members — and a whopping, 91.4 percent increase on its PPO plans. Kaiser Permanente requested a 37.4 percent increase on its HMO plans. The average rate increase requested, across insurers and plans, was 30 percent.

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President Trump is sending a plan to Congress that calls for stripping more than $15 billion in previously approved spending, with the hope that it will temper conservative angst over ballooning budget deficits.

Almost half of the proposed cuts would come from two accounts within the Children’s Health Insurance Program (CHIP) that White House officials said expired last year or are not expected to be drawn upon. An additional $800 million in cuts would come from money created by the Affordable Care Act in 2010 to test innovative payment and service delivery models.

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There are already more than a dozen reasons people can use to avoid paying the penalty for not having health insurance. Now the federal government has added four more “hardship exemptions”. Under the new rules, people can apply for a hardship exemption that excuses them from having to have health insurance if they:

  • Live in an area where there are no marketplace plans.
  • Live in an area where there is just one insurer selling marketplace plans.
  • Can’t find an affordable marketplace plan that doesn’t cover abortion.
  • Experience “personal circumstances” that make it difficult for them to buy a marketplace plan, including not being able to find a plan in their area that gives them access to specialty care they need.

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Insurance premiums for Affordable Care Act health plans are likely to jump by 35 to 94 percent around the country within the next three years, according to a new report concluding that recent federal decisions will have a profound effect on prices.

The nationwide analysis, issued Thursday by California’s insurance marketplace, finds wide variations state to state, with a broad swath of the South and parts of the Midwest in danger of what the report calls “catastrophic” average rate increases by 2021.

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States that run their own Affordable Care Act insurance market­places significantly outperformed the rest of the country in attracting consumers to sign up for health plans for 2018, according to enrollment tallies released Wednesday.

Overall enrollment stayed essentially level from the year before in the 11 states plus the District with state-based marketplaces, while sign-ups in states that rely on the ACA’s federal exchange fell, on average, by more than 5 percent. Five states with hybrid systems did best of all, according to a report compiled by the National Academy for State Health Policy.

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Americans are among the most generous people in the world. While this nation was founded on the pursuit of a shared dream, the moral pledge of the American people has been to never leave behind our most vulnerable fellow citizens.

When we created Medicaid in 1965 as part of President Lyndon B. Johnson’s War on Poverty, we formalized that commitment and wove a fabric of care that has provided health services for seniors in need, pregnant mothers, low-income children and parents, and people with disabilities. Johnson affirmed the nation’s safety net, saying, “Our aim is not only to relieve the symptoms of poverty, but to cure it and, above all, to prevent it.”

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A House committee voted Tuesday to impose work requirements on Medicaid recipients, something Republicans are seeking as a precondition to expanding the health-care program to more low-income, uninsured Virginians. It was not clear how many of the state’s 1 million Medicaid recipients would be affected if the bill becomes law because the majority are children, the elderly, pregnant women and people with disabilities, all of whom would be exempt under the plan because they are considered to face some barrier to work.

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The Trump administration is exploring ways to allow more Americans toqualify for exemptions from the Affordable Care Act’s individual mandate, which goes away in 2019 but is still in effect this year. The Centers for Medicare and Medicaid Services is reportedly working on guidance that would expand “hardship” exemptions from the mandate that would apply this year, meaning they could be cited by filers preparing their 2018 taxes next year.

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