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August 24, 2017

Eyeing bipartisan reform, senators invite governors to discuss ACA changes

Daily Briefing

    The Senate Health, Education, Labor, and Pensions (HELP) Committee on Tuesday announced plans to hear from governors and state insurance commissioners during two hearings early next month about how to control rising premiums in the Affordable Care Act's (ACA) exchange plans.

    Today at 3 ET: Learn about upcoming changes to hospital inpatient payments in FY 2018

    The hearings, which are set for Sept. 6 and 7, come after Senate Republicans last month failed to pass three different measures to partially repeal the ACA. After the final vote, Senate HELP Committee Chair Lamar Alexander (R-Tenn.) and ranking member Sen. Patty Murray (D-Wash.) said they would hold hearings and work on a bipartisan measure to bolster the exchange market when they returned from August recess. Many exchange insurers have proposed double-digit premium increases for the 2018 coverage year, and in many counties, consumers are likely to have only one health plan option.

    Alexander has said he hopes the committee can work with industry stakeholders to quickly pass a bill that would address rising premiums and increase competition in the exchanges. He has said such a bill could include funding for the ACA's cost-sharing reductions (CSR) and give states additional flexibility in how they use so-called "state innovation waivers" under the ACA, Roll Call reports.

    The Senate is set to return from its August recess on Sept. 5. According to the Wall Street Journal, that leaves lawmakers just 12 legislative days to reach and pass any bipartisan bill before insurers must sign contracts to participate in the exchanges for the 2018 coverage year on Sept. 27.

    Governors scheduled to testify

    While the Senate HELP committee has not yet announced who will testify at the insurance commissioners hearing, Alexander and Murray on Wednesday announced the five governors who will testify on Sept. 7:

    • Colorado Gov. John Hickenlooper (D);
    • Massachusetts Gov. Charlie Baker (R);
    • Montana Gov. Steve Bullock (D);
    • Tennessee Gov. Bill Haslam (R); and
    • Utah Gov. Gary Herbert (R).

    During the hearing, Hickenlooper is expected to share a bipartisan plan he has been working on with Ohio Gov. John Kasich (R).

    In an interview Monday, Hickenlooper and Kasich suggested their plan, which has not yet been publicly released, could include funding for CSR payments. Hickenlooper suggested the plan also could include a reinsurance program to help insurers cover patients with high medical bills. Both governors have also shown a willingness to increase the threshold for the ACA's employer mandate, which currently requires employers with at least 50 workers to offer insurance to employees.

    Kasich said, "We're trying to stabilize insurance markets here first," adding, "You have to find things that you can agree upon and this is the most critical aspect of what needs to be fixed."

    Kasich and Hickenlooper said the plan could be ready as soon as next week.

    Other reform efforts

    Meanwhile, GOP Sens. Bill Cassidy (La.), Lindsey Graham (S.C.), and Dean Heller (Nev.) are continuing to push their health reform proposal, which would maintain most of the ACA's taxes and direct that money to states. According to Roll Call, the lawmakers are discussing the bill with some Republican governors.

    Further, according to the Wall Street Journal, some House lawmakers, including Reps. Mark Meadows (R-N.C.) and Tom MacArthur (R-N.J.), are working on a proposal viewed as a companion to the bill Alexander hopes to pass (McIntire, Roll Call, 8/22; Hellman, The Hill, 8/22; Armour/Hackman, Wall Street Journal, 8/20).

    Today: Learn about upcoming changes to hospital inpatient payments in FY 2018

    Examine CMS’s Final Rule for the Inpatient Prospective Payment System in FY 2018.

    Join our experts this afternoon at 3 pm ET to learn about CMS's updates to payment rates and the Inpatient Grouper, Medicare DSH payments, the three mandatory pay-for-performance programs, and inpatient quality reporting.

    Join the Webconference

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