President Trump has repeatedly said that the Patient Protection and Affordable Care Act is "imploding," and has talked about letting it collapse of its own weight, but his administration isn't doing much hasten its demise, Paige Winfield Cunningham of writes in The Health 202, The Washington Post's daily digest of health news and analysis.
Since the failure of Senate Republicans to pass a repeal-and-replace bill, and insurance companies' agreements to offer Obamacare policies in counties that were in danger of being left out, the spotlight has shifted to the Department of Health and Human Services, headed by Secretary Tom Price, a physician who as a congressman from Georgia railed against Obamacare.
"While you might think Price would be trying to shoot holes in the measure he’s long criticized, his agency’s approach, at least so far, is far from clear-cut, Cunningham writes. "Health-policy observers -- many of them former Obama administration officials who helped implement the ACA -- say Trump’s fiery rhetoric doesn’t match the more measured approach HHS appears to be taking toward the law, at least for now." HHS hasn’t changed rules in ways "that could severely cripple the ability of insurers to participate in the ACA marketplaces or dramatically reduce the rolls of Americans getting coverage there."
In April, HHS finalized "a number of stricter rules that insurers had said are necessary to help them stabilize the individual markets next year and beyond," including one the Obama administration wrote, requiring people who want to enroll outside the open enrollment period in November and December to prove they had major life changes such as a divorce or a new baby. Mike Adelberg, a former top director at the Center for Consumer Information and Insurance Oversight at HHS’ Center for Medicare and Medicaid Services, told Cunningham, “Frankly, if they were really trying to kill the program this is something they could have thrown the brakes on.”
In May, HHS issued a policy easing sales of Obamacare plans by online brokers such as eHealth and HealthSherpa "ACA supporters have raised concerns that online brokers might not present consumers with their full range of options, but even they admit the strategy could boost enrollment numbers by giving shoppers even more venues from which to sign up," Cunningham reports. "And then there are the things HHS could have done to undercut the marketplaces, but hasn’t (yet)."
For example, "Insurers pay the federal government a fee to use the marketplaces; it’s this money that largely funds the day-to-day operations of Healthcare.gov. HHS could either lower the fee -- thus cutting off the flow of funds to even run the marketplaces -- or dramatically increase it, thereby chasing insurers away. HHS has done neither." Also, HHS could redefine the 10 essential benefits required by Obamacare, or allow states to do so, but hasn't.
"Of course, all this doesn’t mean Price is suddenly showering love on the ACA," Cunningham writes. "His agency still won’t answer questions about whether it will advertise Healthcare.gov during the enrollment season, which runs Nov. 1 through Dec. 15. It’s worth noting that the agency slashed in half the sign-up season, which used to run through the end of January. Some state insurance officials complain they’re not hearing as much from the Trump administration unlike the communication they had with Obama's government. . . . But things seem to be chugging along behind the scenes at HHS, according to the National Association of Insurance Commissioners. 'They are doing everything they have done in the past to make sure the exchange is up and running and everything is loaded,' said a spokesperson for the NAIC."
For consumers needing help with Obamacare, HHS has a decision coming up: whether to fund “navigators,” nonprofit and medical that do enrollment outreach. "Navigators in Alaska and Texas told The Health 202 they’re expecting the awards will be doled out in early September, as in the last two years. The agency didn’t respond to a question about it."
"Price is facing a hard reality pitting politics against practicality," Cunningham writes, quoting former Republican Senate Finance Committee staffer Chris Condeluci: “I think HHS and the administration find themselves in a precarious position because on one hand they want to keep up the political rhetoric but they still can’t let the markets crater.”
Since the failure of Senate Republicans to pass a repeal-and-replace bill, and insurance companies' agreements to offer Obamacare policies in counties that were in danger of being left out, the spotlight has shifted to the Department of Health and Human Services, headed by Secretary Tom Price, a physician who as a congressman from Georgia railed against Obamacare.
"While you might think Price would be trying to shoot holes in the measure he’s long criticized, his agency’s approach, at least so far, is far from clear-cut, Cunningham writes. "Health-policy observers -- many of them former Obama administration officials who helped implement the ACA -- say Trump’s fiery rhetoric doesn’t match the more measured approach HHS appears to be taking toward the law, at least for now." HHS hasn’t changed rules in ways "that could severely cripple the ability of insurers to participate in the ACA marketplaces or dramatically reduce the rolls of Americans getting coverage there."
In April, HHS finalized "a number of stricter rules that insurers had said are necessary to help them stabilize the individual markets next year and beyond," including one the Obama administration wrote, requiring people who want to enroll outside the open enrollment period in November and December to prove they had major life changes such as a divorce or a new baby. Mike Adelberg, a former top director at the Center for Consumer Information and Insurance Oversight at HHS’ Center for Medicare and Medicaid Services, told Cunningham, “Frankly, if they were really trying to kill the program this is something they could have thrown the brakes on.”
In May, HHS issued a policy easing sales of Obamacare plans by online brokers such as eHealth and HealthSherpa "ACA supporters have raised concerns that online brokers might not present consumers with their full range of options, but even they admit the strategy could boost enrollment numbers by giving shoppers even more venues from which to sign up," Cunningham reports. "And then there are the things HHS could have done to undercut the marketplaces, but hasn’t (yet)."
For example, "Insurers pay the federal government a fee to use the marketplaces; it’s this money that largely funds the day-to-day operations of Healthcare.gov. HHS could either lower the fee -- thus cutting off the flow of funds to even run the marketplaces -- or dramatically increase it, thereby chasing insurers away. HHS has done neither." Also, HHS could redefine the 10 essential benefits required by Obamacare, or allow states to do so, but hasn't.
"Of course, all this doesn’t mean Price is suddenly showering love on the ACA," Cunningham writes. "His agency still won’t answer questions about whether it will advertise Healthcare.gov during the enrollment season, which runs Nov. 1 through Dec. 15. It’s worth noting that the agency slashed in half the sign-up season, which used to run through the end of January. Some state insurance officials complain they’re not hearing as much from the Trump administration unlike the communication they had with Obama's government. . . . But things seem to be chugging along behind the scenes at HHS, according to the National Association of Insurance Commissioners. 'They are doing everything they have done in the past to make sure the exchange is up and running and everything is loaded,' said a spokesperson for the NAIC."
For consumers needing help with Obamacare, HHS has a decision coming up: whether to fund “navigators,” nonprofit and medical that do enrollment outreach. "Navigators in Alaska and Texas told The Health 202 they’re expecting the awards will be doled out in early September, as in the last two years. The agency didn’t respond to a question about it."
"Price is facing a hard reality pitting politics against practicality," Cunningham writes, quoting former Republican Senate Finance Committee staffer Chris Condeluci: “I think HHS and the administration find themselves in a precarious position because on one hand they want to keep up the political rhetoric but they still can’t let the markets crater.”
from Kentucky Health News http://ift.tt/2wSxo4D
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