Health Reform Weekly

A weekly compilation from Aetna of health care-related developments in Washington, D.C. and state legislatures across the country.

Week of April 27, 2015

A new Kaiser Family Foundation tracking poll finds that the Affordable Care Act (ACA) has slowly made its way into positive territory in the eyes of the public. The poll found that 43 percent of Americans have a favorable view of the health reform law while 42 percent have an unfavorable view. While the difference is a single percentage point, the latest research marks a plurality of favorable views toward the law for the first time since 2012. Sixty percent say that government action to lower prescription drug prices should be a top priority for the President and Congress, as should transparency related to the prices and quality of health care. While a one-point margin is not statistically significant, the media reports that the overall trend toward increasingly positive views is significant.

Another Kaiser Family Foundation poll found last week that few consumers are using available cost and quality data to obtain better care at lower prices. Despite the trend toward greater transparency in health care costs, about two out of three people say it remains difficult to know how much specific doctors or hospitals charge for medical treatments and procedures.


Reps. Charles Boustany (R-LA) and Kyrsten Sinema (D-AZ) announced last week that a majority of House members have signed on as cosponsors of their bipartisan bill to repeal the ACA health insurance tax. Introduced in February, the legislation has now reached 218 bipartisan cosponsors.

The Senate Finance Committee approved legislation last week to extend Trade Adjustment Assistance (TAA) programs, including health-related budget offsets.
Funding provisions in both the Senate bill and a similar House Ways and Means Committee bill partially cover the cost of extending the TAA programs by increasing sequestration cuts for Medicare during the last six months of fiscal year 2024. The legislation also would make adjustments to Medicare coverage and payment policies for renal dialysis services. The measures would also reinstate the health coverage tax credit formerly available to displaced workers who lost their health coverage and jobs as a result of competition from imported products or shifts in production outside the United States.

Secretary of Health and Human Services (HHS) Sylvia Mathews Burwell testified last week on the President’s 2016 budget request at a hearing in the Senate Appropriations Subcommittee on Labor, HHS, Education, and Related Agencies.
Though focused primarily on the budget, Burwell also discussed the ACA and contingency plans for the Supreme Court’s decision on King v. Burwell. Secretary Burwell indicated that Health and Human Services (HHS) has experienced trouble with contingency planning because its authority to deliver subsidies or any aid to federally facilitated marketplace states would be stripped if the Court rules against the law.

On May 28, a U.S. District Court will hear arguments in a lawsuit brought by the House of Representatives against the Obama Administration over changes made in implementation of the ACA. The lawsuit challenges executive changes made to the ACA, such as delays in the employer mandate, and funding for cost-sharing provisions of the law.


CALIFORNIA: Covered California, the state-based exchange, has announced that the Small Business Health Options Program (SHOP) numbers are up 36 percent since August. As of March 1, the program had 15,644 members at 2,289 small employers statewide. That is a significant increase from August 2014 when the SHOP program had 11,500 members and 1,700 employers. Also, Covered California Executive Director Pete Lee announced that the SHOP program is being rebranded as “Covered California for Small Business,” and a major marketing campaign will launch this month.

COLORADO: Two weeks after naming Robert Malone the finalist for the CEO position, Connect for Health Colorado is resuming its conversations with other finalists.
Malone indicated he reconsidered the job based on the cross-country move it would require. Connect for Health’s CEO position has remained open since the original CEO, Patty Fontneau, left last summer. Gary Drews is serving as interim-CEO. When a new CEO is found, the finalist will need to get approval from the Exchange Legislative Oversight Committee.

FLORIDA: Governor Rick Scott issued a statement last week indicating that the state may convene a Commission on Healthcare and Hospital Funding to examine the revenues of Florida hospitals, insurers and health care providers.
Scott said that if the state does not have a final budget at the completion of the current session, a commission will be asked to examine how taxpayer money contributes to the profits or losses of these institutions in Florida. The analysis should help guide legislators in a special session and aid in the development of the fiscal year 2016-17 budget. According to the governor, the analysis should also help the state prepare for the potential loss of Low Income Pool funding if the federal government declines the state’s amendment request.

NEW HAMPSHIRE: The Insurance Department has announced that state residents will have a variety of health insurance options to choose from in 2016. Exchange filings were due April 15, and five insurers submitted plans for 2016.
Four companies applied to offer stand-alone dental plans. The department noted that consumers also may have more options. Both co-ops that entered the state marketplace in 2015 have filed to offer plans in 2016. In June, the department will host public information sessions detailing the health care provider networks likely available to residents in 2016 through the various health plans offered in the marketplace.

TEXAS: The state has started to re-negotiate its Medicaid hospital waiver, which has provided nearly $30 billion to hospitals to serve uninsured Texans. The federal government has stated that it may make waiver renewal dependent on expanding Medicaid eligibility.
Federal officials have officially told Florida that its waiver renewal will be judged with Medicaid expansion in mind. Gov. Greg Abbott has repeatedly stated that he will not expand Medicaid to the nearly one million Texans in the coverage gap. The state Senate sent a letter to the Obama administration stating it would not expand Medicaid coverage until current Medicaid program issues are fixed.

VIRGINIA: Governor Terry McAuliffe announced last week that Virginia will establish the first state-level Information Sharing and Analysis Organization (ISAO).
The move comes in response to President Obama’s executive order directing the Department of Homeland Security to encourage the creation of ISAOs across the United States. ISAOs are intended to complement existing systems that are used to share critical cybersecurity threat information across levels of government and industry. Governor McAuliffe also serves in a leadership role in the National Governors Association (NGA), Homeland Security and Public Safety Committee, and the NGA Resource Center for State Cybersecurity.


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