Though HealthCare.gov sign-ups during this year’s open-enrollment period came up short of last year’s total, the near-final tally defied the odds. More than 8.8 million people enrolled in 2018 coverage through the federally run marketplace before open enrollment ended on Dec. 15, despite a shortened sign-up period and slashed federal funding for advertisements and enrollment assistance. That’s just 400,000 less than the 9.2 million people who signed up during the previous open enrollment, which ran twice as long and was bolstered by a $100 million marketing budget.
In two letters Thursday, a group of Senate Democrats and more than 300 public-health organizations called on top Trump administration officials to lift any restrictions on how Health and Human Services employees communicate in official documents.
The missives come in the wake of reports by The Washington Post that budget writers at the Centers for Disease Control and Prevention and other HHS agencies were instructed to avoid using “diversity,” “vulnerable” and “entitlement” in the narratives they were preparing for the fiscal 2019 budget process, based on a “style guide” that was part of a lengthy budget guidance document. The letters underscore the extent to which the linguistic guidelines have caused an uproar. Multiple departments, including the Justice Department, have drafted documents on “words to avoid,” and others such as the Environmental Protection Agency and Interior have singled out words such as “climate change” for elimination in official documents.
Congress late Thursday approved legislation funding the government through Jan. 19. As they headed out of town for the holiday recess, however, lawmakers left a lot of unfinished healthcare issues on the table. Here’s a look at 10 items that will need attention in 2018:1. Children’s Health Insurance Program: No question now that states are in deep trouble over the dwindling or already-dwindled funds in their programs. Some have already warned families that coverage for their kids may end.
Basic steps to prevent infections — such as washing hands, isolating contagious patients and keeping ill nurses and aides from coming to work — are routinely ignored in the nation’s nursing homes, endangering residents and spreading hazardous germs.
A Kaiser Health News analysis of four years of federal inspection records shows 74 percent of nursing homes have been cited for lapses in infection control — more than for any other type of health violation. In California, health inspectors have cited all but 133 of the state’s 1,251 homes.
Although repeat citations are common, disciplinary action such as fines is rare: Nationwide, only one of 75 homes found deficient in those four years has received a high-level citation that can result in a financial penalty, the analysis found.
More than 8.8 million Americans signed up for Affordable Care Act health plans for 2018 in the 39 states relying on the federal HealthCare.gov website, an unexpectedly robust turnout that approaches the 2017 total, despite an enrollment season cut by half and other moves by the Trump administration to undermine the law’s insurance marketplaces.
The numbers the administration reported Thursday include an all-time high for the number of new consumers signing up in a single week, with 1 million such people picking health plans in the final days before the Dec. 15 federal deadline.
The overall tally is roughly 95 percent of the 9.2 million people who got coverage for 2017 during a three-month sign-up period that ended last January. It defies widespread expectations of the law’s critics as well as supporters that enrollment would slump sharply as the Obama administration’s boosterism gave way to the aggressive opposition of President Trump and congressional Republicans, who have tried all year to repeal much of the ACA.
As congressional Republicans this week crippled the Affordable Care Act’s requirement that most Americans carry health insurance, they simultaneously abandoned in the final politicking of 2017 a pair of measures that President Trump and the Senate’s GOP leader had promised to help cushion the law’s marketplaces.
The measures, pledged to a crucial Republican moderate in exchange for her support on Congress’s massive tax overhaul, would have temporarily restored an ACA subsidy to health insurers that Trump ended this fall and would have given states several billion dollars to help buffer insurance companies from customers with especially high medical costs.
Hours after Congress passed the tax bill Wednesday, President Trump declared the Affordable Care Act “essentially” repealed.
In fact, it’s barely touched.
What was repealed — effective in 2019 — was the requirement that nearly everyone have insurance or pay a penalty at tax time.
“This is important but it’s not the heart of the ACA, by any means,” says Sara Collins, vice president of health care coverage and access for the non-profit Commonwealth Fund.
What the tax bill doesn’t change:
With President Donald Trump poised to sign a tax bill that would effectively kill off the mandate requiring most Americans to buy health insurance coverage or pay a fine, calls for federal legislation to stabilize the individual insurance market are intensifying. But some experts doubt that federal help for 2018 is on the way, and wonder if states would be better off taking action on their own to prop up their markets.The House and Senate this week voted in favor of a $1.5 trillion tax proposal that included a provision zeroing out the individual mandate penalty.
In recent months, both Congress and the media have been fixated on tax reform. Congress just passed the first tax reform bill in thirty years. So, after the Christmas break, maybe they can return to the problem that is foremost in the minds of Americans, our failing healthcare system.
While the tax bill did repeal the coercive penalty for failure to purchase insurance, Americans still face two huge healthcare problems: they can’t get care when they need it and they cannot afford health insurance. And paying for the care itself is beyond everyone’s reach, except for uber-rich.
In fact, while everyone wants relief from the tax burden, a recent Politico-generated survey shows that healthcare is still the No.1 domestic concern for both Republicans and Democrats.
Congress now has two rival bills with dueling views on how the 340B program should look.On Thursday, Reps. Larry Bucshon (R-Ind.) and Scott Peters (D-Calif.) released a bill that would essentially rewrite rules for the 340B hospitals in a way that critics argue would fundamentally alter the program and the way it provides care for vulnerable patients.The Bucshon-Peters bill would stop new disproportionate-share hospitals from enrolling in 340B and halt registration of new child sites for these hospitals. Other provisions include new reporting requirements in place on DSH, cancer and children’s hospitals, and a mandate to make all reported data from these hospitals public.
The commissioner of the Food and Drug Administration questions whether the right financial incentives are in place for drugmakers who develop orphan drugs for rare diseases.
In an interview this week, the FDA’s Scott Gottlieb said the Orphan Drug Act of 1983 has provided “an enormous amount of public health value” over the years, but the “market has changed.”
Gottlieb said it’s time to ask the question: “Do we have the right incentives in place?”
The CMS announced Thursday it has added updated star ratings to its Hospital Compare site using a new methodology after a five-month delay.
The agency had postponed the release of the star ratings since July as it worked to change the methodology and gather stakeholder feedback. The new methodology was designed in response to criticism—particularly from hospitals—that the previous formula was flawed and provided inaccurate information about providers.
The retooled formula slightly flattens the usual bell-curve of hospitals that receive stars on a scale of 1 to 5, with 5 being the highest. In the previous methodology, few hospitals received 1 or 5 stars, and the majority have 2, 3 or 4 stars. While that is still the case, the number of hospitals with 1 or 5 stars has risen.
Renda Bower knows well the cost of drugs to treat rheumatoid arthritis – her husband, son and daughter all have the painful, disabling autoimmune disease. And the family’s finances revolve around paying for them. Even with insurance, Bower’s family last year faced $600 a month in copayments for the drug, plus additional payments on another $16,000 in medical bills racked up in 2016 when a former insurer refused to cover all the doses her 9-year-old daughter needed.