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HEALTH CARE HIGHLIGHTS
CMS Halts ACA Risk-Adjustment Payments and Cuts Funding for Health Coverage Navigators
This week, the Centers for Medicare and Medicaid Services (CMS) announced two new actions that could harm the Affordable Care Act (ACA) marketplaces and enrollment. Last Saturday, CMS announced that it would halt the risk-adjustment program, including $10 billion in payments due to insurers for costs incurred last year. The risk-adjustment program spreads risk of high-cost enrollees across insurance companies, and is a critical provision of the ACA to ensure everyone can get health care coverage regardless of pre-existing conditions. Experts predict that eliminating the payments will increase uncertainty in the markets, raise premiums, and increase costs for the federal government.
Then on Tuesday, CMS announced that it will once again slash funding for navigators to assist in the open enrollment period and will encourage navigators to promote plans outside the ACA marketplace, including association health plans and short-term plans. Funding for navigators this year will be $10 million, down from $36.8 million last year, which was down from $62.5 million the previous year.
Dania Palanker and JoAnn Volk wrote in a Commonwealth Fund blog post:
CHART OF THE WEEK
The Trump administration's decision to suspend the Affordable Care Act's risk adjustment program will inevitably create winners and losers in the law's marketplace.https://t.co/ZGYjAoiBjZ
— Axios (@axios) July 10, 2018
Source: "Where the money stands in ACA risk adjustment ", from Axios.com
(Click tweet to see chart full size)
Via STAT News
This week, after pharmaceutical company Pfizer announced its mid-year price increases, President Trump blasted the company in a tweet, prompting further discussion between the Trump Administration and the company. Pfizer subsequently agreed to roll back price increases, at least temporarily. What does this mean for consumers? According to this STAT news piece, “None of it might make any difference in the amount they pay for their prescription drugs, analysts say.” Read More »
Via Kaiser Health News
What will the Trump Administration’s cuts to navigator funding mean? While some say the decision amounts to sabotage, others say that it is unlikely to be a big factor in enrollment, as evidence by the strong enrollment for 2018, despite cuts to funding for advertising and enrollment assistance. Read More »
Via Cure Magazine
Recent data published in the journal Cancer show that the majority of adolescent and young adult (AYA) cancer survivors, diagnosed between the ages of 15 and 39, live past the five-year mark, highlighting the need for long-term survivorship care. Read More »