Senate Adopts “Current Policy” Scoring Budget Gimmick
The Senate GOP has officially adopted a budget gimmick in its proposed budget reconciliation resolution. Appropriations Chair Sen. Lindsay Graham, R-SC, said he had the authority to adopt the budget scoring method and the Senate parliamentarian said it was appropriate to move forward. The resolution sets lower targets for spending cuts – a minimum of $3 billion. The resolution should be adopted later this week to align in general with the House approach. However, some conservatives in the House are already attacking the gimmick. The House approach sets a $1.5 trillion floor with a goal of $2.0 trillion in cuts over ten years. This could set up a showdown between moderates and conservatives on spending reductions.
The truth is that the current policy approach means much higher deficits to 2034 and after. It is an appalling approach that further inflates our massive debt and burdens future generations.
Additional articles: https://thehill.com/homenews/senate/5226747-republicans-tax-cuts-deficit-senate-parliamentarian/?tbref=hp and https://thehill.com/business/5226495-senate-republicans-eye-budget-resolution-vote-this-week-with-reduced-spending-cuts/?tbref=hp
#budgetreconciliation #congress #trump #spending
https://thehill.com/homenews/senate/5228769-trump-tax-cut-budget-bill-senate
KFF Shows Growth of Exchanges Since 2020
Healthcare policy group KFF has published a great briefer on Exchange enrollment growth. Since 2020, enrollment in the Exchanges has more than doubled, growing by 12.9M from 11.4M to 24.3M, or 113%. Enrollment more than doubled in 20 states since 2020.
KFF found that enrollment grew by 157% on average in states won by Trump, while it increased by an average of 36% in states carried by former Vice President Kamala Harris.
Of course, enrollment is slated to tumble by 3.8 million if the enhanced premiums subsidies are not extended at the end of this year. The Congressional Budget Office (CBO) estimated that it would cost $335 billion over the next 10 years to extend the subsidies permanently.
KFF briefer: https://www.kff.org/policy-watch/enrollment-growth-in-the-aca-marketplaces/ and https://www.kff.org/affordable-care-act/press-release/aca-marketplace-enrollment-has-more-than-doubled-since-2020-with-the-fastest-growth-occurring-in-states-won-by-president-trump-in-2024/
Additional article: https://www.healthcaredive.com/news/aca-enrollment-growth-driven-trump-states-kff/744250/
#exchanges #obamacare #aca #coverage
FTC Pauses PBM Insulin Lawsuit
The Federal Trade Commission (FTC) is pressing pause on its legal fight with major pharmacy benefit managers (PBMs). The Trump administration has been pretty aggressive on antitrust issues, so this does not appear to be an ultimate pullback on the lawsuit. The agency said there are currently no sitting commissioners who are able to join the proceedings since Republicans Andrew Ferguson and Melissa Holyoak have recused themselves.
The suit is an administrative one through the FTC process rather than in the federal courts. PBMs are right that the venue is not appropriate given conflicts of interest in general and due process concerns. That said, a case should be pursued.
Additional article: https://www.fiercehealthcare.com/regulatory/ftc-pauses-lawsuit-against-pbms-over-insulin-pricing
(Some articles may require a subscription.)
#ftc #antitrust #pbms #drugpricing
https://www.modernhealthcare.com/legal/ftc-cvs-caremark-express-scripts-optumrx-paused
Many Questions On Impact Of HHS Layoffs
A series of articles are appearing in light of the announcement of a major reorganization and that an additional 10,000 positions will be eliminated at the Department of Health and Human Services (HHS) and related healthcare agencies. Among the concerns raised include:
- How HHS plans to handle billions of dollars in claims disputes and appeals resolutions
- Layoffs eliminate the division responsible for certifying personal protective equipment that healthcare providers use
- Security and safety of medical devices
- The shuttering of the bureau trying to recoup more than $1 billion in improper payments dispersed to providers during the COVID-19 pandemic
Senate Help Chairman Bill Cassidy, R-LA, has asked HHS Secretary Robert F. Kenndy, Jr. to appear before the committee on the reorganization and layoffs. Democrats have fired off a letter to HHS asking that each impacted agency explain how the proposed reorganization and staffing reductions will improve HHS’ ability to carry out its authorized and funded activities.
Additional articles: https://www.modernhealthcare.com/policy/hhs-restructuring-claims-disputes-oversight and https://www.modernhealthcare.com/politics-policy/hhs-layoffs-niosh-n95-respirators and https://www.healthcaredive.com/news/hhs-fda-layoffs-medical-device-cybersecurity/744153/ and https://www.fiercehealthcare.com/regulatory/providers-owe-1b-federal-government-misused-covid-19-emergency-funds-doge-just-cut
(Some articles may require a subscription.)
#hhs #fda #cdc #nih #layoffs #doge #trump #congress
2024 Job Cuts Big At Health Plans
Across the seven major national publicly traded health plans, employment dropped 4.6% in 2024. Elevance Health, Humana, UnitedHealth Group and Centene cut their workforces, with the biggest reductions coming from the latter two companies. CVS Health and Molina Healthcare kept their workforce steady. Cigna grew its headcount nearly 1.4%.
The moves came due to Medicare Advantage’s (MA) major fiscal woes as well as general problems at health plans.
(Article may require a subscription.)
#medicareadvantage #healthplans #margins
https://www.modernhealthcare.com/insurance/unitedhealth-aetna-humana-job-cuts-layoffs
Kaiser Health News Investigates What The Sickest Face In Terms Of Denials
A Kaiser Health News story discussing the travails faced by the sickest Americans in terms of prior authorization denials and other headaches from health plans.
#priorauthorizations #claimsdenials #healthplans
— Marc S. Ryan
