No Smooth Sailing: Agreement To Run Exchange Amendment Hits Rocks
An agreement between moderate Republicans and the House GOP leadership to allow a vote on an amendment to extend the expiring Exchange is in doubt as the two sides squabble over whether any extension will be paid for by spending offsets.
The amendment would extend the enhanced subsidies for two years but add certain eligibility reforms. But the House leadership is demanding spending offsets due to conservative objections. A full subsidy extension would cost about $35 billion a year.
Conservatives could derail the amendment in the Rules Committee even before it gets to the floor. GOP moderates could vote against the bill as a whole and sink it as Democrats will not support it. As an alternative, the GOP moderates could team up with Democrats to force a vote via one of several discharge petitions, which need 218 signatures to come to the floor without the Speaker’s permission. House Democrats say they’re looking for the green light from their leadership to band together with moderate Republicans.
A free-standing extension would have a better shot at passing the House. In the Senate, 13 Republicans would have to vote with Democrats to reach a 60-vote requirement to pass the bill.
Meanwhile, more is being released on the GOP master reform bill. The bill would approve association health plans, which have employers band together to purchase coverage. These plans have some but not all Affordable Care Act (ACA) protections. Individual coverage health reimbursement arrangements, or ICHRAs, would be expanded. These provide employer subsidies to allow employees to purchase Exchange coverage. Broadened access to stop-loss coverage for mid-size and small employers would be included, which would encourage additional self-insurance vs insurer risk arrangements.
Pharmacy benefits manager reform is also included. And cost-sharing subsidies in the Exchange would be reappropriated. This was defunded under Trump 45. The move would lower overall Silver premiums but have the adverse effect of lowering subsidies now, causing 300,000 to perhaps drop coverage.
The House bill does not endorse expansion of health savings accounts (HSAs), which is what the leading Senate bill proposed to do in lieu of an enhanced subsidy extension.
Additional articles: https://www.modernhealthcare.com/politics-regulation/mh-house-aca-subsidies-association-health-plans/ and https://thehill.com/homenews/house/5650083-aobamacare-subsidies-amendment-vote/ and https://thehill.com/homenews/house/5647098-obamacare-subsidies-house-democrats/
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#exchanges #healthcare #coverage
https://www.fiercehealthcare.com/regulatory/house-gop-healthcare-bill-eschews-subsidy-extension-hsas
Trump Signs Executive Order Reining In State AI Regulation
President Donald Trump signed an executive order that aims to limit and challenge state laws on artificial intelligence (AI). Instead, Trump wants to speed up plans to create one comprehensive, unified approach in lieu of disparate state regulation. There are no specific references to healthcare AI.
On one hand, Trump is right that a patchwork regulatory system would hurt AI advancement. The order directs the Justice Department to establish an AI Litigation Task Force within 30 days to challenge what it says are unconstitutional, preempted or otherwise unlawful state AI laws that harm innovation. It also directs the Commerce Department to identify onerous state AI laws. It threatens to withhold federal broadband funding and other discretionary grants.
On the other hand, states do have a point that Congress has failed to pass any meaningful legislation to regulate or provide safeguards. In general, so far there has been no federal strategy other than the Trump order which points to a no-holds-barred approach. Some states already plan to challenge the order, including New York and New Jersey. Florida Governor Ron DeSantis also spoke out against the Trump order.
Additional articles: https://www.healthcaredive.com/news/trump-federal-policy-preempting-state-ai-laws/807867/
#ai #regulation #congress #trump #healthcare
— Marc S. Ryan
