Government Shutdown End In Sight?
After bipartisan weekend talks, Senate Majority Leader John Thune, R-SD, said Monday that he is “optimistic” lawmakers can strike a deal to reopen the government by the end of the week. He added that a stopgap spending bill could fund government through January or later to allow time to mark up and pass appropriations bills. The House will have to re-pass the temporary funding bill as it expires on November 21. Insiders say that Democrats could give in on their position to include Exchange subsidy extensions if a bill is pre-negotiated, likely with the president, or if GOP leaders announce a commitment to hold an up or down vote on an extension.
Meanwhile, Rep. Marjorie Taylor Greene, R-GA, says Republicans deserve much of the blame for rising premiums, saying Republicans should have reformed the Affordable Care Act (ACA) sooner. “The Democrats passed Obamacare, but yet the Republicans have never done anything to correct the problems that exist with it. … And I don’t think it’s an easy thing to fix. … However, it’s something that we should have a plan for, and [House Speaker] Mike Johnson, for a month now, cannot give me a single policy idea. … And I’m angry about that.”
As well, four moderate House lawmakers, two on each side of the aisle, on Monday proposed a framework to temporarily extend the Exchange enhanced premium subsidies, including a sunset period and an income cap for high earners.
Additional articles: https://thehill.com/homenews/senate/5587098-thune-shutdown-spending-bill/ and https://thehill.com/homenews/house/5584132-democrats-gop-end-shutdown/ and https://thehill.com/homenews/house/5584704-greene-maher-republicans-health-care-premiums-shutdown/
#governmentshutdown #trump #congress #exchanges #healthcare #coverage #aca #obamacare
https://thehill.com/policy/healthcare/5587204-obamacare-tax-credits-extension-proposal/?tbref=hp
Ups and Downs In Medicare Doc Pay
Nearly three dozen physician specialty groups are outraged by reductions in the Medicare physician payment rule and are calling on Congress to halt the cuts for thousands of billing codes.
The Centers for Medicare and Medicaid Services issued a final rule granting a 2.5% rate hike as well as an additional .49% adjustment. But it came with a 2.5% negative efficiency reduction for mostly specialty physician services. The increase was laid out in the One Big Beautiful Bill Act (OBBBA). On balance, the changes are an effort to boost primary care and are justified.
(Article may require a subscription.)
#medicare #physicians #rates
https://www.modernhealthcare.com/politics-regulation/mh-medicare-specialty-physician-pay-cut-2026
Medicaid Health Plan Groups Recommend Work Requirement Implementation Practices
Medicaid Health Plans of America (MHPA) and the Association for Community-Affiliated Plans (ACAP) urged the Centers for Medicare & Medicaid Services (CMS) to allow plans to use more modern communication methods and enable critical data sharing to support the launch of work requirements. It also recommends that plans stand in as the compliance entity for the work requirements, including referring to community resources and educating on requirements.
#medicaid #workrequirements #healthplans
Health Plans Expanding Use Of AI
Becker’s Payer reports on health plans’ use of AI in health plan operations. While health plan adoption has been slow, use cases appear to be expanding.
#ai #healthplans #technology
https://www.beckerspayer.com/virtual-care/how-insurers-are-leveraging-ai-agents/
— Marc S. Ryan
