Assessing Premium Subsidy Extension
Modern Healthcare does a good job assessing the prospects of extending the enhanced premium subsidies for at least one year. There are a group of moderates seeking the extension but conservatives in each house seem to be very uninterested. House Speaker Mike Johnson, R-LA, is saying it is on the table but is non-committal. The wild card is whether Democrats will demand the extension as part of some grand funding compromise on keeping the government open. But would that actually work against them politically in the midterms?
(Article may require a subscription.)
#exchanges #budgetreconciliation #obbba
https://www.modernhealthcare.com/politics-regulation/mh-aca-subsidies-gop-expiring-2026
House Opposes PA In Traditional Medicare
The House Appropriations Committee threw water on the fire when it voted to defund a plan that would have prior authorization (PA) in traditional Medicare on certain high-cost, abused services. Enough Republicans joined Democrats in passing an amendment to a funding bill that would block CMS from prior authorizing certain services, including skin and tissue substitutes, electrical nerve stimulator implants, and knee arthroscopy for osteoarthritis.
The move by the Trump administration seemed disjointed just as major PA restrictions were going into effect and health plans agreed to go further in reforming PA. It shows how deep the bipartisan anti-PA sentiment has come.
#priorauthorization #medicare #healthplans
https://www.medpagetoday.com/publichealthpolicy/washington-watch/117408
HCSC Touts Footprint
HCSC, a mutual Big Blue in the Midwest that acquired Cigna’s Medicare line, touted in a press release this week that it was launching plans in 948 counties across 30 states and the District of Columbia. But all or a vast majority of the footprint is either existing HCSC or existing Cigna plans. As an example, before the sale Cigna had MA in 29 states and D.C. No word on real expansions or contractions.
In addition to Medicare Advantage, HCSC will now have standalone Medicare prescription drug plans (PDP) in 48 states and Puerto Rico as well as Medicare Supplement plans in 48 states.
#medicareadvantage #hcsc #cigna
https://www.beckerspayer.com/payer/medicare-advantage/hcsc-to-offer-ma-plans-in-30-states
— Marc S. Ryan
