Democrats On Attack On Budget Bill Cuts
Democrats are seizing the opportunity to muddy Republicans on the budget reconciliation bill vote and the lack of enhanced subsidy extensions in the Exchanges. A report commissioned by Sens. Ron Wyden, D-OR, and Jeanne Shaheen, D-NH, was compiled by the Georgetown University Center on Health Insurance Reforms.
The report finds the following:
- The Congressional Budget Office (CBO) estimates 4.2 million people will lose coverage in the Exchanges if the enhanced subsidies expire. This is in addition to losses of 2.4 million due to the budget bill and 1.8 million from a recent Trump rule tightening Exchange enrollment and eligibility. This last item has had other estimates of as low as 900,000 impacted.
- Individuals who remain in Exchange plans will see their net premiums increase by 75% on average.
- Enrollment in Exchange plans could decrease by as much as 57%.
- Significant coverage losses and shifts in the Exchange risk pool will mean a median rate increase of 18% in 2026.
In other news, the American Hospital Association alleges that major pharmaceutical companies colluded to devise a plan to replace 340B drug program discounts with rebates. It sent a letter to the Justice Department and the Federal Trade Commission urging an investigation of several brand drug makers. This is a desperate act by the hospital lobby, which is fearful of losing one of several government giveaways.
Additionally, hospitals are pressing for action on and changes to several health policies, including overturning an $8 billion reduction to the Medicaid Disproportionate Share Hospital (DSH) Program in 2026 and more in future years.
Additional articles: https://www.fiercehealthcare.com/regulatory/leading-democrats-press-details-impacts-expiry-aca-subsidies and https://www.modernhealthcare.com/politics-regulation/mh-340b-program-rebate-model-aha/
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#budgetreconciliation #healthcare #coverage #aca #exchanges #hospitals #340b #uninsured
New Study Says States Ill-Prepared For Medicaid Work Requirements
A new study says that more than half of states may be ill-prepared to enact Medicaid work requirements as required by the One Big Beautiful Bill Act (OBBBA). The analysis from the Georgetown McCourt School of Public Policy says its findings are based on eight Medicaid performance indicators to assess how states are currently serving beneficiaries. Researchers found many states currently have lengthy call center wait times, long processing timelines for applications, and low rates of automatic renewals. The report says states are stretched thin even before the new work mandate and requirement to check eligibility every six months for some populations. Twenty-nine states exhibited red flags for at least half of the eight metrics examined.
#medicaid #healthcare #workrequirements
Idaho Drops GLP-1s For Weight Loss For State Employees
Idaho’s health plan for state employees, retirees and their dependents will drop coverage for GLP-1s prescribed for weight loss effective Nov. 1. The changes do not take away access for diabetes. The new policy is expected to reduce premiums by $30 million to $50 million annually.
Other states that have reined in GLP-1 coverage for weight loss include Louisiana, Ohio, and North Carolina.
#glp1s #weightlossdrugs #drugpricing
https://www.beckerspayer.com/payer/idaho-drops-weight-loss-drug-coverage-for-state-employees
— Marc S. Ryan
