republicans

Moderate GOPers Frustrated On Exchange Impasse Frustration is mounting for moderate GOP lawmakers as the GOP has no defined healthcare plan, and Democrats are capitalizing on the lack of affordability in healthcare and the expiration of enhanced subsidies in the Exchange. Millions will see surging premiums as of January 1 with no action to extend the subsidies. Dozens in the GOP caucus in the House from swing districts face an uncertain future. A few GOP senators are also vulnerable. But so far, House Speaker Mike Johnson, R-LA, bolstered by opposition from conservatives, refuses to guarantee a vote in the House. In the Senate, Majority Leader John Thune, R-SD, did agree to hold a vote and Democrats are pushing a three-year extension. Sixty votes are needed to pass the bill. Democrats would need seven GOP defectors. It is a possibility but perhaps not a likelihood. In other news, MedPage Today talks

Schumer Unveils Three-Year Subsidy Extension Senate Minority Leader Chuck Schumer, D-NY, unveiled a clean three-year extension of enhanced premium subsidies for a vote next week in the upper chamber. This came after a group of Senate Democrats gained a commitment from Senate Majority Leader John Thine, R-SD, for a subsidy vote when the group agreed to support a bill to reopen the government. Some Democrats have held talks with centrist Republicans to seek a compromise that would temporarily extend the enhanced subsidies while adding policies such as income eligibility caps, minimum premiums, and anti-fraud measures. This could mean the bill is amended to attract GOP votes to get to 60 votes. Some GOP senators are open to doing so, frustrated with the lack of any real GOP alternative. There are some GOP bills being developed which focus on Health Savings Account support but are not expected to be ready in

Will Subsidy Extension Pass? A Senate vote on a clean, three-year enhanced Exchange subsidy extension is scheduled for next week. And many Republicans are frustrated that their party is divided and no consensus can be reached on any compromise legislation. Any Republican bill would not be ready until after next week. That opens up the possibility that enough Republicans cross the aisle and vote with Democrats to extend the subsidies as is. House Speaker Mike Johnson, R-LA, has not yet committed to bring up the bill, but Democrats and some moderate Republicans could force a vote through a discharge petition. Given the lack of a real Republican bill, GOP lawmakers in both chambers are coming around to a temporary extension of enhanced Exchange subsidies. Conservative House and Senate Republicans either want fundamental reform or no action to extend the enhanced subsidies. Moderate Republicans in the House want either a clean

Nursing Home Staffing Rule In Dustbin The controversial rule seeking to impose nursing home staffing requirements has been officially repealed by the federal government after a judge struck down the Biden administration provision. The rule would have meant huge costs for the industry and actually either forced the shutter of smaller firms or led them to sell out to massive consolidators in the industry. The rule was a political sop to the unions as well. Additional article: https://www.modernhealthcare.com/politics-regulation/mh-cms-nursing-home-staffing-mandate-repealed/ (Some articles may require a subscription.) #nursinghomes #staffing #medicaid #medicare https://www.fiercehealthcare.com/regulatory/hhs-closes-book-controversial-nursing-home-staffing-mandate New ACCESS Model Tests Chronic Care In Medicare The Centers for Medicare and Medicaid Servies (CMS) announced a new payment model on December 1. The ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model tests an outcome-aligned payment approach in Medicare. The model is aimed at expanding access to new technology-supported care options that help people improve their health and prevent

Exchange Subsidy Debate Still Dominates Hill The Exchange subsidy debate continues to dominate Capitol Hill. Sen. Amy Klobuchar, D-MN, predicted Sunday that the Senate will hold a vote on extending Exchange subsidies. “That vote will happen. And whether it will pass is in the hands of Donald Trump and the Republicans,” Klobuchar told CNN. Senate Majority Leader John Thune, R-SD, has committed to a vote, while House Speaker Mike Johnson, R-LA, has not. House Minority Leader Hakeen Jeffries, D-NY, is pressing centrist Republicans to help Democrats extend the tax credits before they expire at the end of the month by signing on to his discharge petition to force a vote in the House. Moderate Republicans in the House say they have their own discharge petition but are waiting to see what the Senate does. Many are critical of President Trump’s equivocation on the subsidies – in one breath he is ready to

Populist Trump Attacks Health Plans President Donald Trump has turned to attacking health plans in the wake of a concerted effort from Democrats accusing him and the GOP of not doing enough to tackle affordability. Trump was thought to be preparing an enhanced subsidy extension plan, but it is either delayed or won’t happen due to opposition from GOP conservatives in Congress. Trump is said to have supported a two-year extension with some reforms of the enhancements along with introducing subsidies for Health Savings Accounts for some to use.  In a recent social media post he directed his ire on healthcare affordability to health plans, saying: “The only healthcare I will support or approve is sending the money directly back to the people, with nothing going to the big, fat, rich insurance companies, who have made $trillions, and ripped off America long enough.” Of course, that is not true. But Trump may

What Is On GOP Menu For Subsidies? A good article in The Hill on Thanksgiving breaking down the GOP dilemma on what to do with the Exchange enhanced subsidy expiration that is looming. The issue pits moderate Republicans against conservative ones. There are competing proposals across the House and Senate. The dilemma: Extend the subsidies and endorse Obamacare or let the subsidies expire and deal with the electoral fallout in 2026. This could be major in dozens of moderate Republican swing districts in the House and several seats in the Senate. Here are some bills percolating on the Republican side: Moderates in both parties in House: One bill would extend the enhanced subsidies for two years but make some changes to assuage conservatives. Those earning less than $200,000 per year for a family of four would keep their subsidies and those earning between $200,000 and $300,000 for a family of four would