Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


Push for Obamacare Fixes Continues

A coalition of health insurance companies and provider organizations has written a letter to Congressional Leadership calling for the inclusion of funding for the Patient Protection and Affordable Care Act’s (ACA) cost sharing reduction (CSR) payments in any potential omnibus legislation. The coalition, which includes the American Medical Association, the American Hospital Association, and America’s Health Insurance Plans (AHIP) is asking Congress to include multiple years of funding for CSRs and a reinsurance program, with the goal of bringing down health care premiums. The conservative wing of the House of Representatives continues to oppose the reinstating of CSR payments, insisting any bill that includes them is the equivalent of a bailout for health insurance companies. While support for CSRs has mainly come from Democratic lawmakers, Republican Senators Lamar Alexander (R-Tenn.) and Susan Collins (R-Maine) have pushed for the payments for months. The White House signaled last week that any plan to shore up the health insurance markets with CSR payments must include provisions like greater availability of short term health plans, the blocking of funding for organizations that have a role in abortions, general changes in consumer protections from the ACA, and alterations to the rules surrounding health savings accounts (HSAs).

Negotiations on including CSR payments in the omnibus for Fiscal Year 2018 (FY18) broke down this week, as lawmakers reached an impasse around funding for family planning and teen pregnancy, including those for Planned Parenthood. Differing versions of the House and Senate Appropriations language for the Departments of Labor, Health and Human Services, and Education have created a roadblock for some House Democrats on the committee, including Budget Committee Ranking Member John Yarmuth (D-Ky.) who called the lack of alignment “a huge issue.”

This could put the odds of passing the bill in the House in peril, as a number of fiscally conservative House Republicans could vote against the spending bill, meaning some Democratic support would be necessary for the legislation to clear the chamber before the March 23 deadline.

UnitedHealth Group to Pass Along Drug Rebates

UnitedHealth Group, the country’s largest insurer, says it will begin passing on rebates it gets from pharmaceutical companies to some customers when they purchase prescription drugs. The insurer says it’s trying to bring greater transparency to drug pricing. It also recently launched a tool that allows doctors to go online and see exactly how much patients will pay for prescription drugs at their preferred pharmacy. U.S. Department of Health and Human Services (HHS) Secretary Azar applauded the move.

Secretary Azar Outlines 4-Point Plan to Accelerate Shift Toward a Value-based System

Last Monday in a speech to the Federation of American Hospitals, HHS Secretary Alex Azar outlined a 4-point plan to accelerate movement toward a value-based system, including: (1) Moving ownership and control of electronic health records from providers to patients; (2) Providing payers and providers with incentives to be more transparent about healthcare costs; (3) Using Medicare and Medicaid to drive industry change; and (4) Reducing regulatory burden. Watch Azar’s full remarks here and read the text of his remarks here.

Speaking to health insurers on Thursday, Azar reiterated much of what he said on Monday, adding that some form of federal government intervention will be needed to provide cost effective outcomes for patients. “The status quo is far from a competitive free market in the economic sense of the term, and health care is such a complex system, that facilitating a competitive, value-based marketplace is going to be disruptive to existing actors,” Azar said to a speech in front of America’s Health Insurance Plans (AHIP). Azar recognized the irony of a Republican administration suggesting potential government intervention, saying this notion “may sound surprising coming from an administration that deeply believes in the power of markets and competition.”

In related news, the Administrator for the Centers for Medicare and Medicaid Services (CMS) Seema Verma announced on Tuesday a new initiative, MyHealthEData, which is designed to improve electronic health record (EHR) patient data access. The initiative is intended to give patients more control of their own EHR data and will do this by breaking down existing barriers to health data access and use. MyHealthEData aims to allow patients to receive copies of their entire EHRs, share their personal health data with anyone they choose, and put themselves at the center of the healthcare system. House Ways and Means Committee Chairman Kevin Brady (R-Texas) and Health Subcommittee Chairman Peter Roskam (R-Ill.) applauded the initiative. Verma also noted that CMS will overhaul its meaningful-use initiative that compelled providers to adopt electronic health records. Chairman of the House Energy and Commerce Health Subcommittee Michael Burgess, MD (R-Texas) applauded the announcement, saying that it builds on the committee’s work in the Medicare and CHIP Reauthorization Act of 2015 (MACRA) and the 21st Century Cures Act.

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