Senators Request Details on New Insurance Scoring Model

Twelve Republican senators are requesting that the Congressional Budget Office (CBO) provide details about its development and testing of a forthcoming health insurance simulation model (HISIM). The model will be used to produce more accurate estimates of health insurance coverage and premiums for generating future baselines and cost estimates. The lawmakers encourage the agency to release additional information about the model to the public prior to when CBO plans to begin utilizing it in the spring of 2019. They request that CBO publish a description of the new model’s specifications, including the data it relies on, its estimation methods, and an explanation of its key assumptions, as well as any computer code. The senators also suggest that the new model be applied to re-estimate federal spending and coverage under the Affordable Care Act (ACA).

Hassan to Introduce Surprise Billing Legislation

Sen. Maggie Hassan (D-N.H.) plans to introduce legislation to eliminate surprise medical bills for individuals with employer-sponsored health plans. The No More Surprise Medical Bills Act of 2018 would prohibit hospitals and providers from charging patients with medical emergencies more than the in-network amount. It would also require hospitals and providers to notify patients in non-emergency situations if services will be considered out-of-network. Without notification and consent, the provider could only charge the in-network amount. The bill would establish an independent entity to resolve any disputes that arise between providers and health insurance plans.

KFF Releases New Data on Individual, Employer Markets

A new study from the Kaiser Family Foundation shows that insurers in the individual market performed better financially in the first six months of this year than in any other year since passage of the Affordable Care Act (ACA). According to the brief, the individual market remains stable and insurers are generally profitable, despite uncertainty about policy changes from Congress and the administration.

Kaiser Family Foundation also released its latest annual employer health benefits survey last week. In 2018, premiums for both individuals and families enrolled in employer health plans increased moderately, while more workers are paying higher deductibles. The survey found that premiums increased by five percent for family plans and three percent for single coverage plans. Eighty-five percent of people enrolled in an employer health plan had a deductible, up from 81 percent last year. The average deductible has also increased to $1,573 compared to $1,505 last year.

Recently Introduced Health Legislation

H.Res.1103 — Expressing support for designation of July as National Sarcoma Awareness Month; Sponsor: Rep. Duffy, Sean P. [R-WI-7]; Committees: House - Oversight and Government Reform

H.Res.1106 — Supporting the designation of October 6, 2018, as National Ostomy Awareness Day; Sponsor: Rep. Payne, Donald M., Jr. [D-NJ-10]; Committees: House - Oversight and Government Reform

H.R.6980 — To amend title XVIII of the Social Security Act to provide coverage for custom fabricated breast prostheses following a mastectomy; Sponsor: Rep. Blum, Rod [R-IA-1]; Committees: House - Energy and Commerce, Ways and Means

H.R.6984 — To add suicide prevention resources to school identification cards; Sponsor: Rep. Correa, J. Luis [D-CA-46]; Committees: House - Education and the Workforce

H.R.6986 — To amend titles XVIII and XIX of the Social Security Act with respect to nursing facility requirements, and for other purposes; Sponsor: Rep. Duffy, Sean P. [R-WI-7]; Committees: House - Ways and Means, Energy and Commerce

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