What's next at the national level with health care reform?

The Colorado Health Policy Coalition shared these thoughts earlier today:

"Two quick updates to round out this busy week on the health care front:

(1) Earlier today Congress passed a one-week funding bill to avoid a government shut-down. This relates to our coalition because agreement on the temporary funding extension was reached, in part, because the White House announced on Wednesday afternoon that Cost Sharing Reduction payments would continue. However, that announcement was short on details, specifically regarding how long the administration would continue the payments. As such, Molina Healthcare warned lawmakers on Thursday that they need assurance that CSR payments will continue and so want to see them included in the long-term spending bill Congress is expected to debate next week.

(2) House Leadership failed to garner the support necessary to bring the American Health Care Act to the floor for a vote this week, as they had hoped to do. The bill still may be considered next week, if moderate Republicans embrace changes to the bill offered through the MacArthur Amendment, which was detailed in our email to you on Wednesday. However, many of those moderates, including Colorado Congressman Mike Coffman, continue to express questions and concerns."

On Wednesday of this week the Coalition shared these thoughts:

"Late yesterday, House Republicans began circulating text of a proposed amendment to the American Health Care Act (AHCA), their health care “repeal and replace” proposal which was pulled from consideration in late March due to lack of support. The Amendment, text of which is attached, is focused exclusively on insurance market provisions of the AHCA and is designed to provide additional flexibility to states.

Specifically, the amendment would:

·      Reinstate Essential Health Benefits as the federal standard for coverage

·      Maintain many of the consumer protection provisions of the Affordable Care Act and the American Health Care Act, including guarantee issue, dependent coverage to age 26, prohibition of denial of coverage based on preexisting conditions and others.

·      Provide a limited and expedited state waiver option to allow for (a) “skinnier” plans to be sold that do not include all of the Essential Health Benefits; and (b) exemption from most of the Community Rating Rules. The waivers would be approved by default, unless specifically rejected by the Secretary of Health and Human Services within 60 days of submission.

Analysis of the amendment is available at the Health Affairs Blog.

The Amendment is being offered by moderate Republican Congressman Tom MacArthur of New Jersey and is supported by President Trump’s administration; however, it is not yet clear if this amendment is sufficient to garner necessary support for passage of the AHCA in the House. The House Republican caucus is meeting this morning to discuss it. There is not yet any timeline for formally debating the amendment. 

Here are some key articles about the latest developments and the political prospects for support of this proposal:

·      House GOP moves to revive failed Obamacare repeal, Politico, 4.26.17

·      House GOP circulates new changes to health bill, The Hill, 4.25.17

·      Moderates chafe at Republican healthcare compromise, Politico, 4.26.17

Meanwhile, discussion about the future of Cost Sharing Reduction (CSR) payments and implications for passing a government funding bill (the topic of our email update to you last Friday) continue. Here is the latest on that subject: Mulvaney and Pelosi feud over Obamacare funds, Politico, 4.26.17."

We don't know what will happen next so I encourage you to continue to engage via the Protect our Care Colorado Campaign! 

State legislative session nearing the end...

Thanks to a contract with Frontline Public Affairs, community safety net clinic directors are receiving periodic email updates on the activities in the current 2017 State of Colorado Legislative Session. Click here to view a 2017 bill tracker specifically for community safety net clinics.

Of particular interest relative to Medicaid was the the introduction this week of HB 1353 as a Joint Budget Committee bill codifying the Accountable Care Collaborative (ACC) into statute. It passed out of its first committee on Tuesday with all Republicans voting against it. (The Republicans seemed to think the bill would lead to an expansion of Medicaid, which it does not.)  Click here to read HCPF's fact sheet about the bill and the ACC. The Center for Health Progress (formerly the Colorado Coalition for the Medically Underserved) is helping coordinate support for HB 1353. Click here to review their handout with those in support listed. If your organization would like to sign-on in support please contact Aubrey Hill, Center for Health Progress, aubrey.hill@centerforhealthprogress.org

Latest from CO Dept. of Health Care Policy & Financing (HCPF)

"Medicaid Primary care payment is changing. HCPF will be conducting a live webinar on May 24th at noon to talk about the coming alternative payment methodology (APM). Learn how the new payment methodology will work and what you need to know and do. Register by clicking the link here: APM Webinar Registration. If you are not able to join live, the webinar will be recorded and posted on the Department's website here: Primary Care Alternative Payment Methodology (APM)"

• At a Glance - April 2017
• CICP Communicates - April 2017

Community Safety Net Clinics “Beyond ClinicNET”

NEXT BIG STEPS

Please Join Us via ZOOM Conference

Wednesday, April 26 @ 1:00-2:00pm

We need your input to pursue the next big steps in organizing a collective voice for CSNCs & the people we serve.  It’s time to select a partner to facilitate our refinement of shared Purpose, Outcomes & Process and develop a funding proposal.  Your engagement and commitment is essential so please prioritize participation!

https://zoom.us/j/4553028278

or

Telephone: 1 408 638 0968
Meeting ID: 455 302 8278

Questions?  Contact Jessica Dunbar at JDUNBAR@RMYCLINICS.ORG or
Kraig Burleson at KraigB@InnerCityHealth.org                                   

What's next at the national level with health care reform?

The Colorado Health Policy Coalition shared these thoughts earlier today:

"It’s been about a month since Congressional leaders withdrew the American Health Care Act and we’ve not seen an alternative emerge…yet. However, speculation about possible Congressional activity as early as next week is flying. Here are links to a few recent articles on likely next steps in Washington:

• Brat: New Obamacare Repeal Bill has ‘Significant’ Changes, The Hill, April 21
• White House Pressures House Leaders on Obamacare Showdown Next Week, Politico, April 20
• White House Turns Up the Heat on Congress to Revise the Affordable Care Act, Washington Post, April 20

Locally, we appreciated seeing Insurance Commissioner Marguerite Salazar weigh in with Colorado’s Congressional delegation today about how federal policy uncertainty could lead to significant increases in insurance costs and further destabilize the market. See the Commissioner’s comments here and read about it in this story from today’s Denver Post.

Commissioner Salazar’s letter comes in response to a couple of key developments last week. On April 13, the Centers for Medicare & Medicaid Services (CMS) issued the final Market Stabilization rule designed to “help lower premiums and stabilize individual and small group markets and increase choices for Americans.” You can read the CMS press release, which includes details about the rule, here or read the rule itself here. Also last week, the administration’s threat of withholding Cost Sharing Reduction (CSR) payments included in the Affordable Care Act as a way to force negotiations over a repeal and replace bill came to a head. These stories from Vox and Bloomberg help to explain the CSR payments and how politically charged this debate over a seemingly small element of the broader health policy framework has become.

These two developments are closely connected in that they relate to stability of the private market and affordability of coverage available there. Perhaps more importantly, the controversy over these measures illustrates just how difficult it is to make effective piecemeal changes to health care.

Reactions these developments have been interesting to see. To get a sense of the opinions on both the Market Stabilization Rule and the importance of the CSR payments to both insurers and consumers, you can read comments from America’s Health Insurance Plans (AHIP) and Families USA, a national consumer advocacy group and see what two former Senate Majority Leaders, Bill Frist and Tom Daschle had to say here. This analysis from the Health Affairs blog and coverage in Modern Healthcare was also helpful."

Want to get active on these issues? Engage in the Protect Our Care Colorado coalition (managed by the Colorado Consumer Health Initiative)!

State legislative session continues and budget stalemate!

Thanks to a contract with Frontline Public Affairs, community safety net clinic directors are receiving periodic email updates on the activities in the current 2017 State of Colorado Legislative Session. Click here to view a 2017 bill tracker specifically for community safety net clinics. Tuesday's update from Frontline:

"BUDGET STALEMATE: Two media articles are now reporting what we have known for the last week: The legislature is stuck in a budget stalemate with Senate Republicans asking the House Democrats to move budget bills forward and the House Democrats waiting for the Senate to act on SB267. In the meantime, funding for rural (and other) hospitals, transportation, and K-12 education, along with the use of Marijuana Tax Cash Funds all hang in the balance.  See today’s Denver Post and Colorado Politics coverage of the issue. One article mentions the possibility of a special session if agreement cannot be reached...

INTERIM COMMITTEES: Any member of the Legislature can request a 2017 interim committee; such committees meet during the “interim” between sessions and can recommend bills for the upcoming (2018) session. With the split chambers of our Colorado legislature, these committees are evenly split between the two parties. Legislation that is approved through an interim committee generally has a better chance of passage and any legislator who decides to sponsor an interim committee bill will not have that bill count toward the 5 total bills each legislator can introduce in their chamber. This year, there are requests for 15 interim committees. Take a look at the list of possible topics – there is something for everyone! The Legislative Council will meet to discuss these on April 28 and is expected to decide on a limited number of committees. Last year they approved only 3 of 7 requested. We will keep you posted as to which committees are approved and please let us know if you are interested in any particular requests."

• Read more about the state budgeting challenges and other health legislation - In Pursuit of Unicorns and a Bipartisan Budget Deal, Allie Morgan, Legislative Director and Policy Analyst, Colorado Health Institute

Latest from the State/HCPF

There continues to be challenges related to the new claims payment system, the Colorado interChange, for processing payments for Health First Colorado (Medicaid) and Child Health Plan Plus (CHP+). Medicaid provider and consumer advocates, including me, are actively engaging HCPF on these issues.        

Click here for the latest Colorado Children's Healthcare Access Program (CCHAP) Practice Manager Newsletter, including helpful tips and known issues with the new Medicaid systems! (The information in the CCHAP newsletters are applicable to all practices, not just pediatric practices!)

Community Safety Net Clinics reconvene virtually April 26, 1-2 pm

Thank you to those clinics that participated in the facilitated strategy session on March 20th! Click here to review the presentation and notes. We will reconvene virtually on April 26, 1-2 pm via Zoom. More info to come! Stay tuned!

What's next at the national level with health care?

Congress is currently in recess but that doesn't mean efforts relative to national health care reform aren't still happening! Although we don't know what will happen next its still a great time to reach out to our elected officials and let them know what you think. Click here to visit the Protect our Care Campaign where you can find ways to engage including events, speaking points, contact info, etc.

The Colorado Health Policy Coalition recently shared these thoughts on the efforts in DC:

'Meanwhile, here is some of what is being said and written about next steps with health reform:

Senate Rs Leave Health Care to the House – On March 28, both Senators Mitch McConnell and John Thune made comments indicating that the Senate would not take up health care reform until the House Republicans came to agreement on a bill that worked for them. Read coverage of these comments from The Hill. Despite this, Senator Mike Lee of Utah published a blog post on Monday in the conservative outlet The Daily Signal calling for continued focus on health reform, saying in part: “If we want to get this policy right—and we owe it to the country to try—then it would be a dereliction of duty to give up on health care reform after just over two weeks of trying.”

Pelosi / Schumer Send Letter to Trump – On March 30, Democrat leaders from the House and Senate sent a joint letter to President Trump urging a focus on enforcing and fixing the Affordable Care Act. Read the letter here.

Wonks Weigh In – A number of health policy experts and pundits have weighed in over the last week about possible next steps and bi-partisan paths forward. They include:

·      Harris Meyer for Vital Signs, Modern Health Care’s blog (March 27),

·      Sara Collins and David Blumenthal for To The Point, The Commonwealth Fund’s blog (March 31),

·      Julie Rovner for Kaiser Health News (April 4),

·      Billy Wynne for Health Affairs Blog (April 4)"

State Legislative Sessions continues and they are in the thick of budgeting!

Thanks to a contract with Frontline Public Affairs, community safety net clinic directors are receiving periodic email updates on the activities in the current 2017 State of Colorado Legislative Session. Click here to view a 2017 bill tracker specifically for community safety net clinics.

Click here to view the latest greatest update on the status of the state 17/18 budget (long bill) from Frontline Public Affairs.

Latest from CO Dept. of Health Care Policy & Financing (HCPF)

• State Innovation Model (SIM) newsletter - April 2017
• At a Glance - March 2017 edition
• Intent to apply for the Primary Care Fund is April 17th! (The application is due May 25.)