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

The Colorado Health Policy Coalition shared this on Wednesday:

"As promised, the non-partisan Congressional Budget Office (CBO) released their revised analysis of the American Health Care Act (AHCA) based on the bill as it passed the House. You can read the analysis here: https://www.cbo.gov/publication/52752

As compared to analysis of the earlier version of the AHCA, the CBO found that this version of the bill would reduce the federal deficit by $119 billion - an amount $32 billion less than earlier versions of the bill. The number of uninsured Americans would be 23 million higher than projections of coverage under current law, representing a slightly lower increase in the number of uninsured Americans than what was projected under the previous version of the AHCA.

The analysis offers helpful insight into the nature of coverage and likely impacts on market stability."

• The most devastating paragraph in the CBO report - VoxCare, March 24, 2017

Continue to stay engaged with the Protect Our Care Colorado campaign as the Senate works on its version of the health care bill!

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

This week HCPF hosted a webinar outlining Medicaid Primary Care Payment Reform. If you are a Medicaid provider, I encourage you to click here to watch the recorded webinar so you are aware of important upcoming changes to Medicaid primary care payments!

This state legislative session saw the passage of bill regarding Medicaid's Accountable Care Collaborative (ACC). The Center for Health Progress (formerly CCMU) managed some of the education regarding the ACC during this process and shared this wrap-up info recently:

• "HB 1353 was introduced and amended with stakeholder feedback, and the bill is intended to codify the ACC in statute and formalize some reporting requirements related to Phase 2. This will help legislative engagement as well as HCPF budgetary requests in the future, which will lead to  
• Many of you signed on in support of the bill. For reference, I have attached the latest HCPF fact sheet I have, which might not be the most updated one. If your organization is missing from the fact sheet, feel free to reach out to Zach Lynkiewicz with HCPF to get the latest version.
• This bill passed in the final days of the session, despite a rocky start in its first committee. It is now awaiting the governor's signature. Hard work from many groups made this bill happen, so thank you.
• We were able to use this opportunity to raise legislators' understanding and knowledge of the ACC, and we anticipate this to be an ongoing need.

ACC General Legislative Education

• With all of your help, we created the finalized fact sheet sharing organizations' support of the ACC as a concept as well as the concepts of ACC phase 2. We encouraged everyone to share the handout in their own meetings with legislators. The final sheet is attached.
• Center for Health Progress lobbyists met with 6 prioritized legislators who are seen as health experts to ensure that they have the adequate background and understanding of the ACC so they can engage in conversations at the Capitol related to the bill or outside of the bill. The meetings were well-received, and when appropriate, we had constituent organizations follow up via email with those legislators to confirm the support within their districts.
• Initially, we had planned on meeting with many more legislators and contacting the remainder via email; however, as the legislative session swung into high-speed at its halfway point, it became more challenging to set up meetings with legislators without a bill at hand. We had to prioritize which legislators to target and hope to get to most everyone through the bill discussion.

ACC Phase 2 RFP Released!

• As many of you have seen already, the RFP for Phase 2 is public with the deadline for bids on July 28." 

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

The Colorado Health Policy Coalition shared this earlier today:

"While health care has largely taken a back seat to news about appointment of a special counsel to investigate ties between the Trump campaign and Russia and the President’s first trip abroad, there are some important developments to be aware of:

·      President’s Budget to Include Significant Cuts to Medicaid – President Trump will release his first comprehensive budget proposal tomorrow, Tuesday, and it is expected to include hundreds of millions of dollars in cuts to Medicaid, reflecting his support of Medicaid policy changes outlined in the American Health Care Act. You can read details in coverage from Bloomberg, The Washington Post, and The Hill. 

·      Revised CBO Score of AHCA to be Released this Wednesday – The non-partisan Congressional Budget Office (CBO) announced on Friday that it will release a revised analysis of the American Health Care Act, as passed by the House, this Wednesday, May 24. The CBO score of an earlier version of the AHCA, released in March, projected that the policy would reduce federal deficits by $337 billion and that 24 million Americans would lose health insurance by 2026; however, the bill was substantially amended in April in order to garner the support needed to pass the bill, so it will be interesting to see what the new analysis of the bill projects.

·      New Developments in Legal Fight Over CSR Payments – The Cost Sharing Reduction (CSR) payments made to insurers under the Affordable Care Act are a key provision to ensuring market stability and have been a political hot button for the last number of months.  Last week, a group of 15 states (Colorado not included) and Washington D.C. filed a motion in the pending court case to argue for continuation of the payments, saying that ending payments would put health insurance for millions of people in jeopardy, thus exposing states to increased financial burden of a higher uninsured population. Learn more about this new motion from this Business Insider article published Friday.  Politico is reporting this morning that the Trump administration will seek another 90-day delay in the lawsuit. The uncertainty about the future of the CSR payments and health care policy more broadly is leading to increased premiums and marketplace instability, as reported last Thursday in this LA Times article.

·      Senate Working on Health Care Bill – In the midst of these developments, members of the US Senate are working on their version of health reform bill. Very few details have been shared and nothing official has been released, but it is rumored that, as compared to the House bill, the Senate bill will make subsidies for private coverage more generous for lower income Americans and will phase out the Medicaid expansions more slowly. Still, no timeline for action has been released and there are many different opinion as to when the Senate may have something to consider. Here are a couple of good recent stories about what the Senate is up to.

o   McConnell steps into Obamacare firing line, Politico, May 21

o   52 ways to repeal Obamacare, Politico, May 11"

Continue to stay engaged with the Protect Our Care Colorado campaign as the Senate works on its version of the health care bill!

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

• Medicaid primary care payment will be changing! (These changes will ultimately replace the primary care "bump" that will continue for the coming 17/18 year.) HCPF will be conducting a webinar on May 24th at Noon to talk about the coming alternative payment model (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. The webinar will be recorded and posted on the Department's website: Primary Care Alternative Payment Methodology (APM). If you are a Medicaid provider you absolutely need to see this webinar!

• CICP Communicates - May 2017

• Hospital Provider Fee Quarterly Update 

• Learn about additional State of CO/HCPF work, including a legislative session update, current Medicaid billing, the Accountable Care Collaborative (ACC) and more in the most recent CCHAP Practice Manager newsletter!

Coalition for Immigrant Health

Organized through the Center for Health Progress, the Coalition for Immigrant Health is being formalized to strengthen and demonstrate the diversity of support in Colorado for improving immigrants' health. "To demonstrate what we believe in, we collectively created these principles. Please note that signing on to the principles does not necessarily commit a clinic to every Coalition campaign or advocacy action. We would still give clinics the ability to opt in as a supporter if, for example, the Coalition wants to work on a bill." Interested in signing on to the coalition or have questions? Contact chris.klene@centerforhealthprogress.org or aubrey.hill@centerforhealthprogress.org

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

The Colorado Health Policy Coalition shared these thoughts last week:

"The dust is beginning to settle from the vote to pass the American Health Care Act in the House. Here are answers to a few key questions and a look at what we know so far about next steps...

What is in the bill that was passed?
Timothy Jost, an Emeritus Professor at Washington and Lee University School of Law and contributing editor to Health Affairs, has been doing an excellent job following the progression of the AHCA for the Health Affairs blog. His post from May 4th provides a very helpful summary of the final bill, as passed with amendments. This excerpt from that post is the most concise summary I’ve seen. In sum it:

• Eliminates the taxes and tax increases imposed by the ACA;
• Phases out enhanced funding for the Medicaid expansions and imposes either a block grant or per capita caps on Medicaid;
• Removes the individual and employer mandate penalties:
• Increases age rating ratios from 1 to 3 to 1 to 5 in the individual and small group market and allows states to go higher by waiver;
• Permits states to waive the ACA’s essential health benefit requirements;
• Imposes a penalty on individuals who do not maintain continuous coverage.
• Alternatively allows states to obtain a waiver to allow insurers to health status underwrite individuals who do not maintain continuous coverage.
• Creates funds of $138 billion to assist states in dealing with high-cost consumers and for other purposes
• Ends the ACA’s means tested subsidies as of 2020 and substitutes for them age-adjusted fixed-dollar tax credits.

The Denver Post ran a story analyzing how the proposal would impact Colorado. And then The Denver Post ran a story re: Colorado’s experience with our state high-risk pools.

What happens next?

Leadership in the US Senate has indicated that they will begin working on their own health care bill, but has not set a timetable for introduction. Senator Mitch McConnell appointed a 13 member Senate workgroup, which includes Colorado Senator Cory Gardner, to craft the Senate bill.

While the content and timeline for the Senate bill remains unclear, Senator Roy Blunt (R-Mo) did commit over the weekend that the Senate will get the Congressional Budget Office to score the bill before voting and indicated that he anticipates what comes out of the Senate will be substantively different from the House bill, thus requiring a conference committee before final passage – meaning this process is far from over."

Stay engaged with the Protect Our Care Colorado campaign as the Senate works on its version of repeal!

State legislative session is over...but will we have a special session?

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 read Frontline's 2017 Year End Legislative Report. It ended up being a fairly productive legislative session! 

• Click here to read more in a piece from The Denver Post

However, the Governor may call the legislature back for a special session! 

• Click here to read why in a piece from Colorado Politics (The Gazette.)

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

• Medicaid primary care payment will be changing! (These changes will ultimately replace the primary care "bump" that will continue for the coming 17/18 year.) HCPF will be conducting a webinar on May 24th at Noon to talk about the coming alternative payment model (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. The webinar will be recorded and posted on the Department's website: Primary Care Alternative Payment Methodology (APM). If you are a Medicaid provider you absolutely need to see this webinar!

• Medicaid Accountable Care Collaborative (ACC) RFP released May 11, 2017

• Important updates from the SIM Office - May 2017

State legislative session nearing the end...May 10.

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.

The budget stalemate is over and the budget (aka the long bill) has been sent to the Governor for his signature. It also appears that the hospital provider fee will in fact become an enterprise (via SB 267) although its kind of a messy imperfect bill that includes, among other things, an increase in Medicaid co-pays. Read more about what's in SB 267:

• Click here to read more in a piece from Colorado Public Radio
• Click here to read more from the Colorado Independent. 

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

This week saw the passage of the American Health Care Act (AHCA) in the House of Representatives by a vote of 217 to 213. (Colorado's Congressman Mike Coffman was a 'no' vote.) The bill will next move to the Senate and will likely change significantly. The Colorado Health Policy Coalition shared these first breaking news stories on the vote: 

•    Washington Post
•    Politico
•    The Hill
•    Fox News

Click here to read, Medicaid Rollback is Still the Big Deal in the AHCA, by Joe Hanel, Manager of Public Policy Outreach, Colorado Health Institute

Stay engaged with the Protect Our Care Colorado campaign as we turn towards the Senate! 

Community Safety Net Clinics “Beyond ClinicNET”

Thank you to those community safety net clinics that were able to participate in the April 26th call! As a result of the call there is now a small Steering Committee working on next steps. Stay tuned!

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

Medicaid primary care payment will be changing! (These changes will ultimately replace the primary care "bump" that will continue for the coming 17/18 year.) HCPF will be conducting a webinar on May 24th at noon to talk about the coming alternative payment model (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. The webinar will be recorded and posted on the Department's website: Primary Care Alternative Payment Methodology (APM).