HealthCare Roundtable e-News – October 23, 2018

McConnell Defends Trump Administration’s Efforts to Return to ACA Repeal After Midterms

With days remaining before midterm elections, Senate Majority Leader Mitch McConnell (R-KY) continued to defend the Trump administration’s efforts to strike down the Affordable Care Act as the party strives to maintain congressional majorities. McConnell recently defended the administration’s decision to ask a federal court to throw out the ACA’s protections for people with pre-existing conditions if it finds the mandate is no longer valid.

“If we had the votes to completely start over, we’d do it. But that depends on what happens in a couple weeks…We’re not satisfied with the way Obamacare is working,” McConnell said, commenting on the party’s failure to repeal Obamacare the first time around (InsideHealthPolicy).

According to a recent Morning Consult/POLITICO survey, support for repeal among Republican voters has hit its lowest point since both organizations began polling the question in early 2017. Talks of repealing ACA have dissipated in recent months, as many Republican candidates are opting to focus on upholding the provisions of the law that protect people with pre-existing conditions.

While most Republicans candidates choose to refrain from campaigning on entitlement reforms before midterm elections, McConnell is betting that Republican voters will be inspired with the direction the party is moving in if a majority is kept.

“It’s consistent with the long-held position of conservative Republicans, and one could argue that these statements are signaling to the base that if they come out and vote Republican that these would be the priorities,” former GOP staffer and health policy lawyer Chris Condelucci said. “It’s a base-energizing exercise.”

Majority of ACOs Look to Stay in Medicare Shared Savings Program

According to a survey by the National Association of ACO’s (NAACOS), nearly 50% of organizations said they will stay in the Medicare Shared Savings Program if CMS agrees to eliminate tracks that don’t include financial risk.

The percentage of organizations looking to stay in the program has increased dramatically since this past spring. 71% of organizations claimed they would leave the program if forced to take on risk, according to the latest survey results as part of comment letter proposing the restructuring of the shared savings program. CMS had received over 400 comments in total before the October deadline regarding organizations’ stances on their participation.

In another comment letter, NAACOS CEO Clif Gaus suggested that more flexibility around beneficiary assignments would lead to an easier transition to a risk-based model, although many ACOs are still concerned about taking on more financial risks.

“NAACOS believes that ACOs should take on risk,” said Gaus in one of the comment letters. “But the speed of CMS’ proposed path to risk and the agency’s proposal to significantly cut financial incentives will make participation in this voluntary program untenable for new ACOs.” (InsideHealthPolicy).

Senate Democrats Failing in Attempts to Overturn Expansion of Short-Term Plans

Earlier this month, Senate Democrats attempted to overturn the recent expansion of short-term healthcare insurance plans by the Trump administration. The resolution failed in a 50-50 vote after Democrats utilized the Congressional Review Act last week to enact a vote to overturn the rule. The plans, which can leave consumers without comprehensive care as a result of not complying with Obamacare standards, has been a steady work in progress since the president finalized the rule back in August.

Numerous industry associations, including the American Heart Association and the American Cancer Society, opposed the plan and argued the policies do more harm than good to consumers. Other groups are weighing in on a potential lawsuit to overturn the rule, arguing the new policies would illegally allow short-term plans to serve as replacements for comprehensive coverage, according to POLITICO.

“We will continue to try and work as hard as we can to block these plans and continue to make it clear to people that these plans take us back to the days of insurance that doesn’t cover much of anything,” said Sen. Maggie Hassan (D-NH) about Democrats’ potential next steps on short-term plans.