The Senate ’s Health Care Bill Threatens Children’s Access to Vital Services
There was significant public outcry over the possibility of dissolving the Prevention and Public Health Fund and eliminating essential health benefits under the American Health Care Act (AHCA)—both proposals were also included in the Senate’s Better Care Reconciliation Act (BCRA).
Yet the treatment of Medicaid’s Early and Periodic, Screening, Diagnosis and Treatment (EPSDT) benefit has received far less attention even though the AHCA and BCRA would make it harder for many children to receive the care they need—including services related to substance misuse and lead poisoning.
The BCRA would permit states to convert...
Source: Health Affairs Blog - June 27, 2017 Category: Health Management Authors: John Auerbach Tags: Featured Following the ACA Medicaid and CHIP Public Health Uncategorized EPSDT Trumpcare Source Type: blogs
CBO Projects That 22 Million Would Lose Coverage Under Senate Bill
On June 26, 2017, the Congressional Budget Office and Joint Committee on Taxation (referred here collectively as CBO) released a cost estimate on the Senate’s Better Care Reconciliation Act (BCRA) of 2017. The JCT separately released an analysis of the revenue effects of the legislation.
The headlines are that the BCRA would reduce spending over the period of 2017-2026 by $321 billion, $202 billion more than the reduction that would result from House American Health Care Act (AHCA). It would also, however, reduce coverage by about 22 million people by 2026, an only slightly smaller coverage loss than under the AHCA, leav...
Source: Health Affairs Blog - June 27, 2017 Category: Health Management Authors: Timothy Jost Tags: Costs and Spending Following the ACA Insurance and Coverage Medicaid and CHIP 1332 waivers Congressional Budget Office continuous coverage requirements The American Health Care Act The Better Care Reconciliation Act Source Type: blogs
Amended Senate Bill Includes Waiting Period for Those Who Let Coverage Lapse
On June 26, 2017, the Republican Leadership released an amended version of the Senate Better Care Reconciliation Act. It is very similar to the version they released on June 22, but includes two changes.
First, it amends a couple of provisions of the stability and innovation funds section to allow both short and long-term funds to be used to purchase health insurance benefits. This was apparently done to align the program more closely with the CHIP program. The stability and innovation fund is being created through the CHIP program, reportedly so as to incorporate CHIP’s abortion funding restrictions.
Second, it ma...
Source: Health Affairs Blog - June 26, 2017 Category: Health Management Authors: Timothy Jost Tags: Featured Following the ACA Insurance and Coverage ACA repeal and replace coverage gap waiting period Source Type: blogs
The Downstream Consequences Of Per Capita Spending Caps In Medicaid
Medicaid, the government program that provides health insurance coverage to low-income and disabled Americans, is the largest payer for health care in the United States in terms of enrollees and the second-largest payer (behind only Medicare) in terms of spending. Escalating health care costs, a growing federal budget deficit, and fiscal challenges in many states have led to calls to reform the program to decrease spending growth. Recent federal reform proposals from House and Senate republicans would change the current financing system in which the federal government guarantees a share of total program spending to states ...
Source: Health Affairs Blog - June 26, 2017 Category: Health Management Authors: Timothy Layton, Ellen Montz and Thomas McGuire Tags: Costs and Spending Featured Following the ACA Insurance and Coverage Medicaid and CHIP Payment Policy Population Health American Health Care Act per capita spending cap system Source Type: blogs
What ’s CHIP Got To Do With It?
Children in US receive their health insurance from multiple sources: the Children’s Health Insurance Program (CHIP), Medicaid, employer-sponsored insurance (ESI), or a qualified health plan on the Marketplace. Each offering has different cost sharing and premium requirements, provider networks, coverage packages, and eligibility criteria. This creates a fragmented system of coverage for children and families, particularly for low- and moderate-income families, who often have children and parents enrolled in across separate coverage sources. Furthermore, this fragmentation leads to disparities in children’s coverage by ...
Source: Health Affairs Blog - June 26, 2017 Category: Health Management Authors: Katie Weider and Rodney Whitlock Tags: Insurance and Coverage Medicaid and CHIP Source Type: blogs
Sounding The Alarms On Children ’s Health Coverage
We reported on this trend in a recent Health Affairs article, in which we found that in 2013, nearly one-third of children in low-income working families above the poverty line got their health coverage through Medicaid or CHIP, up 8 percent from just six years earlier.
Today, more than 40 percent of children and adolescents in this country are now covered by Medicaid and CHIP, second only to employer-sponsored insurance. As a result, children are disproportionately vulnerable to health care reforms that cut public programs. In making any changes, caution is needed, as is an awareness of the many factors leading to familie...
Source: Health Affairs Blog - June 26, 2017 Category: Health Management Authors: David Rubin Tags: Following the ACA Medicaid and CHIP Public Health Quality ACA repeal and replace AHCA Source Type: blogs
ACA Round-Up: QHP Application Deadline Passes, House v. Price, Special Enrollment Periods
June 21, 2017, was the last day for insurers to file qualified health plan applications in the 39 states that use HealthCare.gov, including federally facilitated marketplace (FFM), plan management, and state-based marketplace-federal platform states. There were reportedly a few additional defections, including Anthem from Wisconsin and Indiana, but most insurers are back from last year, and a there are a few new entrants, notably Centene in several states.
According to slides posted at the CMS REGTAP.info website, insurers may make any changes they wish to their plan filings until August 16, 2017, except for adding plans...
Source: Health Affairs Blog - June 25, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage house v. price special enrollment periods Source Type: blogs
Medicaid Round Two: The Senate ’s Draft “Better Care Reconciliation Act Of 2017”
Although it differs in important details, the draft Medicaid provisions of the Better Care Reconciliation Act — the Senate’s version of Affordable Care Act “repeal and replace” — share the vision of its House-passed counterpart, the American Health Care Act: to, as much as possible, shield the federal government from the cost of Medicaid. Like the House, the Senate would accomplish this goal by fundamentally altering the terms of Medicaid itself rather than by ending it and replacing its entitlement structure with a new, successor program as Congress did in 1996 when it replaced the Aid to Families with...
Source: Health Affairs Blog - June 24, 2017 Category: Health Management Authors: Sara Rosenbaum Tags: Featured Following the ACA Medicaid and CHIP Uncategorized ACA repeal and replace block grants Medicaid per capita cap Trumpcare Source Type: blogs
The Senate Health Care Bill
Yesterday, Senate Republican leaders released a discussion draft of their version of health-care legislation, the Better Care Reconciliation Act (BCRA). Senate Majority Leader Mitch McConnell plans to put this legislation to a vote next week with the expectation of passing it.
The Senate Republican plan is best understood as a GOP amendment to the existing Affordable Care Act (ACA). Indeed, one could imagine that, back in 2009, if the Republicans had attempted to modify rather than defeat the ACA, this is the kind of amendment they would have offered. The BCRA repeals most of the tax hikes of the ACA, cuts back substantial...
Source: Health Affairs Blog - June 23, 2017 Category: Health Management Authors: Joseph Antos and James Capretta Tags: Costs and Spending Following the ACA Insurance and Coverage Medicaid and CHIP Source Type: blogs
The Payment Reform Landscape: Is The Debate Over Retrospective Versus Prospective Bundled Payments A Distraction?
Based on surveys of health plans by Catalyst for Payment Reform, less than 3 percent of payments in the commercial market are “bundled.” One can argue that there have been more conferences and webinars about bundled payment than actual bundled payments. In the public sector, however, there is much more experimentation with and usage of bundled payment through Medicare and Medicaid.
There is good reason to pursue bundled payment. At least in theory, a bundle represents the best thinking on how much it costs to treat the course of an identifiable illness, disease, or injury. It also addresses the tendency to inflate cost...
Source: Health Affairs Blog - June 23, 2017 Category: Health Management Authors: François de Brantes and Suzanne Delbanco Tags: Costs and Spending Payment Policy bundled payment Catalyst for Payment Reform Source Type: blogs
Unpacking The Senate ’ s Take On ACA Repeal And Replace
On June 22, 2017, Senate Majority Leader Mitch McConnell (R-KY) released the Senate GOP’s version of Affordable Care Act repeal, the Better Care Reconciliation Act of 2017. The Senate bill is in many respects quite different from the House’s American Health Care Act (AHCA), which was introduced on March 6, 2017; AHCA passed on May 6 by a narrow, mostly party line 217 to 213 vote after lengthy negotiations and a series of amendments.
Although the Senate bill has the same bill number at the House, it entirely strikes the House bill and adopts a new bill with a new title. All of its amendments are amendments of the ACA it...
Source: Health Affairs Blog - June 23, 2017 Category: Health Management Authors: Timothy Jost and Sara Rosenbaum Tags: Costs and Spending Following the ACA Insurance and Coverage Medicaid and CHIP Source Type: blogs
A New Definition Of Health Equity To Guide Future Efforts And Measure Progress
Editor’s note: Paula Braveman was one of the theme advisors for the June 2017 Health Affairs equity theme issue.
Until recently, talking about “equity” as a health researcher in the United States seemed almost radical.
Today, the term “health equity” is mainstream. The number of scientific papers with “health equity” in the title or text has skyrocketed. Some of this work examines the health effects of racism and other forms of discrimination, some addresses biases in science, and some explicitly mentions social justice. It’s gratifying to see a broad research agenda developing around health equity.
In part...
Source: Health Affairs Blog - June 22, 2017 Category: Health Management Authors: Paula Braveman Tags: Featured Health Equity Quality culture of health Source Type: blogs
Health Affairs Web First: Significant Racial Disparities Found In Hospital Readmissions
This study will also appear in the July issue of Health Affairs.
(Source: Health Affairs Blog)
Source: Health Affairs Blog - June 21, 2017 Category: Health Management Authors: Lucy Larner Tags: Elsewhere@ Health Affairs Web First Source Type: blogs
Deploying The Cascade Of Care Framework To Address The Opioid Epidemic Means Taking A Closer Look At Quality Measures
In a March 13, 2017, Health Affairs Blog post, Arthur Robin Williams, Edward Nunes, and Mark Olfson propose repurposing the “Cascade of Care” framework, once used to combat the HIV/AIDS crisis, to fight the opioid epidemic.
Williams and colleagues propose developing performance measures to track the success of the state grants across the five framework stages:
Diagnosis among those affected
Linkage to care among those diagnosed
Medication initiation among those entering care
Retention for at least six months among those initiating medication
Continuous abstinence among those retained
We applaud Williams and colleague...
Source: Health Affairs Blog - June 21, 2017 Category: Health Management Authors: Mady Chalk and Tami Mark Tags: Featured Health Policy Lab Population Health Public Health Quality Cascade of Care data collection systems opioid epidemic Substance Use Disorders tracking and delivery system Source Type: blogs
Building Sustainable Partnerships To Improve Access To Breast Cancer Treatment For Uninsured Women
Breast cancer is a terrifying disease for most women. In the United States, it is the leading cause of cancer deaths among women ages twenty to fifty-nine years. More than 5,100 women are diagnosed with—and at least 1,100 women die from—breast cancer in New York City each year. The breast cancer survival rate is also lower for uninsured women than for those with private health insurance coverage.
Although access to affordable breast cancer screening and treatment has grown substantially over the past few years as a result of increased health insurance coverage options through the Affordable Care Act (ACA), many uninsur...
Source: Health Affairs Blog - June 20, 2017 Category: Health Management Authors: Kumbirai M. Madondo, Janice Zaballero and José Pagán Tags: Costs and Spending Featured GrantWatch Health Professionals Insurance and Coverage Access breast cancer Consumers Health Care Costs Health Care Delivery Health Philanthropy Health Promotion and Disease PreventionGW Hospitals imag Source Type: blogs
