Obamacare Premiums on the Rise

According to a new report from the U.S. Department of Health and Human Services (HHS), Obamacare premiums are on the rise across the country. The data examines benchmark plans on the exchanges, and finds an increase in premiums averaging 37 percent. Due to increasing tax credit subsidies, however, approximately 80 percent of enrollees will have access to a plan for less than $75 a month – an increase from 71 percent during the last plan year. HHS also notes that insurer participation is declining, with an increasing number of counties left with only one insurer – which could in part contribute to higher premiums.

House Passes IPAB, EMS, and CHIP Legislation

The House of Representatives successfully passed H.R. 849, the “Protecting Seniors Access to Medicare Act,” legislation to repeal the Independent Payment Advisory Board (IPAB), by a vote of 307-111 last week. Despite some concerns and objections from Democratic leadership regarding a lack of both urgency and offsets for the bill, 76 Democrats backed elimination of the board. It is not likely that the Senate will act on the legislation before the end of the year. The House also passed H.R. 304, the “Protecting Patient Access to Emergency Medications Act” by unanimous consent. H.R. 304 would clarify that emergency medical services (EMS) professionals are allowed to administer controlled substances pursuant to standing or verbal orders under certain conditions.

Before adjourning for the week on Friday, the House passed H.R. 3922, the CHAMPIONING HEALTHY KIDS Act. The bill would fund the Children’s Health Insurance Program (CHIP) for an additional five years and reauthorize funding for community health centers for two years. Other public health programs, including the National Health Service Corps (NHSC), Teaching Health Center Graduate Medical Education, Family-to-Family Health Information Centers, the Youth Empowerment Program, and the Personal Responsibility Education Program, would be extended for two years. H.R. 3922 also includes a two-year delay of Medicaid disproportionate share hospital (DSH) payment cuts as well as $1 billion in support of Puerto Rico’s and the U.S. Virgin Islands’ Medicaid programs. While the policies contained in the bill were the result of bipartisan negotiations, the final vote fell largely along party lines due to a disagreement over offsets used to pay for the legislation. The bill was offset by raising Medicare premiums for high-income beneficiaries and making cuts to the Affordable Care Act’s (ACA) Prevention and Public Health Fund. H.R. 3922 passed by a vote of 242-174, with 15 Democrats voting in favor of the bill and three Republicans voting in opposition.

The Senate has reached a bipartisan agreement on reauthorization policy, but has not yet identified any pay-fors. A group of 22 Senate Democrats have already warned that they would not support the offsets used in the House in a letter sent to Senate leadership last week. Senate negotiations between Orrin Hatch (R-Utah) and Ron Wyden (D-Ore.) have stalled, and it appears increasingly likely that CHIP funding won’t be renewed until the end of the year as part of the omnibus spending bill or an emergency hurricane aid package – both of which could be difficult to achieve due to outstanding issues.

Bicameral CSR Proposal Officially Introduced

House Ways and Means Committee Chairman Kevin Brady (R-Texas) and Senate Finance Committee Chairman Orrin Hatch (R-Utah) have introduced their bicameral proposal to temporarily extend funding for cost sharing reduction (CSR) payments through 2019. The Healthcare Market Certainty and Mandate Relief Act (H.R. 4200/S. 2052) would require plan issuers to not tie premium levels to the assumption of CSR receipt. It would provide relief from the individual mandate between 2017 and 2021 and relief from the employer mandate between 2015 and 2017. The proposal would also increase the maximum contribution limit for health savings accounts (HSAs).

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