The Trump administration on Thursday outlined ways states will be allowed to waive parts of the Affordable Care Act, a move that has been welcomed by conservatives, spurred rebukes from Democrats and risks legal action.

The Centers for Medicare and Medicaid Services, which implements the health law, released four templates detailing how states may use waivers. States will get significantly more leeway to change the way they distribute and structure ACA premium subsidies that now go to almost nine million people.

HHS on Thursday said it will allow a rule imposing ceiling prices on the 340B drug discount program to go into effect next year, after years of delays.

The long-postponed rule will go into effect on Jan. 1, instead of the earlier-announced July 1, 2019 date, according to a finalized rulemaking.

HHS has delayed the effective date of the ceiling price rule five times. The change will cap the prices drugmakers can charge hospitals that participate in 340B.

 

Customers who buy plans on private health insurance exchange eHealth are taking advantage of their newfound ability to purchase an extended short-term insurance policy without triggering the individual mandate penalty, newly released data from the company shows.

Many more eHealth customers opted for short-term plans over unsubsidized Affordable Care Act-compliant plans during the first half of the ACA open enrollment period for 2019 coverage than during the previous open enrollment, eHealth said.

Momentum is building among House Democrats for a more moderate alternative to single-payer health-care legislation.

The legislation, which would allow people aged 50 to 65 to buy Medicare, is being championed by Rep. Brian Higgins (D-N.Y.), who supported House Minority Nancy Pelosi (D-Calif.) for Speaker in exchange for a commitment to work on his bill when Democrats take control of the House early next year.

 

The Trump administration has a backup plan if a judge strikes down all or parts of Obamacare, a top federal healthcare official said Tuesday.

Centers for Medicare and Medicaid Services Administrator Seema Verma told reporters that “we do have contingency plans” if the healthcare law is struck down — specifically the provision aimed at ensuring people with pre-existing conditions, such as cancer or diabetes, have access to coverage.

Replacing our health care financing system with a single-payer system could have profound and unforeseeable consequences on the capacity of doctors, hospitals and other providers to deliver quality care. Substituting government financing for ESI would: 1.) Place fiscal burdens on taxpayers that the private sector now voluntarily bears; 2.) Require workers with ESI to pay more to finance care for others; and 3.) Eliminate the higher reimbursement rates that private insurers typically pay for medical care.

 

The Trump administration has again approved new rules for some of Kentucky’s Medicaid population, requiring them to either get a job, volunteer in the community or go to school to keep their government-funded health coverage.

The Kentucky Cabinet for Health and Family Services announced the approval on Tuesday, nearly five months after a federal judge blocked the state’s first attempt. State officials say the new rules can begin as soon as April 1 and will be phased in regionally over several months. They will require adults ages 19 to 64, with some exceptions, to complete at least 80 hours per month of “community engagement” to keep their health benefits. That includes getting a job, looking for a job, going to school, volunteering for community service or taking a job training course.

The Centers for Medicare & Medicaid Services (CMS) has proposed polices for 2020 to strengthen and modernize the Medicare Part C and D programs. The proposal would ensure that Medicare Advantage and Part D plans have more tools to negotiate lower drug prices, and the agency is also considering a policy that would require pharmacy rebates to be passed on to seniors to lower their drug costs at the pharmacy counter.

Texas v. Azar likely will incite another episode of Washington hysteria and irrationality. It also will give states the chance to divert health care policy from its calamitous course.

Congress should proceed deliberately and let states lead the way.

In May New Jersey imposed a health-insurance mandate requiring all residents to buy insurance or pay a penalty. More states will feel pressure to follow suit in the coming year as the federal mandate’s penalty disappears Jan. 1 and state legislatures reconvene, some with new Democratic majorities intent on “protecting” ObamaCare. But conflicts with federal law will make state-level health-insurance mandates ineffective or unduly onerous, and governors and legislatures would do well to steer clear.

While states can require citizens to purchase health coverage, they will have trouble ensuring compliance.