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.

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.

The Trump administration earlier this year made it easier for small businesses and self-employed workers to band together to buy insurance that didn’t have to abide by all of Obamacare’s rules. This story out of Nebraska highlights an early success of an association health plan. Under the new Trump administration rule, employer Land O’Lakes now offers workers comprehensive coverage at up to 35% less than exchange plans in the state. Land O’Lakes, several Nevada chambers of commerce, and the National Restaurant Association have formed association plans this year and each say they want to do what’s best for small businesses and their workers by providing an option that may be a better fit for a family than what’s available in the traditional individual and small-group markets.

HHS Secretary Alex Azar on Wednesday said Medicaid may soon allow hospitals and health systems to directly pay for housing, healthy food or other solutions for the “whole person.”

In a speech supported by the Hatch Foundation for Civility and Solutions and Intermountain Healthcare in Washington, Azar said Center for Medicare and Medicaid Innovation officials are looking to move beyond existing efforts to partner with social services groups and try to manage social determinants of health as they see appropriate.

The CMS may soon make it easier for states to use federal funds to pay for Medicaid enrollees to receive treatment at inpatient mental health facilities. The agency issued a letter to Medicaid directors Tuesday saying they will be able to cover an average of 30 days of care at institutions of mental disease, or IMDs, through a new waiver. In a speech shortly before the announcement, HHS Secretary Alex Azar said the Trump administration is increasingly concerned that Medicaid beneficiaries aren’t receiving critically needed care because of the IMD exclusion. “Today, we have the worst of both worlds: limited access to inpatient treatment and limited access to other options,” Azar said at the National Association of Medicaid Directors conference Tuesday. “It is the responsibility of state and federal governments together, alongside communities and families, to right this wrong.”

Uninsured individuals, people between jobs, recent graduates, and new retirees, among others, now have access to affordable short-term plans. These plans—an opportunity that arose from flexibility granted with new federal rules—allow Americans to purchase health plans they can afford and are right for them. There will be thousands of new options on the market (see this new analysis for more detail and data), giving Americans something they haven’t had in years: choice of health insurance and carrier. By contrast, for an individual on the exchange, in a majority of U.S. counties, only one insurer is offering plans. The data also show that these choices cost significantly less for someone that is uninsured than plans on the individual market.

CMS has issued a proposed regulation that makes smaller changes to the standards states meet when running their Medicaid plans. The proposed rule would give states some new flexibility in setting rates for their managed care plans and ensuring insurance companies have adequate provider networks. The CMS worked with Medicaid directors to develop the proposal. “Today’s action fulfills one of my earliest commitments to reset and restore the federal-state relationship, while at the same time modernizing the program to deliver better outcomes for the people we serve,” CMS Administrator Seema Verma said in a statement.

Late last week, President Trump and Health and Human Services Secretary Alex Azar announced a plan to deal with the high cost of prescription drugs in the U.S. relative to the price of the same drugs in other developed countries. The reason for this disparity is well-known: Other countries impose socialized medicine price controls on prescription medicines, while here in the U.S. the price charged is closer to the true market price of the product.