Enrollment in the health-care marketplaces still appears to be lagging halfway through the ACA’s sixth sign-up season. Total sign-ups this year are down by about 300,000 people compared to the same time last year—a roughly 11% decline. However, this is the first year marketplace premiums are dropping instead of rising. Not only are premiums lower, but government subsidies for low-income Americans who want health insurance continue to be more generous than in years past.

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.

 

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.

We’ve entered the last two months of the 115th Congress, the last Congress under Republican control for who-knows-how-long. Many Republicans think the midterm disappointment was an aberration, and that reclaiming control of the House is more-or-less a given thing in the next election cycle. But the future is a foreign country. Democrats controlled the House of Representatives for years, until they didn’t. Who is to say when the House returns to Republican control?

The 2020 presidential election will be consequential for the future of health reform, with the two major-party nominees taking very different views on the future of the Affordable Care Act (ACA), as well as the policies needed to lower health costs and continue to expand access to coverage. The Republican nominee will likely signal broad opposition to the ACA and a desire to replace it with a state innovation–based approach to reform, based on the Graham-Cassidy-Heller-Johnson legislation considered by the Senate in the fall of 2017. This article takes that legislation as a starting point, contextualizes it within the broader health reform discussion, and suggests ways to improve upon it to enhance the affordability of and access to coverage and to ensure that states have adequate flexibility to implement their policy goals.