Whitfield L. Knapple, MD, FACG Chair, ACG National Affairs
Whitfield L. Knapple, MD, FACG
Chair, ACG National Affairs

On Wednesday, February 1st, the U.S. Senate Health, Education, Labor, and Pensions (HELP) Committee held a hearing on the impending fate of the Patient Protection and Affordable Care Act (known as the “ACA”), titled “Obamacare Emergency: Stabilizing the Individual Health Insurance Market.” Overlapping themes included: the need for a clear layout of plans provided to the insurance markets to ensure transparency and stability, and empowering the states to tailor to their own unique markets.  The current shortcomings and areas of improvement of the ACA were discussed, including the need for more effective risk pooling mechanisms, shortening the 90-day grace periods, tightening special enrollment opportunities, and easing reporting burdens for employers.  Panelists emphasized that action is needed by the end of March 2017 in order for the market to adequately plan for 2018, and to avoid the risk of a significant decrease in available insurers. The Committee Chair, Senator Lamar Alexander (R-TN) also suggested leaving “a separate discussion” for reforming Medicare and Medicaid.

On Thursday, February 2nd, Rep. Greg Walden (R-OR), Chairman of the U.S. House of Representatives Committee on Energy and Commerce, held a hearing titled “Patient Relief from Collapsing Health Markets,” which focused on several pieces of legislation introduced by Republicans intended to aid with the improvement of the existing insurance markets.  These bills include: the Plan Verification and Fairness Act of 2017 (HR 706), which requires patients utilizing special enrollment periods to provide additional pre-enrollment verification; the Health Coverage State Flexibility Act of 2017 (HR 710), which updates the length of the allowed grace period to encourage increased, active coverage; the State Age Rating Flexibility Act of 2017 (HR 708), which updates the current age rating ratio from 3-1 to 5-1; and the Preexisting Condition Protection and Continuous Coverage Incentive Act of 2017, a draft bill designed to protect those with pre-existing conditions  In his opening statement, Rep. Walden stressed his current concerns with the ACA and the need for immediate action, that “…it’s time to end the partisan rhetoric and actually come to the table and solve these problems.”

HHS Nomination Update

Also, on Thursday, the U.S. Senate voted 51-48 (along party lines) to proceed with a floor vote for the nomination of Tom Price, MD (R-GA) to lead the U.S. Department of Health and Human Services.  Final confirmation may be as soon as next week.  President Trump’s pick to lead the Centers for Medicare and Medicaid Services (CMS), Seema Verma, MPH, is still awaiting confirmation.

Here is some background on Seema Verma, MPH:

  • A Medicaid health policy consultant (SVC, Inc.) based in Indiana.
  • Worked with Vice President-elect Mike Pence on Indiana’s Medicaid expansion and reforms.
  • Also worked on other states’ Medicaid reforms, such as Iowa, Kentucky, Maine, Ohio, and Tennessee.
  • Some common themes of these Medicaid reforms include: requiring more Medicaid beneficiary cost-sharing and contributions to health savings accounts (scaled for income), and imposing some penalty for those not re-enrolling within open periods.
  • Verma is seen as an expert in Medicaid, meaning that someone else in CMS/HHS may be leading the Medicare-related policies.

Whitfield L. Knapple, MD, FACG

Chair, ACG National Affairs Committee