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The repeal of the Affordable Care Act’s individual mandate has been projected to cause insurance premiums to rise by an average of 10 percent through 2027. Those hikes would be mitigated, however, if Congress funded the ACA’s cost-sharing reduction subsidies and a $10 billion, two-year reinsurance program, according to an analysis from Avalere.

The American Hospital Association (AHA) suggested the Medicare Payment Advisory Commission (MedPAC) pump the brakes on advocating for major changes to Merit-based Incentive Payment System (MIPS), saying any major shifts wouldn’t have “the benefit of data or experience” considering this is the program’s first performance year.

The largest health insurers—UnitedHealthcare, Aetna, Anthem, Cigna and Humana—are getting nearly 60 percent of their total combined revenue from Medicare and Medicaid plans, according to a Health Affairs study, with that money more than doubling since the Affordable Care Act (ACA) was passed.

In a final rule issued on Nov. 30, CMS finalized changes to several mandatory bundled payment programs, canceling two surrounding hip fractures and cardiac care and reducing requirements in a joint replacement bundle.

The Congressional Budget Office (CBO) said passing an Affordable Care Act (ACA) stabilization measure after getting rid of the ACA’s individual mandate would still leave 13 million fewer people insured by 2027 and cause premiums increase by an average of 10 percent over the same time period.

 

Recent Headlines

ACA funding bills would cancel out hikes from repealing individual mandate

The repeal of the Affordable Care Act’s individual mandate has been projected to cause insurance premiums to rise by an average of 10 percent through 2027. Those hikes would be mitigated, however, if Congress funded the ACA’s cost-sharing reduction subsidies and a $10 billion, two-year reinsurance program, according to an analysis from Avalere.

AHA to MedPAC: Eliminating, changing MIPS would confuse providers

The American Hospital Association (AHA) suggested the Medicare Payment Advisory Commission (MedPAC) pump the brakes on advocating for major changes to Merit-based Incentive Payment System (MIPS), saying any major shifts wouldn’t have “the benefit of data or experience” considering this is the program’s first performance year.

Major insurers’ reliance on Medicaid, Medicare revenues could be used to boost ACA participation

The largest health insurers—UnitedHealthcare, Aetna, Anthem, Cigna and Humana—are getting nearly 60 percent of their total combined revenue from Medicare and Medicaid plans, according to a Health Affairs study, with that money more than doubling since the Affordable Care Act (ACA) was passed.

CMS finalizes cancellation of mandatory bundles

In a final rule issued on Nov. 30, CMS finalized changes to several mandatory bundled payment programs, canceling two surrounding hip fractures and cardiac care and reducing requirements in a joint replacement bundle.

CBO: Funding CSRs won’t mitigate impact from repealing individual mandate

The Congressional Budget Office (CBO) said passing an Affordable Care Act (ACA) stabilization measure after getting rid of the ACA’s individual mandate would still leave 13 million fewer people insured by 2027 and cause premiums increase by an average of 10 percent over the same time period.

5 things to know about Alex Azar’s first hearing as nominee for HHS Secretary

One Republican said he wouldn't support the nomination of Alex Azar, if the former pharmaceutical executive can't support importation of pharmaceuticals from other countries. 

Letting states pick essential health benefits may ‘undermine’ ACA

Insurers, hospitals and regulators had a largely negative reaction to a major provision of the proposed Affordable Care Act (ACA) benefit parameters for 2019 that would allow states to define their own “essential health benefits” which ACA-compliant insurance plans have to cover, saying it may return the nongroup market to its pre-ACA state.

States warn CHIP recipients benefits may end in January

Nearly two months after authorization for the Children’s Health Insurance Program (CHIP) expired, two states are sending letters to families about the potential loss in insurance coverage for their children unless Congress approves funding—and another says it’s already out of money.

What healthcare groups want from ‘new direction’ on CMMI payment models

Fewer electronic health record requirements, smaller payment reforms and changing the definition of financial risk are some of the changes suggested by major healthcare groups in response to the CMS request for information on future models at the Center for Medicare and Medicaid Innovation (CMMI).

Actuaries to Congress: Repealing individual mandate could threaten insurer solvency

If the Affordable Care Act’s individual mandate is repealed as part of a Republican tax cut plan, premiums will likely rise and insurers will exit the individual market, according to the American Academy of Actuaries.

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