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Friday, Mar 10 2017

Full Issue

From Addiction Treatment To Hospital Finances, Stakeholders Nervous About GOP Bill's Effects

As industry, patients and advocates begin to dig into the details of the Republican legislation, concerns grow about its impact on a wide array of services.

The Republican proposal to replace the Affordable Care Act would strip away what advocates say is essential coverage for drug addiction treatment as the number of people dying from opiate overdoses is skyrocketing nationwide. Beginning in 2020, the plan would eliminate an Affordable Care Act requirement that Medicaid cover basic mental-health and addiction services in states that expanded it, allowing them to decide whether to include those benefits in Medicaid plans. (Zezima and Ingraham, 3/9)

Legislation that dismantles the Affordable Care Act and passed through two key House committees Thursday would hurt hospitals financially and possibly lead to debt downgrades, according to Moody's Investors Service and S&P Global Ratings. The bill relies on per-capita Medicaid caps and tax credits instead of mandates for individual insurance. The House GOP bill to repeal and replace Obamacare is likely to leave more older and sicker Americans unable to afford insurance than coax younger and healthier people to buy coverage, S&P said. (Barkholz, 3/9)

Anthem CEO Joseph Swedish called several provisions of the Republican health care bill 鈥渆ssential,鈥 and called for their quick passage in a Thursday letter to two House committee chairmen obtained by Morning Consult. Swedish鈥檚 support for the proposal comes as many doctors and hospital groups have said they don鈥檛 support the bill as it鈥檚 currently written. Other advocacy groups like AARP and conservative organizations have also slammed the proposal. (McIntire, 3/9)

A controversial medical device tax imposed to help pay for the Affordable Care Act would be scuttled under the GOP proposal to repeal and replace it. The 2.3-percent excise took effect in 2013 and was suspended by Congress for 2016 and 2017. It will be back again in 2018, unless Congress acts. (Eaton, 3/9)

The Republican replacement plan for Obamacare would end consumer fines for not having health insurance -- and for employers, the $2,000 to $3,000-per-worker fine for not providing insurance. Yet the underlying obligation for employers to provide that insurance would not disappear. Nor would all of the Affordable Care Act's red tape, which some human resources executives say adds聽significantly to their administrative burden. This is one of the oddities of the new American Health Care Act, which some are calling Trumpcare. (Koff, 3/9)

The tanning industry found little to celebrate during Barack Obama鈥檚 presidency, but it鈥檚 starting to cheer up. Mr. Obama鈥檚 signature health law, the Affordable Care Act, put a 10 percent excise tax on indoor tanning services, and during his two terms, the federal government and states sought to deter the use of tanning beds by young people in particular, citing evidence that it causes skin cancer. ... But now, the bill Republicans proposed this week to repeal the A.C.A. would abolish the tanning tax. (Goodnough, 3/9)

A proposal to replace the Obama health care law would cut out a pillar of funding for the nation's lead public health agency, and experts say that would likely curtail programs across the country to prevent problems like lead poisoning and hospital infections. The Republican bill calls for the elimination of a $1 billion-a-year fund created for the Centers for Disease Control and Prevention by the Affordable Care Act in 2010. The fund's goal: Pay for public health programs designed to prevent illness and, therefore, reduce health care costs. (Stobbe, 3/9)

The House Republicans鈥 plan to replace the Affordable Care Act, announced Monday, would bar reproductive health care providers who offer abortion from receiving federal Medicaid reimbursements for one year. Although no federal money is spent on abortions except in cases of rape, incest or where the mother鈥檚 life is at risk, about 40 percent of Planned Parenthood鈥檚 revenue for other services 鈥 including contraception, sexually transmitted infection testing and cancer screenings 鈥 comes from the government, mostly through Medicaid. (Thomson-DeVeaux, 3/9)

Women seeking abortions and some basic health services, including prenatal care, contraception and cancer screenings, would face restrictions and struggle to pay for some of that medical care under the House Republicans' proposed bill. The legislation, which would replace much of former President Barack Obama's health law, was approved by two House committees on Thursday. Republicans are hoping to move quickly to pass it, despite unified opposition from Democrats, criticism from some conservatives who don't think it goes far enough and several health groups who fear millions of Americans would lose coverage and benefits. (Jalonick, 3/9)

The Republican replacement for the Affordable Care Act, now fighting聽its way through Congress, removes the individual聽insurance mandate at the heart of Obamacare and phases out the Medicaid expansion that accounts for millions of the newly insured.聽One piece it appears to have spared, so far: the聽Medicare Hospital Readmission Reduction Program. It's not a household name. But HRRP has been quietly improving the quality of health care鈥攚hile saving聽the federal government billions of dollars鈥攂y聽penalizing hospitals that have too many readmissions within 30 days of patient discharge. (Shanker, 3/10)

In other health-policy news from Capitol Hill -

A little-noticed bill moving through Congress would allow companies聽to require employees to undergo genetic testing or risk paying a penalty of thousands of dollars, and would let employers聽see that genetic and other health information. Giving employers such power is now prohibited by legislation including the 2008 genetic privacy and nondiscrimination law known as GINA. The new bill gets around that landmark law by stating explicitly that GINA and other protections do not apply when genetic tests are part of a 鈥渨orkplace wellness鈥 program. (Begley, 3/10)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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