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Morning Briefing

Summaries of health policy coverage from major news organizations

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Monday, Jul 18 2016

Full Issue

Will Federal Officials Practice What They Preach Over Aggressive Insurance Rate Reviews?

Four states — Missouri, Oklahoma, Texas and Wyoming — have left it up to the federal government to review rate increases. And while officials have urged states to take a firm stance on unwarranted spikes, it is unclear if they will significantly pare back rates themselves. In other news, the calls to "repeal and replace" the health law grow shakier now that so many Americans are covered.

For several years, the Obama administration has urged state insurance regulators to use tools provided by the Affordable Care Act to hold down health care premiums. Now federal officials will have a chance to practice what they preach as they confront big increases proposed in several states where they are responsible for reviewing rates. Federal officials defer to the insurance commissioners in 46 states deemed to have “effective rate review” programs. But in Missouri, Oklahoma, Texas and Wyoming, the federal government is in charge of reviewing rates. (Pear, 7/16)

Cleveland, we have a problem. As Republicans gather to anoint their presidential ticket, Donald Trump's plan for replacing "Obamacare" appears to be anything but solid. A nonpartisan analysis recently found it would make 18 million people uninsured. ... "I don't think they can credibly do 'repeal' until they have a solid legislative proposal to replace it," said Lanhee Chen, policy director for the 2012 Mitt Romney presidential campaign. "Politically, you can't really do 'repeal' without the 'replace' coming in right behind it." Trump "has made some vague pronouncements, but that's not a plan," he added. Many conservatives are hoping House Speaker Paul Ryan, R-Wis., will have the answer. (Alonso-Zaldivar, 7/18)

Meanwhile, Medicare's program testing accountable care organizations faces hurdles as participants withdraw, and a look at why co-ops are struggling —

Medicare's newest program testing accountable care organizations is not even a year old, and three out of 21 participants have already exited. ... The remaining 18 are still within the range of 15-20 ACOs CMS officials thought would participate. But the exiting parties indicate Medicare's payment reforms, which center around quality and the ability to keep costs down, still have not completely won over many hospitals and doctors. (Herman, 7/15)

Failures among member-run health insurance co-ops are forcing thousands of consumers to find new health insurance coverage, while renewing questions about the viability of a once-promising program created by the Affordable Care Act. In Illinois, about 49,000 people must find coverage after state regulators last week ordered Land of Lincoln Mutual Health Insurance Co. to close in the face of steep losses. (Liss, 7/17)

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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