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ACA Round-Up: Oregon 1332 Waiver Approved, Silent Returns Rejected, And More

Oregon’s newly approved 1332 waiver proposal is the fourth such waiver proposal CMS has approved and the third proposal involving a reinsurance program. Oregon will reinsure 50 percent of claims, in excess of an attachment point to be determined, up to $1 million.

October 19, 2017 | Following the ACA

The Next Chapter In Transparency: Maryland’s Wear The Cost

With the nation struggling to find a path toward high-quality, affordable, and accessible care, the benefits of illuminating both quality information and underlying costs is a rare area of bipartisan agreement.

October 19, 2017 | Costs and Spending, Quality

State Attorneys General Ask Court For Injunction Reversing CSR Payment Halt

Quoting from President Trump’s tweets, the states argue that his termination of CSR payments was “arbitrary and capricious” and thus violated the Administrative Procedures Act. They also say the president violated his constitutional duty to "take care that the laws be faithfully executed."

ACA Round-Up: Alexander-Murray And CSR Payments, QHP Quality Ratings, And More

In states that allowed insurers to assume CSR payments would be cancelled, rather than require insurers to refile rates, delaying open enrollment, the Alexander-Murray proposal would leave increased rates in place but require insurers to rebate overpayments to enrollees and the federal government.

Traveling The Valley Of The Shadow Of Death In 2017

Hospitals, physicians, pharmacists, and civic leaders have not made plans as to how to serve large numbers of elderly people living in the community with serious and worsening disabilities.

October 18, 2017 | End of Life & Serious Illness

The Alexander-Murray Market Stabilization Package: What’s In It And Where’s It Going?

We don’t yet have final bill text or a CBO score, but in today’s announcement from Senators Alexander and Murray we have some details on policies that should help stabilize consumer access and premiums in the individual market in the next few years.

Despite Leaving Key Questions Unanswered, New Contraceptive Coverage Exemptions Will Do Clear Harm

On October 6, the Trump administration released an overhaul of federal regulations governing religious objections to the Affordable Care Act’s (ACA) contraceptive coverage guarantee. With exemptions to the contraceptive guarantee expanded, there are lots of questions and concerns that will not...

October 17, 2017 | Following the ACA, Public Health

Salvaging MACRA Implementation Through Medicare Advantage

Unless there are substantive changes to how the law is implemented, MACRA is unlikely to realize the goal of establishing a Medicare payment system that rewards the value and not the volume of health care services.

October 17, 2017 | Medicare, Payment Policy

A Framework For Understanding 'Savings' From Accountable Care Organizations

The complexity of the ACO payment structure means there are a few ways one could measure savings. The semantic questions here are challenging and variation in how terms are used can lead to confusion. We attempt to clarify the meanings of “savings” and draw out the implications for the program.

A New Plan To Rescue The ACA: Medicare-At-55

With the Trump Administration's recent executive order on health care, the need for proposals to help stabilize the insurance market has grown. One proposal is Medicare-at-55, which would extend Medicare to the 55-64 age group, and could be a potential fix to insure the near-elderly and provide...