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What's Going On With Healthcare?

April 6, 2017

There has been a lot of speculation about next steps with the American Health Care Act (AHCA), with meetings at the White House and in the Capitol between senior Trump Administration officials and Members of Congress who were opposed to the bills. While there has not been a “deal” brokered per se, there have been some significant developments.

Congressmen Schweikert (R-AZ) and Palmer (R-AL) filed an amendment to AHCA at the Rules Committee this morning. AHCA creates a Patient and State Stability Fund to allow states to: provide financial assistance for high-risk individuals; stabilize individual and small group markets; lower the cost of insurance in the individual and small group markets; create incentives to purchase insurance; promote access to preventive health and dental services; and provide assistance for out-of-pocket costs.

The amendment strikes the provision that allows states to provide assistance to insurance companies in the individual market that have claims that exceed $1 million and inserts a new federal invisible risk sharing program. The program provides the Administrator of the Centers for Medicare and Medicaid Services (CMS) $15 billion starting in January of 2018 until the end of the year of 2026 to provide payments to insurance companies in the individual market that experience high claims. The language directs the CMS Administrator to define the details of the program including eligibility and conditions that would automatically qualify for automatic enrollment in the program.

Leader McCarthy sent a memo to Republican Members providing them with a healthcare update and stating that the Rules Committee will meet today to add this amendment to the AHCA. The Leader described this action as a positive step but said there is more work to be done. He also let Members know it is possible they will be called back from the recess early for a possible vote on the AHCA on the House floor.

Freedom Caucus Chairman Mark Meadows also described this amendment as a positive step. However, he did not indicate overall support for the AHCA.

Rich Meade

Rich Meade, a Vice Chairman at Prime Policy Group and Chair of the firm’s Healthcare Practice has over 25 years of experience in legislative, regulatory, political and public relations strategy. He previously served as Chief of Staff to the House Budget Committee. Rich has helped his clients navigate many complex regulatory and legislative landscapes to achieve many public policy successes including transitioning to a new Medicare payment and quality system, and developing, with the Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC), a health information exchange (HIE) on the Nationwide Health Information Network (NwHIN).
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