Health Care

Overnight Healthcare: Insurers get win on ObamaCare deadlines

The Obama administration delivered a key victory to health insurers on Wednesday by announcing a new crackdown on people who sign up for insurance after the national marketplace deadline.  

The government will now require ObamaCare customers to prove that they are eligible for the law’s “special enrollment periods.”

It’s the administration’s latest – and largest – move to quell growing fury among insurers, who have long sought a verification process for the special sign-up periods.

{mosads}The new policy earned tentative approval from the trade group, America’s Health Insurance Plans (AHIP). “This latest effort will ensure qualified enrollees have access to coverage during important life transitions while also cutting down on the abuse and misuse of special enrollment periods which lead to higher costs for consumers,” Clare Krusing, AHIP spokeswoman, wrote in a statement Wednesday.

The change to the program was announced one day after AHIP released a sharply critical report, which said people who signed up after the deadline had “significantly higher medical claims than others” — suggesting people were waiting until they become sick to sign up for insurance. Read more here. http://bit.ly/1S25k22

SENATE APPROVES FDA NOMINEE: Dr. Robert Califf officially made it through confirmation on Wednesday in an overwhelming 89-4 vote. There were a handful of objections, though, that had thrown some obstacles into the process, centered on the FDA’s handling of the opioid epidemic and Califf’s ties to the pharmaceutical industry. Read more here. http://bit.ly/1Ron9q0

ABOUT THAT OTHER NOMINEE… The Obama administration is reportedly considering Nevada’s Republican Gov. Brian Sandoval to replace Justice Antonin Scalia on the Supreme Court – a move that could make waves in health law.

Sandoval has been described as one of the few Republican governors who have gone “all in” on ObamaCare, creating his own state exchange while also agreeing to expand Medicaid. But the conservative governor once called ObamaCare “unconstitutional,” a sign that he could be more fractious with Senate Democrats than expected. Still, it’s an uphill battle: The Senate GOP reiterated this week that it would not consider Obama’s nominee.

BURWELL ADMITS ABORTION LAW INQUIRY TOO SLOW HHS Secretary Sylvia Burwell acknowledged Wednesday that the administration has not moved fast enough in investigating an alleged violation of abortion law.

Burwell was questioned at a congressional hearing Wednesday about a California state agency’s decision in 2014 to require all health insurance plans in the state to cover abortions, which Republicans say is a clear violation of the federal Weldon Amendment, protecting insurance plans from discrimination if they decline to cover abortions.

The HHS Office of Civil Rights, which has the responsibility of enforcing the Weldon Amendment, said in December 2014 it had opened an investigation into California’s actions. But the investigation is still not complete.

“I would like for it to have moved more quickly than it has moved, but the investigation is open, and until it is closed, I am not at a place to discuss in terms of what the investigation has yielded or will yield,” Burwell said. Read more here. http://bit.ly/1S23xdl

GAO FINDS OBAMACARE ‘VULNERABLE’ TO FRAUD The administration took a “passive” approach to preventing ObamaCare fraud and the system remains “vulnerable,” according to a report from the nonpartisan Government Accountability Office (GAO).

The GAO found that 431,000 applicants in 2014, who received about $1.7 billion in subsidies, still had unresolved inconsistencies in their applications as of April 2015, months after the coverage year had ended. Inconsistencies, such as when an applicant’s information does not match federal databases, can involve Social Security numbers or immigration status. Read more here. http://bit.ly/1mYny7M

GRASSLEY BLOCKING HHS NOMINEE OVER PLANNED PARENTHOOD Sen. Chuck Grassley (R-Iowa) plans to hold up the appointment of Dr. Mary Wakefield as Health and Human Services (HHS) deputy secretary until he receives an adequate response from the department about how it is probing claims against Planned Parenthood’s fetal tissue program.

Grassley said he and three other senators wrote to HHS last summer “regarding fetal tissue harvesting practices” of Planned Parenthood, which receives federal grants from the department.

“Response to the letters did not fully answer the questions raised and, furthermore, raised additional concerns. Follow-up inquiries to HHS also failed to address some of the questions,” Grassley wrote. Read more here. http://bit.ly/1p5BpLc

DATE PICKED FOR FIRST PLANNED PARENTHOOD PANEL HEARING: The House’s special committee investigating Planned Parenthood announced that it will hold its first hearing next Wednesday, hearing from professors and medical practitioners on bioethics and fetal tissue.  

It’s scheduled at nearly the same time as oral arguments for a key abortion case at the Supreme Court, Whole Women’s Health v. Hellerstedt.

BOEHNER, PELOSI HONORED FOR HEALTH POLICY: Boehner and Pelosi received top accolades from the American Medical Association on Tuesday night for their role in eliminating the much-maligned “doc fix.”   

“Speaker Boehner cobbled together a rare bipartisan coalition that resulted in the permanent repeal of Medicare’s flawed physician payment formula,” the group wrote in a statement about Boehner. On Pelosi, the group said the minority leader “ensured that the repeal was a bipartisan effort that attracted the overwhelming support of the Democratic caucus.”

WHAT WE’RE READING:

Supreme Court abortion case seen as pivotal to clinics (New York Times)

More rural hospitals are closing their maternity units (NPR)

Proving Zika guilty: A long and painstaking task (Reuters)

IN THE STATES:

3 pregnant women in Florida contract Zika virus (Local ABC 10)

Puerto Rico to hold firm on condom prices to fight Zika virus (The Guardian)

Judge: NYC can fine chains that don’t post salt warnings (AP)

ICYMI FROM THE HILL:

Pennsylvania governor diagnosed with prostate cancer http://bit.ly/1oBErpJ

Senate reaches deal on $250M Flint package http://bit.ly/1p5Dhnd

 

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