DCMedical News: Friday, September 16, 2022
DCMedical News is published every day both the House and the Senate are scheduled to be in session.
THE BIG STORY Thursday, September 15, 2022
Census Bureau Study Shows Variability in Uninsured, Covered Populations
The newly released American Community Survey (here) shows a decline in the share of people without health insurance, driven by an increase in public coverage in 36 of the States. “During the past two years, Congress passed measures to improve access to public and private health insurance coverage during the COVID-19 Public Health Emergency including continuing coverage for people receiving Medicaid and introducing policies to help people access and afford the cost of care. These and other federal and state policies contributed to an increase in public coverage in 36 states, leading to lower uninsured rates in 28 states in 2021. Only one state – North Dakota – had a higher uninsured rate in 2021 than in 2019.”
Christian Owned Company Objects to Requiring HIV Prevention Drugs in Obamacare Plans; a Federal Judge Agrees
BMJ reports (here) “The future of preventive medical services under the Affordable Care Act (ACA), often referred to as Obamacare, is in doubt following a 7 September decision [here] by federal judge Reed O’Connor in Fort Worth, Texas. O’Connor struck down a key provision of the ACA that requires insurers and employers to cover HIV prevention drugs, on the grounds that the requirement violates the religious freedom of a Christian owned company.” Washington Post coverage here.
The Patient Protection and Affordable Care Act requires that all health insurance automatically cover basic prevention services such as screening for disease and the provision of vaccinations, and prohibits additional co-payments by patients who use those services, the covered list developed by the US Preventive Services Task Force (PSTF). Created the 1984, the USPSTF had only advisory authority, but that changed with PPACA.
“Several conservative Christian plaintiffs, including Braidwood Management, a 70 person company, filed a lawsuit objecting to the preventive care mandates,” claiming that “providing coverage for HPV vaccination and pre-exposure prophylaxis to prevent HIV infection” makes them “complicit in facilitating homosexual behaviour, drug use, and sexual activity outside of marriage between one man and one woman.” Reed also declared the USPSTF unconstitutional.
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Medical Debt Burden
The Consumer Financial Protection Bureau reports (here) that “58 percent of all third-party debt collection tradelines were for medical debt, making medical debt the most common debt collection tradeline on credit records. The next most common collections tradeline was telecommunications debt, at only 15 percent of tradelines,” and that “Medical debt collections are less predictive of future payment problems than other debt collections are,” but that “Uninsured and out-of-network patients are often charged prices that are much higher than what in-network insurers pay—even though the uninsured may have little ability to pay.”
Fat Joe Says, “Post Your Prices”
Rapper Fat Joe (here, also here), in a TV ad about hospital price transparency requirements that began running this spring, takes on hospital industry executives. The ad contends that “hospitals are disobeying a law that requires them to publicly post the prices they charge cash-paying patients and insurance companies for every service they offer.” The ads are paid for by a group called “Power to the Patients,” (here).
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE PLANS
Public Charge ≠ Medicaid Use
A final rule (here, 455 pages) was published September 9 in the Federal Register defining the public charge basis for immigration purposes. “Individuals who are likely to primarily rely on their own resources, while secondarily relying on some government support, are less readily characterized as public charges. DHS does not believe that the term is best understood to include a person who receives benefits from the government to help to meet some needs but is not
primarily dependent on the government.”
The PHE is Ending. How About Simplifying Medicaid and CHIP Enrollment?
Modern Healthcare reports (here) that “Applying for Medicaid or Children's Health Insurance Program benefits would become much easier under a proposed rule the Centers for Medicare and Medicaid Services published Wednesday.” A CMS memo is here, the proposed rule as published in the Federal Register is here. “The proposed rule precedes the looming resumption of eligibility redeterminations, which are expected to cause 15 million people to lose benefits when the COVID-19 public health emergency lapses.”
An AHLA summary reports that “The proposal calls for standardizing state eligibility and enrollment policies, limiting renewals to once every year, giving applicants 30 days to respond to information requests, and requiring pre-populated renewal forms--and recordkeeping requirements. The administration also is proposing to end lifetime benefit limits in CHIP and to eliminate pre-enrollment waiting periods so children can enroll in coverage right away. Under the proposal, states also could immediately transfer children’s eligibility directly from Medicaid to CHIP when a family’s income rises, to prevent lapses in coverage.” Comments on the proposed rule are due November 7.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
September 19, 20, 21, 22, 28, 29, 30
October 11, 12, 13, 14, 17, 18, 19, 20, 21
November 14, 15, 16, 17, 18, 29, 30
Notes to Fred Hyde, MD, JD, MBA, news@dcmedicalnews.org