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$1.6 Trillion Emergency Spending Bill Ices Out Health Insurers

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Health insurers were hoping Congress would use the new, $1.6 trillion emergency spending bill as a vehicle for stabilizing the individual major medical market.

The 2,232-page version that the House unveiled late Wednesday — the Consolidated Appropriations Act, 2018″ bill, or “spending omnibus” bill — includes no new commercial health insurance programs or funding.

If adopted and implemented as written, the CAA-2018 bill would:

  • Emphasize that Congress wants the head of the Centers for Medicare and Medicaid Services (CMS) to give Congress a report on the idea of expanding Medicare and Medicare enrollees’ access to telehealth services.
  • Require any federally funded health plan that covers prescription drugs to cover contraceptives  —  while forbidding any federally funded plan that covers from contraceptives from discriminating against health care providers who decline to provide contraceptives because of religious beliefs or moral convictions.
  • Encourage the District of Columbia to include a “conscience clause” exception, for people who oppose the use of contraceptives, in any D.C. legislation that addresses health plans’ contraceptive benefits.
  • Extend the current ban on use of the cash in the CMS program management account to pay bills related to the Affordable Care Act risk corridors program, which was supposed to provide subsidies for ACA exchange plan issuers who suffered poor financial results in 2014, 2015 and 2016.

Those appear to be just about the only provisions related to heath insurance for anyone other than federal employees, federal judges or veterans in the current version of the CAA 2018 bill text.

America’s Health Insurance Plans, a group for health insurers, put out a statement expressing disappointment about the lack of major medical stabilization provisions.

“Premium reduction measures in the individual market would have ensured that Americans who buy their own coverage had more affordable choices that offer access to high-quality care,” AHIP says in the statement. “We are disappointed that Congress was unable to take this opportunity to help reduce premiums for hardworking Americans.

Americans in the individual market deserve the same access to stable and affordable coverage that people in the group health, Medicare Advantage and Medicaid managed care markets enjoy, AHIP says.

“We will continue to work with state leaders, Congress, and the administration to  ensure that every American has affordable choices for 2019 and beyond,” AHIP says.

A copy of the text is available here.


One provision of possible interest to insurers, and to long-term care and special needs planners, would provide $10 million in grant funding, or $2 million per year from this year through 2022, for programs that try to prevent people with dementia and developmental disabilities from “eloping,” or “wandering” out of the reach of the people trying to protect them from harm.

The program would also fund efforts to improve the country’s response to cases of elopement.

The provision builds on a grant program from the 1990s that focused on efforts to prevent and respond to elopements by people with Alzheimer’s disease. The law creating the grant program is still on the books but ran out of funding years ago. The CAA-2018 bill would create the new, broader anti-wandering grant program by amending the existing law and adding funding.

The Bill’s Future

The CAA-2018 drafters have packaged it as an amendment to H.R. 1625, an anti-human-trafficking bill.

Members of the House Rules Committee voted around 12:30 a.m. today to approve the rule the lawmakers will use to consider the bill on the House floor. Rep. Pete Sessions, R-Texas, the chairman of the committee, said after the vote that he expects the House to begin debating the bill around 9 a.m. today.

Supporters of the bill are hoping to get the bill through both the House and the Senate by Friday.

If approved, the bill would provide the funding the government needs to operate through Sept. 30, the end of the current federal fiscal year. If lawmakers fail to get a spending bill in place quickly enough, parts of the federal government could shut down at midnight Saturday.

It’s not clear whether the bill can get through either the House or the Senate.

Some House Republicans, including Rep. Mark Meadows, R-N.C., the chairman of the Freedom Caucus, have said they will vote against the bill, because they believe the process used to develop the bill was rushed and secretive.

Sen. Rand Paul, R-Ky., has objected to a section at the end, the CLOUD Act , that would establish rules for international data storage operations. He retweeted an analyst who suggested the CLOUD Act could let foreign countries demand data from U.S. companies.

“But  guess what?” Paul tweeted. “Congress can’t vote to reject the CLOUD Act, because it just got stuck onto the Omnibus, with no prior legislative action or review.”

— Read 8 Things to Know About Telehealth for 2018 on ThinkAdvisor.

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