October 2018

The Departments of Health and Human Services and Treasury (“the Departments”) released updated guidance setting forth their interpretation of Section 1332 of the Affordable Care Act (ACA), which authorizes states to waive certain provisions of the ACA. The guidance details new principles to be advanced by state waivers and outlines how the Departments will review waiver applications going forward. The guidance is effective immediately, though there is a 60-day comment period. For a summary of the guidance and implications for states, see this Health Affairs blog post.

The Centers for Medicare & Medicaid Services (CMS) proposed this week requiring drug manufacturers to include the price of drugs in television ads. Under the proposed rule, prescription drug manufacturers would be required to post the Wholesale Acquisition Cost for drugs covered in Medicare or Medicaid in direct-to-consumer television advertisements. Kaiser Health News has an article that details the proposal.

The Centers for Medicare & Medicaid Services (CMS) announced this week that the average premiums for individual health coverage on healthcare.gov, the federal marketplace, will drop by 1.5 percent for 2019, marking the first-time average premiums have fallen since the implementation of the federal exchange in 2014. Kaiser Health News published an article that examines the factors contributing to the average decline in premiums.

Also this week, CMS took several steps to support both Florida and Georgia in response to Hurricane Michael. Health and Human Services Secretary Alex Azar declared a public health emergency in Florida on Wednesday, before Michael made landfall, and a public health emergency in Georgia on Thursday. Our thoughts are with all those who are struggling in the aftermath of the hurricane and working in both states to care for affected residents. Updates follow.

On Wednesday last week, the Senate passed legislation, H.R. 6 - SUPPORT for Patients and Communities Act, to address the opioid epidemic, which now goes to President Trump for his signature. The Kaiser Health News podcast What the Health? walks through the details of the final version of the bill (starts at 1:27), and the Addiction Policy Forum produced a summary that outlines the 41 key components of the opioid package. Also, on Monday State Health and Value Strategies hosted a webinar, facilitated by experts at Manatt Health, on the implications of the proposed public charge rule for Medicaid. The  proposal would change how the Department of Homeland Security determines whether immigrants are “likely at any time to become a public charge,” which may put immigration status at risk. The slide deck and recording are on SHVS's website.

This week began with the release of a proposed rule by the Department of Homeland Security (DHS) that seeks to change how DHS determines whether immigrants are dependent on the government for financial support. On Monday, October 1, State Health and Value Strategies hosted a webinar, facilitated by experts at Manatt Health, on the changes proposed by DHS in determining whether immigrants—when seeking admission to the United States, an extension of their stay, or status change to become a legal permanent resident—are “likely at any time to become a public charge,” which may put immigration status at risk, and the implications of the proposed rule for Medicaid. Updates follow.