June 29 Update: The cost of health care; New resource hub for state health policy; Medicaid and CHIP enrollment update

The cost of health care was the subject of a hearing this week held by the Committee on Health, Education, Labor and Pensions. In case you missed it, you can watch a recording. The hearing was the first in a series on how to reduce the cost of health care in the United States and featured testimony from Niall Brennan, head of the Health Care Cost Institute, who argued that price increases are to blame for rising costs rather than an increase in the utilization of care. Also on the topic of the cost of health care in the U.S., Leavitt Partners released a report this week, the product of a combined quantitative and qualitative analysis of factors that may be influencing total cost of care in health care markets across the United States. Updates follow.

  • Delaware — A resolution to create a Medicaid buy-in study group to study the adoption of a Medicaid buy-in for people with incomes above 138% federal poverty level passed the Senate and House this week. We have updated our map that tracks state activity on Medicaid buy-in with a link to the legislation.
  • District of Columbia – The Council of the District of Columbia unanimously approved an individual mandate as part of the Budget Support Act of 2018. The District’s individual mandate is now the third state-level mandate after Massachusetts and New Jersey.
  • Massachusetts – The Centers for Medicare & Medicaid Services (CMS) rejected the state’s request to implement a limited formulary. As part of a proposed amendment to its Section 1115 waiver, Massachusetts requested to implement the formulary to address rising drug costs.
  • Michigan – At the end of last week, Governor Rick Snyder announced that he had signed Senate Bill 897 that adjusts the requirements for health care coverage under the state’s Medicaid expansion. Pending approval of a waiver from CMS, beneficiaries will be required to have at least 80 hours per month at a part-time job, a postsecondary educational institution or high school equivalency test training, a job training program, volunteer work or community service, an internship, or substance abuse treatment.
  • New Jersey – The Department of Banking and Insurance posted an updated Section 1332 draft waiver application. We have a link to the latest version of the application on our map that tracks state 1332 waiver activity.
  • Oklahoma — CMS approved Oklahoma’s state plan amendment to allow the state to negotiate supplemental rebate agreements with drug manufacturers. Under the approved amendment, Oklahoma can enter into tailored agreements with manufacturers and jointly set benchmarks for clinical outcomes of drugs, which, if not achieved, would yield additional rebates for the state.
  • West Virginia — The Department of Health and Human Resources’ Bureau for Medical Services announced Medicaid recipients will begin receiving the second phase of new services under the state’s 1115 Substance Use Disorder Waiver beginning July 1, 2018. Phase two services expand coverage to include adult residential treatment, peer recovery support services and withdrawal management services.

New Resource Hub for State Health Policy Research

Do you ever see a brief on a topic relevant to your work, but later can’t remember how to find it? The Robert Wood Johnson Foundation has created a hub for Foundation-funded state-level health policy research at the newly revamped and refreshed StateNetwork.org. The site brings together resources from across RWJF grantees into one easy-to-navigate place, so you never lose a brief again. You can also subscribe to new product alert emails, and bookmark the site for your future research.

Latest Medicaid and Children’s Health Insurance Eligibility and Enrollment Report

The April 2018 Medicaid and CHIP Application, Eligibility Determinations, and Enrollment Report was released this week by CMS. The report includes state Medicaid and Children’s Health Insurance Program (CHIP) agency activity for the month. The report is one of a series of reports on state Medicaid and CHIP data, and it includes point-in-time data reported by states. One highlight from the report: over 16.1 million additional individuals were enrolled in Medicaid and CHIP in April 2018 as compared to the period prior to the start of the first Marketplace open enrollment period (July – September 2013), in the 49 states that reported relevant data for both periods, representing nearly a 29 percent increase over the baseline period.

Lawmakers Who Worked on the Affordable Care Act Look Back

During a session at the annual Aspen Ideas Festival in Colorado, the lawmakers who forged the Affordable Care Act (ACA) joined Kaiser Health News’ Julie Rovner to discuss the experience. Former Senators Max Baucus (D-Mont.) and Chris Dodd (D-Conn.) and former Representatives Henry Waxman (D-Calif.) and George Miller (D-Calif.) and retiring Representative Sander Levin (D-Mich.) led the five key committees that pushed the Affordable Care Act toward its passage in 2010. In their conversation with Rovner, the lawmakers discuss the partisan battles over the ACA, how their efforts in Congress differed from an earlier effort by the Clinton administration to revamp health care, and the problems that arose because they couldn’t get a bill through Congress to make corrections to the ACA.