Health Care

Amid Rate Increases, NY Points To DC Uncertainty

The uncertainty over repealing and replacing the Affordable Care Act, now giving way to the future of subsidies under the law, has played a factor in growing rates in the individual and small group health insurance markets.

Insurance rates for those in New York’s health care exchange will rise, with individual plans rising more than 14 percent on average, and small group plans increasing by more than 9 percent on average. State officials say the increases are driven in part by the higher cost of care and prescription drugs.

But there’s another factor as well.

“We believe also it is driven by the uncertainty that has come out of Washington,” said Donna Frescatore, the executive director of New York’s health exchange, known as NY State of Health.

That uncertainty has come from President Donald Trump, who has threatened to end subsidies under the Affordable Care Act that keep plans affordable. Ending those subsidies, which include tax credits for those with qualifying incomes, could lead to lower quality care and fewer people being insured.

“Should those cost sharing reductions be eliminated, the price of insurance will go up,” Frescatore said. “That is something we hear from consumers as well as organizations throughout the state.”

Members of Congress say they want to find ways of stabilizing the marketplace after broader efforts to repeal the law have failed. In the meantime, New York’s health care exchange officials say they’re working to reassure policyholders their insurance will remain in place.

“We want people to be certainly aware of what could happen in Washington, but we also want to encourage people to continue shopping for coverage,” Frescatore said.

Since 2011 when the exchange was established, health officials say there’s been a 55 percent reduction in rates for individuals.

Coalition Urges NY House Delegation To Push For ACA Subsidies

A coalition of organizations ranging from the health care union 1199/SEIU to the Business Council sent a letter Friday to the state’s House delegation urging them to push for subsidies made available under the Affordable Care Act that President Trump has threatened to discontinue.

The money, known as cost-sharing reduction, or CSR, payments, are subsidies to insurance companies that help cover out-of-pocket costs for low-income people.

“If the CSRs are discontinued and the State is unable to modify rates, it would disrupt the stability of the New York marketplace,” the groups wrote in the letter. That disruption, along with the loss of significant Essential Plan funding, would result in more uninsured New Yorkers, more financial instability for providers and higher costs for all.”

Signing on to the letter Greater New York Hospital Association, Citizen Action, the New York State Nurses Association and the state AFL-CIO, among others.

The future of the funding is now the subject of litigation as well, with Attorney General Eric Schneiderman and California Attorney Xavier Becerra being given approval this week to defend the payments in court. The case dates back to the Obama administration when House Republicans challenged the legality of the payments. The Trump administration has signaled it will not continue to defend the case in court.

Trump’s threat to yank the subsidy payments comes after the failure of Republicans in Congress to approve legislation that would repeal the broad strokes of the Affordable Care Act. Some lawmakers now are discussing smaller fixes to the law that would stabilize markets in a bid to gain Democratic votes for the potential legislation.

CSR Letter to New York State Congressional Delegation by Nick Reisman on Scribd

Rep. Collins On Health Care: ‘We Wasted Six Months’

Even as President Trump took to Twitter over the weekend urging Republican Senators not to give up on health care and invoke the “nuclear option,” one of his biggest supporters says the debate for now is all but over. Rep. Chris Collins, R-NY-27, said he believes Trump actually feels the same way.

“Now what he’s saying to the Senate is, of course, if you can get it done, go get it done. I see zero chance of them doing it so it’s more of a rhetorical statement that he’s making,” he said.

Collins, in Rochester on Monday, took it a step farther, saying Trump was never in favor of Congress taking on repeal of the Affordable Care Act right away, because it didn’t have Democrat support. The congressman said he and the President are in favor of waiting for the current system to implode so there will be more of a public outcry for change.

“I would remind people, the President was right on January 1. We wasted six months. We did not get anything done and now we will be pivoting to tax reform where we can potentially get some bipartisan support. It’s not as emotional.”

Collins said he’s not concerned about potential gridlock from representatives who want to address health care before moving on to other legislation. He said it’s leadership and committee chairmen that drive legislative agenda, not individual members of Congress.

Reed Won’t Support Senate Bill Without Faso-Collins

Republican Rep. Tom Reed on Monday in a statement said he would not support the Senate’s health care reform legislation without the inclusion of the amendment to shift Medicaid costs from county governments to New York state.

“I stand firmly with the people of New York and will oppose the present Senate health care bill if the bill does not include the provision to shift the Medicaid burden from the taxpayers and local governments back to the state, where it belongs,” Reed said in a statement. “We cannot waste this opportunity to right this wrong, nor continue to ignore the needs of our hard working neighbors and friends of New York.”

The amendment, backed by Reps. John Faso and Chris Collins, has been bottled up with a procedural snag in the Senate bill. Faso has vowed to include the provision in a separate bill.

The U.S. Senate this week is attempting to mount the votes for a health measure that would either repeal and replace the Affordable Care Act or commit to a “clean” repeal measure that would take up replacement later on.

Gov. Andrew Cuomo has vehemently opposed to the Faso-Collins amendment and is pushing a campaign to unseat the Republican House members from New York who have backed it.

On Twitter, Cuomo spokesman Rich Azzopardi said, “Without the fig leaf of this political Ponzi scheme, he can’t justify a bill that hurts his own constituents. No one is fooled.”

Higgins on Heath Care: ‘It Appears They Don’t Have The Votes’

From the Morning Memo:

Now with at least four U.S. Senators publicly opposing the Republican health care bill, it appears Mitch McConnell and crew may have to go back to the drawing board. That doesn’t even include Sen. John McCain, R-Arizona, who is recovering from surgery to remove a blood clot above his eye.

“I don’t think they can pass it and if they’re waiting for Senator McCain, it’s kind of odd because he’s already expressed opposition to it,” Rep. Brian Higgins, D-NY-26, said.

Higgins, in Buffalo on Monday, was very confident McConnell would not be able to rally the Senate the way Speaker Paul Ryan rallied his Republicans in the House. The Democratic congressman continues to be a vocal and unabashed critic of the plan.

“It appears as if they don’t have the votes anyhow and they shouldn’t have the votes. This is fraud being perpetrated against the American people,” he said.

The company line for Higgins has been that Democrats and Republicans have to come together to find ways to drive down costs while improving access and quality. He believes Congress can do it.

“In the aftermath of this epic failure on the part of the Senate to do a health care bill, that should be the basis from which we do a bill that really affects in a positive way financially and in terms of health care quality, the needs of the American people,” he said.


HANYS Takes Critical View Of Senate Health Care Bill

The Healthcare Association of New York State in a statement Thursday criticized the latest version of the U.S. Senate bill to replace the Affordable Care Act, also known as Obamacare.

HANYS President Bea Grause called the revised bill “a race to the bottom” when it comes to both coverage and consumer protections.

At the same time, the association took a dim view of the amendment offered by Sen. Ted Cruz that would allow insurance companies to provide cheaper plans that offer fewer benefits as allowed by the Affordable Care Act.

Supporters say the move would bring down premiums; opponents contend it would create two systems of healthy people with inexpensive plans and sick people with costly ones.

“Cuts have consequences. The revised BCRA will devastate New York’s healthcare system and New York’s economy,” Grause said. “We will continue to strongly oppose it, and support federal policies that provide meaningful health coverage for all.

“If this bill gets through the U.S. Senate and goes back to the House for a final vote, HANYS will strongly urge all members of the New York State Congressional Delegation to oppose it, as it is markedly worse than the HANYS-opposed and House-passed American Health Care Act, and would seriously undermine the healthcare system.”

Collins Says McConnell Secretive Health Care Tactic Is ‘Smart Politics’

From the Memo:

U.S. Senate Democrats may be protesting the behind-the-scenes effort of Majority Leader Mitch McConnell to garner support for a new health care bill – an undertaking with which even some of McConnell’s own GOP members are none too pleased.

But the GOP leader has the support of Rep. Chris Collins. The WNY congressman said while some may want to see a more transparent process with open hearings, that’s not the reality McConnell faces.

“We can only lose two senators and like we did in the House, we almost didn’t get something out of the House,” Collins said. “I think there was a lesson learned there, so I actually would say politically, and to get this done it’s so important, Mitch McConnell’s doing the right thing even though some would disagree with me.”

McConnell is reportedly hoping for a vote on the yet-to-be-made-public legislation before the July 4 recess. He has pointed out Democrats will have an opportunity to propose amendments to the bill once it hits the floor, though they’ve so far been employing other, procedural tactics to slow the process.

Collins called McConnell’s approach “smart politics.”

“The fact is the opposition is just waiting to go, and the fact is the more information you put out and the sooner it goes out, the more likely the opposition is going out, and the less likely you’re going to get 50 votes in the Senate,” he said.

At a meeting yesterday with the Hamburg Chamber of Congress, the congressman said he also envisions a system that allows people to purchase insurance across state lines. That’s a platform President Donald Trump campaigned on, but was not realized in the House bill.

“That’s what we call this third bucket,” Collins said. “We repeal and replace where we can in accordance with the parliamentarian procedures on a budget reconciliation, which has to have a financial direct impact on the U.S. budget, which selling insurance across the state lines does not meet that. We’ve got the regulatory issue that Secretary Price of HHS can deal with and then there was going to be those other things.”

Collins believes there is enough bipartisan support for an open national market to get at least the 60 votes needed to pass the legislation outside of the budget reconciliation process.



Rep. Reed Says CBO Assumes States Will Get Waivers

From the Memo:

Rep. Tom Reed may have conceded Tuesday that the Congressional Budget Office’s projections that less people will be insured under the American Health Care Act makes sense, but the Southern Tier Republican certainly didn’t agree with every assertion in last week’s report.

Reed said when the CBO stated the legislation would adversely affect sick Americans more than healthy ones, it made flawed assumptions.

“What they’re doing is they’re saying in that hypothetical situation where a waiver is granted to a state, that there could be a potential adverse impact on such an individual. That’s a lot of assumptions. That’s a lot of hypothetical,” he said.

Reed noted it’s been widely reported that states could apply to waive requirements that protect patients with preexisting conditions from paying higher premiums under the AHCA. Lost in that reporting and in the CBO, Reed believes, is the fact those states would have to prove to the federal government that they have a plan to provide better care to their residents than the federal health care regulations would provide.

In New York, in particular, Reed said the waiver component of the bill is essentially a moot point.

“New York State won’t be a waiver state,” he said “I’m very confident of that.”

When further pressed though, Reed admitted proposed massive cuts to the Medicaid system would have an impact on his home state. The Governor’s Office said the AHCA would cut $4.7 billion from New York’s Medicaid budget – on top of the costs the Collins-Faso Amendment would transfer from the county to the state.

Reed noted, of course, raising taxes to make up for the lost revenue from the federal government is an option but he doesn’t believe state lawmakers would do that to constituents already facing a heavy burden. Instead, he hopes legislators would earnestly look at making cuts and reforming the health care system.

“At the end of the day, we’re not passing the buck to the state but we’re just saying, look at, we’ll be a partner but we’ve got to be a partner that’s doing things in an innovative way, a different way that’s rewarding good outcomes and improving people’s quality of life,” he said.

“I don’t want to tell them one or the other. I want to work with them as partners and say let’s work together.

DCCC Launches Campaign Against NY Congressional Members

UPDATED 2:30 p.m. – The Democratic Congressional Campaign Committee is launching a digital campaign in response to a new amendment to the Republican health care plan. The proposal, seen as a potential compromise between the Conservative House Freedom Caucus and more moderate Republicans, would allow states to opt out of provisions that guarantee patients with preexisting conditions receive coverage and don’t pay more.

Also written into that amendment, according to the DCCC, is an exemption that would keep those protections in place for members of Congress, should their state seek the waiver. A spokesperson for the committee said it’s a clear indication they understand the potential impact of the legislation on patients.

“Removing protections for people with pre-existing conditions will go down in infamy as one of the most heartless acts of this Republican Congress. As proof of the repeal bill’s devastating impact, Representatives Zeldin and Tenney are exempting themselves from the punishment they are willing to inflict on their constituents,” said DCCC Spokesman Evan Lukaske. “This digital ad campaign will educate voters in targeted districts about this morally bankrupt Congressional Carveout.”

Among the GOP representatives who the campaign is targeting are Claudia Tenney (NY-22), Lee Zeldin (NY-1), and John Faso (NY-19).  The committee said while Tenney and Zeldin have not publicly committed to voting for the plan, they have been very supportive of repealing the Affordable Care Act in general.

“It’s shocking that Nancy Pelosi and her liberal allies would claim to have any credibility left as they sit in Washington watching Obamacare collapse around them. Democrats are desperate to deflect attention away from their failed record – which has caused premiums to skyrocket, restricted choices for consumers, and suffocated small businesses with higher taxes and more regulations,” National Republican Congressional Committee Regional Press Secretary Chris Martin responded.

Higgins: AHCA ‘Screws’ Americans

From the Morning Memo:

Think Democratic Rep. Brian Higgins plans to vote for the American Health Care Act when the House votes on the bill today? Think again.

“They’re looking to screw the American people; this bill screws the American people,” Higgins said.

The Buffalo Democrat didn’t mince words about his feelings for the legislation, calling it a scam perpetrated on the American people.

Higgins said if the ACHA is passed, people between the ages of 50 and 64 will see premium increases and less health care, while insurance companies and executives get tax cuts.

“There’s an unemployment tax on the unemployed so if your insurance lapses because of unemployment, the insurance companies will hit you with a penalty that goes directly to the insurance companies,” he said.

Higgins said he won’t support an amendment introduced by his Western New York colleague, Republican Rep. Chris Collins, despite the fact it’s supported by the state Association of Counties and could provide mandate relief, explaining: “It’s an exchange for supporting this bill, and this bill is a disaster.”

This is something of a turnaround for the Democratic congressman, who over the weekend was saying he supports Collins’ proposal to have the state take over the counties’ share of Medicaid.

Higgins later said that upon taking a closer look at the amendment, he discovered it presents New York with a double whammy: the cost cuts it would face under the other parts of the health bill, along with the $2.3 billion it would lose annually from the counties. “New York State is going to get clobbered under this bill,” he told The Buffalo News.

Higgins said Congress should be discussing a way to leverage the 57 million Medicare participants and negotiate lower prescription prices with pharmaceutical companies.