GOP Chairman in Talks With Trump Officials on Restarting Key Obamacare Payments; Oklahoma Medicaid Approved for Drug Pricing Experiment; House Panel Advances Bill That Would Temporarily Halt Obamacare’s Employer Mandate

GOP Chairman in Talks With Trump Officials on Restarting Key Obamacare Payments

On July 16, 2018, Kevin Brady (R-TX), House Ways and Means Committee chair, announced that he’s working with the Trump administration (http://thehill.com/policy/healthcare/397294-gop-chairman-in-talks-with-trump-officials-on-restarting-key-obamacare) to restore funding to key Affordable Care Act (ACA) payments. Previously, the White House suspended more than $10.4 billion in payments to insurers, which brought criticism from Democrats and stern warnings of rising healthcare premiums.

When it comes to discussing the future of the ACA, and especially the money associated with it, both sides often use particularly harsh words. “Sabotage” was uttered about the funding cuts for ACA navigators (https://voice.ons.org/advocacy/trump-slashes-obamacare-outreach-funding) whose role was educating and enrolling Americans interested in coverage through the healthcare program. With those cuts, fewer people are signing up, which places a greater burden on the states. Now, people are complaining to their local representatives about why their coverage is gone and why they can’t get enrolled. Will this groundswell of vocal voters be enough to lobby change for ACA funding cuts? Only time will tell.

Oklahoma Medicaid Approved for Drug Pricing Experiment

To lower the burden of cost for prescription medications, the Centers for Medicare and Medicaid Services (CMS) announced that Oklahoma would be granted the nation’s first experimental drug pricing model (https://apnews.com/2ba91c08a7e946f9bc8c777c9d656f26/Oklahoma-Medicaid-approved-for-drug-pricing-experiment). The value-based system echoes a similar approach with CMS’s Oncology Care Model (https://voice.ons.org/news-and-views/how-the-oncology-care-model-is-redefining-quality-care), which is being piloted at institutions throughout the country. By prescribing only the medication patients need and reimbursing companies based on the effectiveness of their drugs, CMS hopes to save patients money on their prescriptions.

Although the verdict is out on the drug pricing experiment, the Medicaid State Directors Association believes this might be a starting point to delve into the idea of value-based purchasing for medications in other states. Increased reimbursements for drugs that demonstrate more effectiveness is an intriguing idea. On the other hand, what happens with drugs that work on fewer people for more specialized diseases, such as immunotherapies? No one has an answer yet, but in an incentivized system for payment, new ways of thinking about health care could be rewarded. And after all, states are the incubators of innovation. Get involved (https://voice.ons.org/advocacy/get-involved) at the local, state, or national level and make an impact in your oncology nursing practice.

House Panel Advances Bill That Would Temporarily Halt Obamacare’s Employer Mandate

Despite attempts to reinstate funding for other aspects of the Affordable Care Act (ACA), the House Ways and Means committee approved a bill that temporarily halts penalties for the employer mandate through 2022 (http://thehill.com/policy/healthcare/396770-house-panel-passes-bill-that-would-repeal-obamacares-employer-mandate). The mandate currently would levy taxes against companies providing no insurance or high-cost insurance plans to employees.

ACA’s individual mandate provision was repealed in 2017, but the change doesn’t go into effect until 2019. Repealing the employer mandate is another attempt to chip away at the ACA. In theory, removing financial penalties on employer-sponsored plans gives businesses some financial breathing room. However, the essential goal of GOP lawmakers is to repeal as much of the ACA as possible, little by little, in case the Congress majority shifts in the November midterm elections, where campaign promises, including “Medicare for All (https://voice.ons.org/advocacy/trump-slashes-obamacare-outreach-funding),” are being seriously discussed. ONS works with lawmakers on Capitol Hill to provide education and perspective for issues like access to affordable care (https://www.ons.org/advocacy-policy/positions/policy/access), pain management (https://www.ons.org/advocacy-policy/positions/practice/pain-management), and the importance of nursing workforce initiatives (https://www.ons.org/advocacy-policy/positions/policy/nursing-workforce-issues).