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CEO Power Panel: No Repeal Without Replace

Shortly after Donald Trump’s unexpected victory in the presidential election, leaders of the six-hospital Mission Health system decided to put large capital investments on hold. They wanted to preserve financial flexibility in case the new Republican administration pushed through “very harmful changes and reductions in payment,” said Dr. Ronald Paulus, CEO of the Asheville, N.C.-based system.

Meanwhile, Mission Health chose to continue investing in population health initiatives, its new health insurance company and its Medicare Advantage program.

Paulus said those decisions flowed out of the huge uncertainty caused by Trump’s and congressional Republicans’ promise to rapidly repeal and replace the Affordable Care Act. “It’s eight years going in one direction, then turning on a dime and going in a completely different direction,” he said. “Uncertainty wreaks havoc in any industry. As a nation, we should decide on a direction and provide some long-standing stability.”

Healthcare CEOs, Paulus among them, are willing to consider Trump’s healthcare reform ideas. But they have strong concerns about whether his plan would match the ACA’s performance in expanding coverage and slashing the uninsured rate to less than 9%, according to Modern Healthcare’s post-election Power Panel survey, which got responses from 93 of 123 CEOs contacted. Leaders of large hospitals and health systems are disproportionately represented on the panel, but the participants also include CEOs of insurers, suppliers and technology companies, as well as associations representing sectors across the industry.

Beyond the ACA, the CEOs surveyed stressed the need for action to curb the growth of prescription drug prices, with 60% saying that should be a top priority for the new administration and Congress.

Read the full article here.

Employee Benefits Update – Year-End Compliance Checklist

2016 Year-End Compliance Checklist

With the results of the Presidential election just behind us, it is likely that the landscape of employee benefit plans—and the regulations that govern them—will change. For the time being, however, there are still some important compliance deadlines quickly approaching, so we wanted to remind plan sponsors of these key compliance actions as 2016 comes to a close.

Click here to access the checklist with deadlines and required actions.

Virginia, Richmond Region Fare Relatively Well in Health Insurance Analysis

Competition counts in Virginia’s health insurance marketplace.

The availability of insurance options will remain relatively robust and increases in premiums relatively low in the Richmond region when enrollment begins Tuesday in the federally operated marketplace under the Affordable Care Act, according to an analysis by The Associated Press called “Dwindling Choices, Higher Costs.”

In comparison, five states will have only one insurer in their marketplaces. Eight states, including North Carolina and Tennessee, will have just one for a majority of their local jurisdictions, according to the national AP analysis, which found that about one-third of all U.S. counties will have just one insurer.

“When you look nationally, we’re in a much better position,” said Jill A. Hanken, senior attorney at the Virginia Poverty Law Center, which operates the Enroll Virginia navigator site to help people shop on the federal exchange. “Virginians are seeing lower costs and more choice than many other states.”

The analysis also reinforced federal data released early this week that showed an average increase of 22 percent nationally in premiums for a “silver” benchmark plan bought by a 27-year-old, but an increase of 10 percent in Virginia. The AP analysis, using the second-lowest silver plan for a 50-year-old participant, showed an average increase of 9.7 percent in Virginia.

Read the full article here.

“Now What Do We Do?” Trumpcare?

Of course, “Now what do we do,” is the famous line from Robert Redford’s character in The Candidate, stunned by his victory and confused about what to do next.

But it doesn’t really apply here.

A few thoughts as all of this sinks in:

  • Some will tell you the Republicans are unprepared for repeal and replace. Wrong. There is a plan. Don’t let anyone tell you there is not. The plan was written by Paul Ryan as part of his “Better Way” document released in June of this year. It is not in legislative form, but it is as detailed as the plan Bill Clinton or Barack Obama had the morning after they were elected. I fully expect Speaker Ryan to take the point on putting the legislative details on the table, which will generally follow this outline.
  • As I pointed out in my blog post earlier this morning, Obamacare will effectively be repealed. No ifs, ands, or buts about it. The Trump voters voted for him expecting that he and the Republicans would do it and there is no turning back. This will be the first if not one of the first agenda items. Speaker Ryan, at his press conference this morning, reaffirmed that.
  • The repeal part will be the easiest part––not a literal repeal but a defunding of the money used for the exchange subsidies, the Medicaid expansion, and that run the exchanges.
  • The much harder part will be the replacement. Republicans will say to Democrats, “Help us create the new insurance system or be responsible for the consequences.” Some are saying the Democrats won’t cooperate. Here is why they will. In 2018, there are 23 Democratic and two Independent Senators (who caucus with the Dems) that will be up for reelection––a great many in states that Donald Trump won last night! There is a clear mandate here to replace Obamacare. If these Democrats fight it and that arguably results in millions of people thrown off their coverage they will do so at their peril.

Read the full article here.

Anthem Threatens Obamacare Retreat If Results Don’t Improve

Health insurer Anthem Inc., which has so far stuck with the Obamacare markets as rivals pulled back, said it may retreat in 2018 if its financial results under the program don’t improve next year.

Anthem’s comments up the stakes for the Obama administration as the enrollment season for 2017 Affordable Care Act plans begins, with consumers already facing fewer choices and higher premiums in many markets.

“If we do not see clear evidence of an improving environment and a path towards sustainability in the marketplace, we will likely modify our strategy in 2018,” Anthem Chief Executive Officer Joseph Swedish said on a call Wednesday discussing third-quarter results. “Clearly, 2017 is a critical year as we continue to assess the long-term viability of our exchange footprint.”

Anthem expects to post a narrow profit margin next year in exchanges created under the ACA, following losses that Swedish called “disappointing.” Profitability will improve thanks to plan changes and premium increases averaging more than 20 percent, but Anthem said it will take more than that to stabilize markets that have so far drawn about half the membership it was planning for. The company called for eliminating a tax on health insurers, as well as changes to regulations that govern how plans are sold and administered.

Read the full article here.