News & Analysis as of

States May See Earliest Opportunities to Alter Health Care Landscape

While the titans on Capitol Hill clash over the best answer to the Affordable Care Act (ACA), the Trump administration is promoting action at the state level that could produce meaningful impact soon. Health industry...more

Trump Administration Signals More Administrative Flexibility for State Medicaid Programs, with Emphasis on “Most Vulnerable...

In her first act as CMS Administrator, Seema Verma joined HHS Secretary Tom Price in writing to the nation’s Governors to urge collaboration on improving the Medicaid program, with an emphasis on services for “truly...more

Provider Payments Under a Medicaid Per Capita Cap

In a February 24th blog post, we described Medicaid block grants and per capita caps in terms of A x B = C to demonstrate how those payment policies work. ‘A’ is the amount a state is paid per beneficiary, ‘B’ is the number...more

Manatt on Health Reform: Weekly Highlights - March 2017 #2

CBO finds that the number of uninsured would nearly double under the American Health Care Act; CMS's new Administrator is confirmed; and New Mexico and Massachusetts move to protect reproductive healthcare under ACA repeal....more

Manatt on Health Reform: Weekly Highlights - March 2017

House Republicans release long-awaited ACA repeal and replace legislation, Arkansas proposes a new waiver amendment to lower expansion adult eligibility levels, and California and Maine are considering new policies to tackle...more

Manatt on Medicaid: Monthly Expansion Recap - March 2017

Arizona - Appeals Court Hears Arguments in Medicaid Expansion Lawsuit - A three-judge State Appeals Court panel heard an appeal of the Maricopa County Superior Court's decision that Arizona's Medicaid expansion plan...more

House Republicans Release Obamacare Repeal and Replace Policy Brief; Senate Finance Committee Holds Hearing on Verma CMS...

On February 16, 2017, House Republicans released a policy brief on how to repeal and replace the Affordable Care Act (ACA). The brief builds upon the ideas outlined in the 2016 “A Better Way” proposal and promises action on...more

Manatt on Health Reform: Weekly Highlights - February 2017 #4

The Kansas House sends approved Medicaid expansion legislation to the Senate; governors remain divided on Medicaid reform; and the Kaiser Family Foundation publishes a new library of 108 Medicaid expansion studies....more

Capitol Hill Healthcare Update

Trump’s speech: Clarity on ACA next steps? President Trump will address a joint session of Congress on Tuesday, and the expectation is that he will use the primetime moment to outline – at least in broad strokes – his...more

CMS Issues Proposed Changes to ACA Healthcare Exchanges

On February 15, 2017, CMS issued a proposed rule which the Trump administration contends will reform and stabilize the individual and small group health insurance market exchanges created pursuant to the Affordable Care Act...more

Trump Administration Takes First Steps to Support Exchanges, but Key Questions Remain

In an effort to stabilize the Exchanges and encourage issuer participation, the Centers for Medicare & Medicaid Services (CMS) recently extended the federal Exchange application and rate filing deadlines and published a...more

CMS Releases Proposed Rule for ACA Market Stabilization

On February 15, 2017, the Centers for Medicare & Medicaid Services (“CMS”), at the direction of the Trump administration, released a long-expected proposed rule (“Market Stabilization Proposed Rule”)designed to help stabilize...more

Capitol Hill Healthcare Update

Meeting privately with Senate Republicans to discuss next steps on the ACA was among the first actions taken last week by the new Secretary of the U.S. Department of Health and Human Services Tom Price. But GOP senators left...more

CMS Proposes Affordable Care Act Exchange, Individual, and Small Group Insurance Market Changes

Not relying on Congress to take action on the Affordable Care Act, the Centers for Medicare and Medicaid Services (“CMS”) has proposed new regulations intended to attract health insurance issuers back into ACA health...more

Reducing the Regulatory Stranglehold on Federally Facilitated Exchanges: Will It Work?

The Centers for Medicare and Medicaid Services (CMS) recently issued a proposed rule aimed at improving the individual and small group markets that have been plagued with instability as issuers continue exiting the Exchanges....more

CMS Proposes Changes to Stabilize ACA Health Insurance Markets

At the same time Republican Congressional leaders are attempting to develop legislation to repeal and replace the Affordable Care Act (ACA), CMS has published a proposed rule that is intended to help stabilize the Affordable...more

President Trump Props Up the ACA: A Summary of the New Administration's ACA Market Stabilization Regulation

On February 15, President Trump and new Department of Health and Human Services (HHS) Secretary Tom Price released their first proposed regulations addressing the Affordable Care Act (ACA). While remaining committed to...more

What’s Ahead for Value-Based Health Care?

Prior to the presidential election in November, experts believed that the trend toward value-based payment – the concept of rewarding providers based on the quality of care delivered, rather than the number of procedures...more

Health Update - February 2017

Securing the Safety Net for America's Vulnerable Populations - Editor's Note: America's population is aging rapidly. By 2029, 75 million baby boomers will have reached age 65 and older, and older adults will represent...more

Trump administration issues proposed health insurance market stabilization rule: Will it be enough to stabilize exchange...

On 15 February 2017, the Centers for Medicare & Medicaid Services (CMS) took a step toward addressing concerns about the stability of the individual and small group health insurance markets by proposing a modicum of...more

One In – Two Out and Healthcare Regulation

President Trump signed an executive order (the “Order”) on January 30th, 2017 aiming to reduce bureaucracy by requiring agencies to remove two regulations for every one new regulation they implement. The cost of any new...more

CMS, IRS Address Affordable Care Act Issues in Transition

The Centers for Medicare and Medicaid Services (CMS) and the IRS have each published guidance on matters arising under the Affordable Care Act (ACA). It is too early to tell whether these measures—some of the first guidance...more

“Patient Protection and Affordable Care Act; Market Stabilization” Proposed Rule

On February 15, 2017 the Centers for Medicare & Medicaid Services (CMS) released a proposed rule entitled, “Patient Protection and Affordable Care Act; Market Stabilization.” Excerpt - In general, the proposed rule...more

Medicaid Outlook: Policy and Regulatory Change in 2017

Perspectives on Health Care and Life Sciences - Medicaid has been a vital part of the American health care safety net for more than 50 years. Today, Medicaid, along with the State Children’s Health Insurance Program...more

New Bundled Payments Are a Go…For Now

CMS issued a final rule on January 3, 2017, implementing three new episode payment models (EPMs) and a Cardiac Rehabilitation (CR) incentive payment model under the authority of the Center for Medicare & Medicaid Innovation...more

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