Good morning … Eight days to go until Affordable Care Act enrollment begins. (I'm counting today.)
Federal funding for the Children's Health Insurance Program ran out at the end of last month, and several states have already said they need stopgap funding. But there's a good chance Congress won't be able to get a bill to President Trump's desk before December.
Bottom line: Only a handful of states will exhaust their funds this year, but 27 more are on track to run out of money in the first quarter of 2018.
Why it matters: CHIP covers roughly 9 million kids nationwide.
A federal judge said he's expecting to decide today whether the Trump administration has to keep making the ACA's cost-sharing reduction (CSR) payments while the courts figure out whether it was legal for him to cut off that funding unilaterally.
Eighteen states have challenged President Trump's decision to stop paying the CSRs, and argued before U.S. District Court Judge Vince Chhabria yesterday that the payments should continue while that lawsuit proceeds. Chhabria did not seem convinced, according to Reuters, pointing to steps that allowed insurers to compensate for the loss of the CSR payments by raising their premiums. He questioned whether the states would really suffer the grave injuries they claimed.
Iowa pulled the plug yesterday on its request for a state innovation waiver, after CMS warned last week that the state would likely have to help pay for its new system if the waiver were approved.
What it had requested: Iowa's proposal was the furthest-reaching that any state has come up with: It would have substantially redirected federal funding and altered regulations to create an insurance market that looked a lot like the ones Republicans envisioned in their repeal-and-replace legislation.
Be smart: Iowa's application got a lot of attention after The Washington Post reported that Trump had told CMS to reject it, because he wanted states' insurance markets to implode. Whatever Trump's input, though, Iowa's proposal had already stretched the bounds of what the ACA allows in this waiver process.
Couple of quick updates on the ACA stabilization bill in Congress::
Keep this on your radar: my colleague Bob Herman reports Devoted Health, a new insurance company that will only sell Medicare Advantage plans, just raised $62 million, according a new financial disclosure. The startup will start selling Medicare Advantage plans in 2019.
The players: Some big names are backing Devoted Health: Former HHS Secretary Kathleen Sebelius and former Senate Majority Leader Bill Frist are on the board. Todd and Ed Park, brothers who both worked at electronic health record and billing company athenahealth, are the co-founders; they also recruited Venrock's Bob Kocher as chief medical officer.
Get smart: Medicare Advantage is where the big money is. The ACA marketplaces grab a lot of headlines, but they are a blip on the radar when compared with the hundreds of billions of dollars tied up in private Medicare plans and care for seniors.
This isn't good: The U.S. has no official tally of how many women die each year from complications related to pregnancy or childbirth, according to ProPublica. It's widely assumed to be somewhere between 700 and 900, but estimates vary widely depending on who's counting.
Why it matters: Because we don't have good records on deaths from pregnancy and childbirth, we also don't know how many of those deaths were preventable, or how the U.S. mortality rate is changing. "Doubts about U.S. data on maternal deaths are so profound that some experts have questioned if the rise in U.S. rates over the last 25 years is a mirage," ProPublica reports.
What we're watching today:
What we're watching this week:
What's on your mind? I welcome your tips and feedback: firstname.lastname@example.org