Good morning ... Open enrollment is almost over — and so is the individual mandate.
Enrollment through HealthCare.gov closes on Friday, meaning it's time for "The Surge" — the rush of applications that usually coincides with big enrollment deadlines. No one's quite sure how big a surge to expect this year, but there's a lot riding on it since enrollment is lagging well behind previous years. If that gap is going to close even slightly, it'll be this week's surge that closes it.
What they're saying: It's incredibly hard to predict how big this year's wave of last-minute sign-ups will be, in large part because this year's enrollment period is structured so differently.
The bottom line: Although there are theoretical reasons why this week could bring an especially big enrollment surge, the smart money is on a smaller-than-usual bump, leading to a significant decline in total enrollment.
Large health insurance companies would be among the biggest winners under Republicans' tax overhaul bill, Axios' Bob Herman reports this morning.
Why? Because nearly all of their business is based in the U.S. and they consequently pay close to the full 35% corporate tax rate — so they'd have a lot to gain if Congress cuts the corporate tax rate to 20%.
Yes, but: The Affordable Care Act requires insurers to spend 80%–85% of their premiums on medical care (the exact ratio varies among different lines of business), leaving only the remaining 15%–20% for overhead and profits.
Insurers would likely need to rebate some of their tax-cut gains back to their customers in order to comply with those requirements. But, as Bob notes, there are steps the companies could take to move money around and keep more of the windfall for themselves and their shareholders.
Hey, look, it's another study finding that "consumer-directed" health plans — that is, insurance with a low premium but high deductibles and other cost-sharing — don't actually make us savvier patients.
Why it matters: From a policy perspective, the idea behind these plans is that if patients have more "skin in the game" when the bill comes, they'll be smarter about choosing efficient providers and foregoing unnecessarily expensive care. But, as much sense as that makes in Econ 101 terms, it doesn't seem to actually happen in the real world.
Ascension and Providence St. Joseph Health are considering a merger, The Wall Street Journal reports — which would create the largest hospital system in the country.
Between the lines: An Ascension/Providence merger would almost immediately displace what was, just last week, about to be the largest non-profit health system in the country: a merger of Catholic Health Initiatives and Dignity Health.
What we're watching this week: ACA enrollment and HealthCare.gov's performance. As always, ongoing negotiations over Collins' health care demands, as well as the Children's Health Insurance Program. Public conference committee meeting Wednesday on the tax bill.
HELP Committee hearing Tuesday on the price of prescription drugs; HELP hearing Wednesday about the 21st Century Cures Act and mental health.
Energy and Commerce oversight subcommittee hearing Tuesday on fraudulent treatments for opioid addiction; health subcommittee hearing Wednesday on the drug supply chain.
What's on your agenda? I'd love to know: email@example.com