Good morning ... Today, Axios says goodbye to our colleague Sam Jacobson. Sam worked on the business side and is a cool guy, but most importantly to Vitals readers, he was also very patient about forwarding misdirected email to me. In his absence, y’all are going to need to learn my correct email address. It's firstname.lastname@example.org.
A large and diverse group of health care stakeholders and legal experts is jumping into the latest legal challenge to the Affordable Care Act’s individual mandate.
Why it matters: DOJ’s decision to put pre-existing conditions back on the chopping block has elevated this case’s political profile in a serious way — and there are a lot more people lining up against DOJ than behind it.
What they’re saying:
Five law professors — including two who've been on opposite sides of past ACA lawsuits — weighed in to argue that no other provisions of the ACA need to fall if the court strikes down the individual mandate.
The impact: Striking down the entire ACA would increase the number of uninsured Americans by 50%, according to a new Urban Institute analysis.
Insurance companies would end up footing the bill for many of the policy changes and new federal spending in the House's package of opioid legislation, my colleagues Bob Herman and Caitlin Owens report.
The details: To pay for policies like extended Medicaid coverage for substance abuse treatment, House Republicans are using a couple of offsets that would affect insurers' bottom lines.
Of note: The Senate’s version of the opioid bill could have different offsets. And the dialysis pay-for in particular may not reach any finish line because insurers and employers have opposed it in other bills over the past two decades, Weissenstein noted.
Photo: Ann Johansson/Corbis via Getty Images
The arrest of a suspect in the Golden State Killer case has ignited a fresh debate among genealogists about the ethics of letting law enforcement freely search through millions of people’s genetic information — and it’s dividing the companies that sell home DNA tests to consumers.
Where they stand: 23andMe, one of the most popular home testing services, does not voluntarily share consumers’ information with police.
“Once the floodgates are open, there's a potential for genealogists who are not ethical to cause a lot of harm,” Kennett said.
Blue Cross Blue Shield of Michigan headquarters in Detroit. Photo: Raymond Boyd/Getty Images
The Republican tax overhaul didn't just benefit publicly traded health care companies. The Blue Cross and Blue Shield insurers collected a major windfall, too, Bob reports.
By the numbers: 15 Blues companies cumulatively reaped $2.26 billion in tax savings just in 2017 from favorable changes to their "net deferred income taxes," according to a new report from ratings agency A.M. Best.
The details: Eliminating the corporate alternative minimum tax, a policy that ensured companies pay some minimum level of taxes on their income, created a lot of the benefit for the Blues. It also helped that Republicans kept a special tax loophole that only applies to certain Blue Cross and Blue Shield insurers.
What to watch: 2019 premium rates for all health plans sold by the Blues.
House Republicans have again proposed defunding big parts of the ACA, even targeting some funding streams that the Trump administration has left alone. The cuts are included in a draft of the annual HHS appropriations bill, released yesterday.
The bill would:
Separately from the ACA, the House proposal would eliminate federal funding for Certified Community Behavioral Health Clinics.
Threat level: Low. There’s a good chance Congress will pass another continuing resolution, rather than individual appropriations bills. Either way, no funding bill is likely to pass without Democratic votes, and Democrats will not agree to defund the ACA.
Yes, but: This draft is still a sign that Republicans aren’t backing down, at least rhetorically, in the next round of health care wars.
The federal government does not have to pay out billions of dollars under the ACA’s risk corridors program, a federal appeals court ruled yesterday.
The details: The risk corridors program was initially set up as a fund that high-performing insurers would pay into, and low-performing insurers would collect from.
What’s at stake: This dispute has gone on so long that most insurers have already made up the difference through premium increases. But of course that also means past years’ premium increases might not have been as high if these payments had continued.
Thanks for reading, and have a great weekend.