Sep 12, 2017

Senate health care talks focus on state innovation waivers

HELP Ranking Member Patty Murray and Chairman Lamar Alexander in a hearing. Photo: Alex Brandon/AP

Members of the Senate HELP Committee honed in on idea today that might help resolve the biggest sticking point (so far) in their effort to stabilize the Affordable Care Act. Republicans and Democrats are divided over how much leeway states should have to waive certain provisions of the ACA, including some of its most popular consumer protections.

Former Health and Human Services Secretary Michael Leavitt raised a middle-ground approach that caught the attention of HELP Chairman Lamar Alexander: keep federal guidelines around how much of an enrollee's total health care costs plans must cover, but to give states more flexibility over which specific benefits plans cover. Leavitt said he and Alexander discussed the idea before the hearing.

  • Currently, it's difficult for states to get around the ACA's essential health benefits, which mandate which benefits — like mental health care or maternity coverage — plans must offer.

"What we're suggesting here is rather than try to lay out 11 different categories, where everyone is exactly the same, the states have the flexibility to have actuaries determine if their benefit package is of equal value to those essential benefits," Leavitt told me after the hearing.

The concern: Doing this could lead to adverse selection if, for example, maternity coverage is no longer mandatory and only pregnant women choose plans that offer maternity coverage.

Other ideas floated at today's hearing included changing the rules governing how much of enrollee's health care costs must be covered; and giving states more flexibility surrounding cost-sharing.

The other big issue: How long to fund the ACA"s cost-sharing subsidies. Democrats are pushing for longer than a one-year extension, although Republicans outside the committee are largely loathe to fund them at all.

Go deeper

Situational awareness

Photo: Brett Carlsen/Getty Images

Catch up on today's biggest news:

  1. Mike Bloomberg offers to release women from 3 NDAs
  2. Wells Fargo to pay $3 billion to settle consumer abuse charges
  3. Bloomberg campaign says Tennessee vandalism "echoes language" from Bernie supporters
  4. Scoop: New White House personnel chief tells Cabinet liaisons to target Never Trumpers
  5. Nearly half of Republicans support pardoning Roger Stone

Wells Fargo agrees to pay $3 billion to settle consumer abuse charges

Clients use an ATM at a Wells Fargo Bank in Los Angeles, Calif. Photo: Ronen Tivony/SOPA Images/LightRocket via Getty Images

Wells Fargo agreed to a pay a combined $3 billion to the Justice Department and the Securities and Exchange Commission on Friday for opening millions of fake customer accounts between 2002 and 2016, the SEC said in a press release.

The big picture: The fine "is among the largest corporate penalties reached during the Trump administration," the Washington Post reports.

Bloomberg offers to release women from 3 nondisclosure agreements

Mike Bloomberg. Photo: Brett Carlsen/Getty Images

Mike Bloomberg said Friday his company will release women identified to have signed three nondisclosure agreements so they can publicly discuss their allegations against him if they wish.

Why it matters, via Axios' Margaret Talev: Bloomberg’s shift in policy toward NDAs comes as he tries to stanch his loss of female support after the Las Vegas debate. It is an effort to separate the total number of harassment and culture complaints at the large company from those directed at him personally. That could reframe the criticism against him, but also protect the company from legal fallout if all past NDAs were placed in jeopardy.