In the News: May 4–10
Sg2 is dedicated to helping our clients interpret the latest news and trends in health care. Below you’ll find our analysis of this week’s key industry headlines, along with links to related Sg2 resources.
House Passes the American Health Care Act
On May 4, the House of Representatives narrowly passed (217 to 213) the American Health Care Act (AHCA), the Republican plan to repeal and replace the Patient Protection and Affordable Care Act (ACA). This is a significant milestone for Republican lawmakers, who added substantial amendments to woo the necessary House Republican votes.
However, this is still a bill, which means its fate is still uncertain. Now it goes to the Senate, where lawmakers have indicated that they will “start from scratch.” Sg2 will continue to track the AHCA as it looks to move through the Senate, conference committee and the desk of President Trump. In the meantime, read this recent Health Affairs article that traces the AHCA journey thus far.
The American Health Care Act Affects Preexisting Conditions
A recent Time article highlights the potential impact of the American Health Care Act (AHCA) on people with preexisting conditions. Of particular note are the following featured recent studies:
- A report from AARP found that “premiums could reach as high as $25,700 per year for people in high-risk pools.”
- A report from the Center for American Progress “found that insurers could charge people with metastatic cancer as much as $142,650 more for their coverage, a 3,500% increase.”
- A list of preexisting conditions identified by the Kaiser Family Foundation that “were universally used to deny people coverage.”
Even though the AHCA is still a bill—expected to undergo substantial changes in the coming weeks—Sg2 believes strategic planners must consider the potential impact to patients and providers. Read the Sg2 consulting spotlight Turn Uncertainty Into a Strategic Asset With Environmental Scenario Planning to learn how organizations can position themselves to design hard-hitting plans without knowing what the future holds.
The Future of CHIP Looks Cloudy
Following the House passage of the American Health Care Act (AHCA), a Modern Healthcare article highlights how the AHCA may impact the future of the popular Children’s Health Insurance Program (CHIP). CHIP funding extensions have been tied to a broader piece of health care legislation before, with its most recent extension tied to an overhaul of Medicare clinician payment under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This so-called “clean extension” did not bring any substantial changes to CHIP; however, as this Center for Children and Families article summarizes, substantial changes could have been made with alternative proposals considered at that time.
Sg2 continues to follow potential policy impacts for pediatrics, as this has been a particular area of concern following the change in administration. Check out the Sg2 FAQ Impact of Policy Changes on Pediatrics to learn more about the repeal effort and what it means for pediatrics.