Sign-ups for ACA Exchange policies were anemic
- About 9.2 million people made plan selection as of the close of open enrollment using the federal exchange. Last year's FFM enrollment figure was 9.6 million, a decline of about 4 percent. A more complete report will be out in March.
- Was it the Trump administration's decision to pull planned advertisment that caused the decline?
- And Maryland appeared immune with increased enrollment
The speed at which the Trump administration is operating is disorienting. Among this week's activites:
- A "one in two out" regulatory order. It was later amended to apply just to new economically significant regulations but for the health care industry, that is good enough.
- Trump met with Pharma executives, toned it down on price controls and offers hope for deregulation
- CMS sent to the Trump White House a rule on "Stabilizing the Marketplaces," in response to the President's Day One EO
Senate Democrats tried to thwart Trumpace on confirmation of the President's nominees
- Democrats boycotted a Senate Finance Committee vote in order to deny a quorum under Committee rules and delay consideration to Tom Price as nominee to HHS Secretary
- For Hatch, rules are made to be broken. With only Republicans in attendance, Senate Finance cleared the way for Price's confirmation. Expect a full Senate vote next week.
The rhetoric arround the future of the ACA softened somewhat with some members referring to "fixes," but don't get your hopes up
- The Freedom Caucus is having none of that and still advocates to root and branch removal
- Hatch wants all the taxes gone, which certainly would complicate just a "fix" to the law
- If rhetoric softening was intended to invite cooperation of Democrats, last week's hearings seemed to suggest it was a waste of time. On the House side, subcommittee hearings of Energy and Commerce devolved into witness badgering and outrage over pending repeal. The Senate HELP Committee was a wee bit more of a love-fest but Democrats still insist the ACA be amended and not repealed
- The divisions on the topic of the ACA make "regular order" changes unlikely though not impossible. But, as we have pointed out for years, Republicans could have everything they want using three tools - two of which are gifts from Democrats - Section 1332 and 1115 waivers and CMMI. The idea appears to be catching on.
Hospital associations keep losing their political stroke. For evidence look no further than:
- Florida Governor Rick Scott takes aim in his latest budget at the Medicaid supplemental payments made to hospitals and the protection they get from managed care. Here is the summary.
- Meanwhile, the AHA and FHA argue for a restoration in ACA era Medicare cuts - something literally no one on Capitol Hill appears inclined to consider
The federal government has no idea how many of the 74 million people enrolled in Medicaid are actually eligible, according to testimony this week from the OIG and the GAO. The problem? No data. Full report from the GAO is here.
CMS issued its Medicare Advantage and Part D Advance Notice and Call Letter, backing off some provisions that worried the industry. Expected pay raise for plans? 0.25 percent.
Georgia might keep its provider tax so it can continue to draw down federal Medicaid dollars - a topic of hearings on Medicaid reform last week
Louisiana Heart Hospital closed. The culprit? Move to outpatient for many cardiovascular treatments.
For AET, freedom is just another word for nothing left to lose so they won't be returning to the ACA exchanges in 2018
The Hedgeye View:
JT Taylor's Latest Capital Brief, Feb. 3, 2017
FIELD NOTES (HQY) | "IT WOULD TAKE A POLITICAL DISASTER TO STYMIE 25% GROWTH IN THE HSA MARKET", Feb 3, 2017
#ACA2.0 | HEALTHCARE EMPLOYMENT +2.5% IN JANUARY, Feb. 3, 2017
ATHN | MORE BITTER THAN SWEET | 2017 BOOKINGS +15-30% YOY, Feb. 3, 2017
ACA REPEAL AND REPLACE: TRUMP ADMINISTRATION'S REGULATORY ACTIONS BEGIN WITH "MARKET STABILIZATION", Feb. 2, 2017
HOLX | TAKING CREDIT AND CASTING BLAME, Feb. 2, 2017
CERN | THOUGHTS INTO THE PRINT 4Q16, Feb. 2, 2017
#ACA2.0 | JANUARY ADP HEALTHCARE EMPLOYMENT +2.7%, Feb. 1, 2017
HCA | A BAD BUSINESS WELL MANAGED, Feb. 1, 2017
ATHN | THOUGHTS INTO THE PRINT 4Q16, Jan. 30, 2017
POSITION MONITOR | HCA EARNINGS PREVIEW, ATHN TRACKER, FISHY ENROLLMENT & FIELD NOTES, Jan. 29, 2017
ATHN-TRACKER | CPSI, CERN, QSII, MDRX | AMBULATORY STABLE & INPATIENT ACCELERATING | 12 HOSPITALS, Jan. 29, 2017
(Hit Sales@Hedgeye so they can hook you up)
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Call with questions. It is a coin toss for us as to whether we watch the Super Bowl or review last week's Energy & Commerce Subcommittee testimony, so we should be ready with answers
Emily Evans
Managing Director
Health Policy
@HedgeyeEEvans
