The healthcare battle is heating up as we approach the election campaign season. It is looking like a battle-royale prize fight, which is certain to go more than 15 rounds and my attention is riveted as each punch is thrown.
Last week, the Trump administration was dealt two serious setbacks in their efforts to thwart the Democrats’ liberalization of healthcare policy. Last year, rules were written to allow associations to band together to purchase insurance and, Democrats allege, circumvent requirements of the Affordable Care Act (ACA). The court ruled that the association rules were nothing short of an end around by Trump on the law requirements which is a violation of the Employee Retirement Income Security Act (ERISA). The second gut punch was the rejection of state-imposed work requirements for Medicaid eligibility which has been on the Republican list of priority items. Invalidating these initiatives, the court emphasized that the President would not be given free rein to reshape Medicaid as he saw fit.
An article in Law360 reviewed other Trump administration wins (which may still be challenged) and losses:
- Pennsylvania and California blocked liberalization of “no-cost contraceptive” rules
- Several state courts ruled that those states were significantly underpaid on ACA cost-sharing programs
- A Washington, D.C. federal court disallowed payment reductions on the federal 340B drug program which provides for significant subsidies
- Zeroing out of the individual mandate penalty
- Liberalizing short-term medical policy rules
- Increasing drug pricing pressure with elimination of rebates on federally-purchased drugs
- Requiring pricing transparency for hospital costs and in drug advertising
- Eliminating the Individual Payment Advisory Board
Trump’s latest parry is to try and strike ACA altogether by latching on to the federal Texas court ruling invalidating ACA because the individual penalty “tax” was eliminated. Maybe the feds can find funding by selling pay-per-view tickets – it would be a top seller.