ASAHP NEWSWIRE ARCHIVES

Employee Share Of Healthcare Premiums

According to the Medical Expenditure Panel Survey—Insurance Component 2018 Chartbook, among private-sector establishments offering health insurance in 2018, enrolled employees paid 21.3% of the premium for single coverage, 27.1% for employee-plus-one coverage, and 27.8% for family coverage.

Survey results can be obtained at https://meps.ahrq.gov/data_files/publications/cb23/cb23.shtml.

Burden Of Health Care Payments Among Americans With Lowest Incomes

Higher-income American households pay the most to finance the nation's health care system, but the burden of payments as a share of income is greatest among households with the lowest incomes, according to a new RAND Corporation study.

The study can be obtained at https://onlinelibrary.wiley.com/doi/epdf/10.1111/1475-6773.13258.

Unfunded Health Care Liabilities Leave States And Taxpayers At Risk

Today, the American Legislative Exchange Council (ALEC) released a report on unfunded liabilities. Beyond public pensions, state governments offer retired public employees other post-employment benefits (OPEB), such as health insurance. Currently, total state unfunded OPEB liabilities exceed $1 trillion (e.g., California $166 billion+, New Jersey $129 billion+, and New York $128 billion+).

The report can be obtained at https://www.alec.org/app/uploads/2020/01/OPEB-Web.pdf.

HRSA Nurse Anesthetist Traineeships Notice of Funding Opportunity

The Health Resources and Services Administration is now taking applications for its Nurse Anesthetist Traineeships program. The program aims to increase the number of Certified Registered Nurse Anesthetists providing care, especially to rural and underserved populations. The closing date for applications is March 6, 2020. Estimated total program funding is $2,250,000 and 80 grant awards are expected.

More information may be accessed here.

HRSA Scholarships for Disadvantaged Students Notice of Funding Opportunity

The Health Resources and Services Administration is now taking applications for its Scholarships for Disadvantaged Students grants program. The program promotes diversity among the health professions by providing awards to health professions and nursing schools, for schools to provide scholarships to full-time students from disadvantaged backgrounds who have a demonstrated financial need. The closing date for applications is March 3, 2020. Estimated total program funding is $48.2 million and 79 grant awards are expected.

More information may be accessed here.

Affordable Care Act And Racial Disparities

According to a data brief released by the Commonwealth Fund, the ACA’s coverage expansions have led to historic reductions in racial disparities in access to health care since 2013, but progress has stalled since 2016. Insurance coverage disparities between white adults and black adults and Hispanics were reduced more in states that expanded Medicaid than in states that did not. 

The data brief can be obtained at https://www.commonwealthfund.org/sites/default/files/2020-01/Baumgartner_ACA_racial_ethnic_disparities_db.pdf.

States’ Actions To Make Health Care More Affordable

Recent regulatory changes by the Trump administration and uncertainty about the Affordable Care Act’s future have put the onus on states to explore policy options for safeguarding and improving their residents’ coverage. An issue brief from the Commonwealth Fund examines a variety of state policies designed to strengthen individual market coverage and improve affordability.

The issue brief can be obtained at https://www.commonwealthfund.org/sites/default/files/2020-01/Giovannelli_states_indiv_market_coverage_affordable_ib.pdf.

What Is The Price Of College?

A new report from the National Center for Education Statistics (NCES) describes four measures of the price of undergraduate education in the 2015–16 academic year: total price of attendance (tuition and living expenses), net price of attendance after all grants, out-of-pocket net price after all financial aid, and out-of-pocket net price after all aid excluding student loans. Estimates are based on the 2015–16 National Postsecondary Student Aid Study, a nationally representative study of students enrolled in postsecondary institutions in the 50 states, the District of Columbia, and Puerto Rico.

The report can be obtained at https://nces.ed.gov/pubs2020/2020470.pdf.

Rise In Hospital Employment In 2019

The Bureau of Labor Statistics (BLS) reported that employment at the nation's hospitals rose by 0.17% in December to a seasonally adjusted 5,297,100 workers, which is 8,800 more than in the previous month and 102,000 more than a year ago. The nation's overall unemployment rate remained unchanged in December at 3.5%.

BLS data can be obtained at https://www.bls.gov/news.release/empsit.t17.htm.

Comparison Of House And Senate Legislation To Control Drug Prices

A report from The Commonwealth Fund compares provisions of current bills and initiatives involving an effort to reduce drug prices, an issue that will continue to be prominent in 2020.

The report can be obtained at https://www.commonwealthfund.org/blog/2020/new-legislation-control-drug-prices-how-do-house-and-senate-bills-compare-update.

2020 Federal Health Insurance Exchange Enrollment Period

Approximately 8.3 million individuals selected or were automatically re-enrolled in plans using the HealthCare.gov platform during the 2020 open enrollment period.  Snapshots provide point-in-time estimates of weekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov. The final snapshot reports new plan selections, active plan renewals, and automatic enrollments. It does not report the number of consumers who paid premiums to effectuate their enrollment.

A fact sheet can be obtained at https://www.cms.gov/newsroom/fact-sheets/2020-federal-health-insurance-exchange-enrollment-period-final-weekly-enrollment-snapshot.

When Student Loans Linger

More than 1.5 million borrowers who first took out loans before 2000 still have debt. Borrowers with debt from the mid-1990s or earlier tend to have higher default rates, have lower credit scores, and live in lower-income neighborhoods than more recent student loan borrowers.  A report from the Urban Institute discusses policy solutions that could provide relief for borrowers and decrease the chances of recent borrowers holding loans for decades. 

The report can be obtained at https://www.urban.org/sites/default/files/publication/101492/when_student_loans_linger.pdf.

Helping States Strengthen Efforts To Address Affordability Of Health Care

Altarum’s Healthcare Value Hub released a scorecard today rating 42 states and the District of Columbia on their adoption of evidence-based policy actions to improve affordability of health care for residents.

The scorecard can be obtained at https://www.healthcarevaluehub.org/application/files/3815/7836/5366/Healthcare_Affordability_Scorecard_-_Summary_Report.pdf.

States Request Supreme Court To Review ACA Decision

Twenty states and the District of Columbia petitioned the Supreme Court on January 3, 2020 to review this term a recent federal appeals court decision that held the Affordable Care Act's individual mandate unconstitutional. 

The petition can be obtained at https://oag.ca.gov/system/files/attachments/press-docs/California%20v.%20Texas%20Petition%20for%20a%20Writ%20of%20Certiorari.pdf.

Low-Tech Solutions That Advance Value

Combining low-tech and high-tech solutions has the greatest potential to help hospitals and health systems reduce cost, improve outcomes, and enhance the patient experience, according to a new issue brief from the American Hospital Association. The report has examples of how hospitals and health systems are using low-tech solutions to achieve value, from reducing energy use to addressing the social determinants of health and implementing team-based care.

The issue brief can be obtained at https://www.aha.org/system/files/media/file/2019/12/value-initiative-issue-brief-8-low-tech-solutions-advance-value.pdf.

ACA’s Individual Mandate Struck Down

The Fifth Circuit Court of Appeals on December 18, 2019 struck down the Affordable Care Act’s individual mandate, affirming a lower court’s ruling in part. Unlike the lower court, the Fifth Circuit did not decide on the constitutionality of the rest of the health care law, leaving it to that same lower-court judge to determine whether there are parts of the ACA that might pass legal muster. A breakdown from the Commonwealth Fund describes what it means if the ACA disappears.

Additional information can be obtained at

https://www.commonwealthfund.org/blog/2019/fifth-circuit-appeals-court-strikes-down-affordable-care-acts-individual-mandate.

Business Leaders’ Views On The 2020 Policy Environment

The third annual review of top policy trends by PricewaterhouseCoopers (PwC) identifies seven policy areas in 2020 where uncertainty could shift due to the groundswell among citizens, regulators, and businesses. Influencers to watch are highlighted, along with shifts that businesses should be prepared to get ahead of regulatory scrutiny and enforcement proactively. Health care is included in the analysis.

More information can be obtained at https://www.pwc.com/us/en/library/risk-regulatory/strategic-policy/top-policy-trends.html.

Fiscal Year 2020 Spending Agreement Passes House, Sees Senate Action This Week

The House today passed two appropriations packages that would provide funding for Fiscal Year 2020, after agreement on the spending deal was reached by congressional and Administration leaders on Monday. The Senate is expected to pass the bills (the Labor-HHS-Ed bill is one of eight large bills that make up one minibus package, while four national security bills make up another minibus package) prior to the December 20 midnight deadline when the current Continuing Resolution ends. Overall, the bill includes $184.9 billion in discretionary funding, an increase of $4.9 billion over the 2019 enacted level and $43 billion over the President’s 2020 budget request.

The bill includes a total of $94.9 billion for HHS, an increase of $4.4 billion above the 2019 enacted level and $16.8 billion above the President’s budget request -- with the largest increase ($2.6 billion) directed to the National Institutes of Health. The bill provides $7.04 billion for HRSA, a $193 million increase over the FY 2019 level. HRSA Title VII health professions programs will receive $424.5 million, a $32.3 million increase over the FY 2019 level. The Behavioral Health Workforce Education & Training program receives $102 million, geriatric programs receive $40.7 million, and the Health Careers Opportunity Program will be funded at $15 million.

The Department of Education receives a total of $72.8 billion in discretionary appropriations – $1.3 billion above the 2019 enacted level and $8.7 billion above the President’s budget request. For Higher Education programs, the bill provides $2.5 billion, an increase of $163 million above the 2019 enacted level and $941 million above the President’s budget request. For federal student aid programs, the bill provides $24.5 billion, which is $75 million above the 2019 enacted level and $1.5 billion above the President’s budget request. Within this amount, the bill provides $865 million for the SEOG program, $1.2 billion for Federal Work Study, and an increase to the maximum Pell grant to $6,345.

The legislative package which includes the Labor-HHS-ED bill may be accessed here and a division by division summary may be found here. A table included HRSA Title VII programs be accessed here.