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On the Hill: ACA Marketplace Stabilization, 340B Inquiry

The Senate Health, Education, Labor, and Pensions (HELP) Committee will continue to focus this week on a stabilization package for the Affordable Care Act (ACA) insurance markets.

Insurers must sign contracts with the federal government by the end of this month to participate in the ACA marketplace in 2018. Congress is aiming to pass legislation to stabilize the markets by the same deadline. But disagreements remain regarding the specifics of the bill: Democrats hope to provide multiple years of funding for cost-sharing reduction payments; Republicans want to provide such payments for one year and expand the ACA’s Section 1332 State Innovation Waivers, enabling states to opt out of some ACA requirements.

The HELP Committee will hold two hearings this week to try to reach consensus before the deadline. A Sept. 12 hearing will focus on state flexibility and a Sept. 14 hearing will include testimony from health care stakeholders.

Congress also seeks to pass by Sept. 30 a set of health policy extenders (known as the “minibus”). Lawmakers still need to write the bipartisan legislation, which could avert Oct. 1 cuts to Medicaid disproportionate share hospital payments and reauthorize funding for the Children’s Health Insurance Program; community health centers; the Maternal, Infant, Early Childhood Home Visiting Program; and the National Health Service Corps. Congress potentially could pass a freestanding bill that includes all of the extenders.

Meanwhile, Sens. Lindsey Graham (R-SC), Bill Cassidy (R-LA), and Dean Heller (R-NV) this week are expected to reveal a new bill to repeal and replace the ACA, which reportedly would replace funding for Medicaid expansion and private insurance subsidies with $1.2 trillion in block grants.

Committee Activity

The House Committee on Energy and Commerce Subcommittee on Oversight and Investigations last week issued formal requests for information to 20 340B Drug Pricing Program covered entities, including some essential hospitals. The letters ask for detailed information by Sept. 22 regarding the entities’ use of 340B.

The Senate Committee on Finance on Sept. 12 will hold a hearing on health care costs and coverage.

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About the Author

Erin Delaney is a former legislative affairs associate at America's Essential Hospitals.

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