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policy

Newly elected House Speaker Mike Johnson (R-La.) confronts a looming deadline to fund the federal government. Essential hospital advocates come to Washington, D.C., for the association's fall legislative fly-in, Policy Assembly.

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state-action

Covered California says the program will reduce out-of-pocket costs for more than 600,000 enrollees, eliminate silver plan deductibles, and assist those predicted to lose Medi-Cal coverage.

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policy

The FAQ respond to concerns about the definition of cost sharing and facility fees in the No Surprises Act and Affordable Care Act.

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policy

The association urged an appeals court to restore an Affordable Care Act requirement that most health plans cover certain preventive services.

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state-action

To qualify, an individual must be enrolled in family insurance through an employer that is deemed unaffordable and has a renewal date other than Jan. 1.

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policy

The brief urges an appeals court to restore an Affordable Care Act requirement that most health plans cover certain preventive services.

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We joined other national hospital groups to urge the U.S. Court of Appeals for the 5th Circuit to keep in place pending appeal an Affordable Care Act requirement that most health plans cover certain preventive services without cost sharing.

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aca
policy

The rule would allow DACA recipients to be eligible for health care coverage through the Affordable Care Act marketplace, Medicaid, and the Children's Health Insurance Program.

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policy

The proposal includes numerous policy and payment changes to Medicare’s Inpatient Prospective Payment System for fiscal year 2024, including a 2.8 percent increase in inpatient payment rates.

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The administration's decision to expand Medicaid and Affordable Care Act coverage to Deferred Action for Childhood Arrivals recipients marks an important step toward ensuring this marginalized group has access to vital health care services.

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policy

At two Senate hearings, Health and Human Services Secretary Xavier Becerra presented the Biden administration's health care budget. In a joint statement, America's Essential Hospitals and other organizations raised concerns about a new alliance between drug companies and community health centers.

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policy

The president vowed to veto attempts to roll back Inflation Reduction Act measures to reduce prescription drug prices. He also voiced his plan to make permanent pandemic-related increases to Affordable Care Act premium subsidies.

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policy

CMS reports that open enrollment through the health insurance marketplaces for 2023 totals 16.3 million people, a 13 percent increase from 2022.

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policy

The proposed administrative dispute resolution process delegates the majority of decision-making authority to Office of Pharmacy Affairs staff and has no minimum monetary threshold for claims.

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policy

America's Essential Hospitals urges HHS to codify a nondiscrimination standard and establish nondiscrimination training for all health care workers.

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policy

Lawmakers return to their states and districts for August recess following last week's passage of the Inflation Reduction Act. The bill includes provisions of note for essential hospitals, including those to extend Affordable Care Act subsidies and fight climate change.

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policy

Notable for essential hospitals, the bill contains an extension of Affordable Care Act advance premium tax credits, and historic drug pricing provisions that give the federal government power to negotiate drug prices on behalf of Medicare beneficiaries.

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The Inflation Reduction Act preserves access to affordable health care coverage and takes historic steps to fight climate change but it falls short of providing the support essential hospitals need as front-line providers during public health crises.

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policy

President Joe Biden signed the legislation Aug. 16 after the House sent it to his desk with a 220-207, party-line vote. It extends Affordable Care Act subsidies through 2025 and makes other changes of interest to essential hospitals.

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policy

The proposed rule expands the definition of discrimination "on the basis of sex" and explicitly includes telehealth services in nondiscrimination policies.

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policy

The bill, which passed by a 51-50 margin, would extend Affordable Care Act subsidies through 2025, allow Medicare to negotiate drug prices, invest in measures to mitigate climate change, and make other changes of interest to essential hospitals.

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By extending ACA subsidies, the legislation would safeguard access to care for millions of individuals and families — a critically important outcome, given the ongoing threat of COVID-19 and the emergence of monkeypox.

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policy

The final rule raises the essential community provider threshold from 20 to 35 percent and uses wait time standards to evaluate qualified health plans for network adequacy.

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policy

The legislation delays looming Medicare payment cuts and creates an expedited pathway for debt limit relief; Senate Democrats this week are expected to release legislative text for a $2 trillion debt limit increase — sufficient to last through the 2022 midterm election.

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policy

Consumers now can preview health plans and prices on healthcare.gov ahead of open enrollment, which runs Nov. 1, 2020, through Jan. 15, 2021.

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policy

The rule, released by the Department of Health and Human Service and the Department of Treasury, extends open enrollment, adds a new special enrollment period, expands navigator responsibilities, and modifies Section 1332 innovation waivers.

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aca, hhs
policy

The departments of the Treasury and Health and Human Services proposed extending open enrollment in the Affordable Care Act marketplaces, adding a new special enrollment period, expanding navigator responsibilities, and modifying Section 1332 innovation waivers.

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policy

The lawsuit, brought by individual plaintiffs and 18 Republican-led states, argued the ACA’s individual mandate was unconstitutional and that the entire ACA had to be dismantled as a result. The court's decision was made on procedural grounds and did not rule on the underlying merits of the case.

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Today’s U.S. Supreme Court decision on the Affordable Care Act (ACA) is a decisive victory for patients, hospitals, and all who believe no one, especially people of limited financial means, should go without access to affordable health care.

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policy

HHS will interpret and enforce the Affordable Care Act's prohibition on discrimination "on the basis of sex" to include sexual orientation and gender identity. The change comes in response to a Trump administration rule in June 2020 that removed protections for transgender and LGBTQ individuals.

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policy

In a set of letters, America’s Essential Hospitals urges the administration and congressional leaders to address pressing facility needs of essential hospitals and the health care safety net.

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policy

The Centers for Medicare & Medicaid Services is extending until Aug. 15 the special enrollment period for 36 states using the federal health insurance marketplace, giving consumers more time to view new options under the American Rescue Plan, including lower premiums and plan upgrades.

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policy

In an annual report to Congress, the Medicaid and CHIP Payment and Access Commission finds an increase from 2018 to 2019 in the number of uninsured and in charity care and bad debt. The report includes state-specific projections of the Medicaid disproportionate share hospital allotment.

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policy

In response to an executive order, a new issue brief reviews four policy areas under Section 1115 demonstrations and their impact on Medicaid coverage and access to care. The brief notes all examined areas create barriers to enrollment and reduce coverage, leading to adverse health effects.

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policy

A federal court vacated several policies in the Trump Administration’s 2019 health insurance marketplace rule for violating federal law, including provisions related to review of network adequacy, standardized options, income verification requirements, and reducing medical loss ratio rebates.

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policy

The special enrollment period, intended to ensure access to health coverage amid the the COVID-19 pandemic, will continue through May 15. The enrollment period applies to consumers in the 36 states that use the federal marketplace platform.

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policy

President Biden released an executive order to strengthen Medicaid and the Affordable Care Act. The order calls for a special enrollment period on the federally facilitated exchange for uninsured or underinsured individuals — particularly those hardest hit by the COVID-19 pandemic.

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policy

The proposed rule builds on a CMS final rule on interoperability and patient access; it would leverage application programming interfaces to improve patients’ access to their electronic health information and reduce burden on providers related to prior authorization.

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policy

A new final rule from the Health Resources and Services Administration provides details on the long awaited administrative dispute resolution process, including the composition of a dispute resolution panel, types of claims covered entities and manufacturers can bring before the panel, and more.

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policy

The Health Resources and Services Administration finalized a rule creating a 340B Drug Pricing Program administrative dispute resolution process for covered entities and drug manufacturers; the rule marks a long-delayed implementation of an Affordable Care Act requirement.

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policy

Responding to concerns raised by the association and lawmakers, the Department of Health and Human Services has altered detrimental reporting requirements for the Provider Relief Fund, including one regarding lost revenue.

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policy

The House-passed $2.2 trillion COVID-19 relief package would increase Medicaid disproportionate share hospital allotments and the Provider Relief Fund. Meanwhile, Congress now has until Dec. 11 to pass its annual spending bills or agree to another short-term CR.

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policy

HHS finalized a rule overhauling the ACA to remove some nondiscrimination protections for transgender individuals and requirements for treating people with limited English proficiency. In a statement, the association said the decision puts the health and safety of vulnerable populations at risk.

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policy

The Department of Health and Human Services finalized a rule overhauling parts of the Affordable Care Act to remove nondiscrimination protections for transgender individuals and certain language access requirements for providing health care services to people with limited English proficiency.

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policy

CMS issued the 2021 final notice of benefit and payment parameters rule and letter to issuers updating regulatory and financial standards for plans offered on the health insurance marketplaces. CMS provides detailed options for issuers to adopt value-based designs for marketplace plans.

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state-action

Under the proposed Section 1115 waiver, Oklahoma would accept a per-capita cap on federal funds for the Medicaid expansion population and incorporate other market-based reforms.

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policy

In its March report to Congress, the Medicaid and CHIP Payment and Access Commission included chapters analyzing Medicaid disproportionate share hospital payments, state readiness to report on core quality measure sets, and Section 1115 waiver evaluations.

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policy

The Supreme Court announced it will review the court decision finding the Affordable Care Act’s individual mandate unconstitutional. The case, now expected to be heard this fall with a decision likely in 2021, will determine the fate of the law.

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policy

CMS issued guidance outlining how states can receive a block grant or per-capita cap in exchange for additional administrative flexibility. Through a Section 1115 demonstration waiver, these new financing arrangements would apply to coverage of optional Medicaid patient populations.

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policy

In an amicus brief, America's Essential Hospitals joined other national hospital associations in calling for an expedited Supreme Court review of a case that will determine the future of the Affordable Care Act. The court on Tuesday denied the expedited schedule.

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policy

A U.S. Court of Appeals panel upheld a ruling on the constitutionality of the individual mandate but returned the case to a lower court to decide whether that nullifies the entire law.

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aca
policy

The package, expected to become law, would delay a $4 billion cut to Medicaid disproportionate share hospital payments through May 22, 2020. It does not include proposals to reduce surprise medical bills or prescription drug prices.

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state-action

This marks the second consecutive year the uninsured rate for children has increased following continuous decreases after enactment of the Affordable Care Act. Only North Dakota saw a decrease in the uninsured rate for children.

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policy

The court struck down parts of the law that explicitly prohibit discrimination based on gender identity and termination of pregnancy.

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policy

America’s Essential Hospitals expressed concern that changes to nondiscrimination protections will decrease access and worsen outcomes for vulnerable patients, including transgender individuals and individuals with limited English proficiency.

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policy

The agreement would stop a $125 billion budget cut and increase defense and nondefense discretionary spending while raising the debt limit for two years.

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policy

The tools include a checklist of required waiver elements and model templates to help states better understand their options and the waiver approval process.

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policy

A House panel marked up legislation to eliminate $16 billion in Medicaid disproportionate share hospital cuts, mitigate surprise bills, and fund expiring health care programs.

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policy

As Congress returns from the July Fourth recess, lawmakers focus on legislation to reduce surprise medical bills and prescription drug costs, as well as extend short-term funding for community behavioral health clinics.

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policy

A proposed rule from the Department of Health and Human Services would overhaul parts of Section 1557 of the Affordable Care Act, removing some nondiscrimination protections for transgender individuals and requirements for covered entities treating people with limited English proficiency.

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aca, cms, hhs
policy

The rule would eliminate protection from discrimination in health care settings based on gender identity and roll back requirements to notify individuals with limited English proficiency of antidiscrimination policies and access to translation services.

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policy

A bipartisan group of 300 House lawmakers sent a letter to leadership calling for a two-year delay of Medicaid disproportionate share hospital cuts. The House will vote on a legislative package to expedite the availability of generic drugs and protect parts of the Affordable Care Act.

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Essential Insights

Decisions made at the state and federal levels regarding Medicaid expansion continue to evolve nearly a decade after passage of the Affordable Care Act.

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policy

The House this week will take up legislation to protect people with pre-existing conditions and help generic drug and biosimilar manufacturers bring their products to market. A House letter calling for a delay of Medicaid DSH payment cuts has 286 bipartisan signatures; the deadline to sign is May 8.

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policy

In a new request for information, the agency seeks ideas for innovative programs and waiver concepts states could consider in developing Section 1332 waivers. The request follows October 2018 guidance aimed at increasing state flexibility.

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state-action

The Department of Justice and 18 Republican-led states filed legal briefs in Texas v. United States arguing to uphold a ruling that the Affordable Care Act is invalid. Oral arguments in the appellate court are scheduled for the week of June 8.

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aca
policy

CMS finalized the Notice of Benefit and Payment Parameters for the Affordable Care Act’s health insurance marketplace and the annual letter to issuers offering plans on the federally facilitated marketplaces for plan years beginning on or after Jan. 1, 2020.

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policy

Hearings focused on rising drug costs and pricing transparency. Sen. Elizabeth Warren (D-MA) reintroduced a measure to bolster consumer protections under the Affordable Care Act. Both chambers will return to legislative business on April 29.

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policy

America’s Essential Hospitals, in coalition with other national hospital associations, has filed an amicus brief urging the Fifth Circuit to uphold the Affordable Care Act and overturn a Texas district court’s decision declaring the individual mandate and, in turn, the entire law unconstitutional.

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policy

The guidance comes in response to a recent federal court decision striking down a regulation expanding the availability of association health plans.

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policy

The legislation allows states to establish Medicaid health homes to coordinate complex care for children and provides $20 million in additional funding for the "Money Follows the Person" demonstration program, among other provisions.

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policy

The United States District Court for the District of Columbia ruled that expanding the availability of association health plans illegally circumvents the Affordable Care Act and violates the intent of federal insurance laws.

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policy

The House also will mark up a dozen bills aimed at lowering health care and prescription drug costs. House and Senate committees move forward on work to address surprise billing.

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policy

Affordable Care Act–mandated reporting requirements for tax-exempt hospitals remain in effect despite ongoing lawsuits and a Senate Finance Committee inquiry.

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state-action

America's Essential Hospitals reviews examples of state-led litigation and state legislation regarding various coverage-related provisions of the Affordable Care Act.

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policy

Long-expected "Medicare-for-all" bill formally introduced; Congressional hearings continue to focus on rising health care costs and prescription drug prices.

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policy

As the president prepares to deliver his State of the Union address this week, Congressional committees remain focused on health care costs and threats to the Affordable Care Act.

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policy

Congressional leaders and the White House reached a deal to fully reopen the federal government until Feb. 15; congressional hearings this week focus on prescription drug prices and protections for individuals with pre-existing conditions.

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policy

Medicaid and CHIP Payment and Access Commission members unanimously approved three recommendations to mitigate the impending Affordable Care Act–mandated Medicaid disproportionate share hospital allotment reductions.

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policy

Proposed provisions aim to further the Trump administration’s goals to lower premiums, increase market stability, reduce regulatory burden, and protect taxpayers.

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policy

As the partial government shutdown continues, the House this week will consider the Pandemic and All-Hazards Preparedness and Advancing Innovations Act and a bill to extend funding for the "Money Follows the Person" demonstration program.

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policy

House and Senate Democratic leaders vowed to pursue legislation to intervene after a judge ruled the Affordable Care Act unconstitutional; negotiations continue on a spending package to fund portions of the federal government before current funding expires on Dec. 21.

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state-action

A judge in the U.S. District Court for the Northern District of Texas sided with a group of Republican governors and attorneys general in 20 states who argued that the law's individual mandate is unconstitutional without the related tax penalty.

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aca

This profoundly troubling decision threatens to leave millions of Americans — including many with pre-existing conditions — little hope for affordable health care coverage and financial stability.

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aca
state-action

Vermonters will experience a 23 percent increase in marketplace premiums, while Tennesseans will see a 26 percent decrease; nationally, premiums will decrease 1 percent on average.

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Essential Insights

The nature of the Medicaid program means these skyrocketing costs have strained federal and state resources, prompting action through both policy and legislation.

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policy

The guidance allows states additional flexibility to waive certain provisions of the Affordable Care Act while preserving access to affordable, comprehensive coverage.

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webinar

Join us for a preview of the 2018 midterm elections, and learn how you can educate congressional candidates about the issues that matter most to your hospital.

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policy

The Senate is expected to vote this week on a bipartisan legislative package to combat the opioid crisis. The House considers legislation to roll back Affordable Care Act provisions.

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policy

The new guidance outlines the types of rules association health plans must follow under the Employee Retirement Income Security Act and reiterates that states and the Department of Labor have a joint responsibility to regulate such plans.

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policy

Under the final rule , short-term, limited-duration insurance plans can be issued for up to 12 months, with a maximum duration of 36 months after renewals and extensions.

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policy

The waivers allow each state to create a reinsurance program to lower premiums in the individual market; the waivers will take effect in 2019 and are approved through 2023.

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policy

A Government Accountability Office witness and several 340B Drug Pricing Program stakeholders testified last week at a House committee hearing; another House committee marked up several consumer-driven health care bills.

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institute

Researchers found a decline in uninsurance rates and an increase in medical service use, access, and diagnosis of certain chronic conditions among previously uninsured adults.

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policy

The Centers for Medicare & Medicaid Services noted that the provisions aim to increase flexibility, improve affordability, strengthen program integrity, empower consumers, promote stability, and reduce regulatory burden in the individual and small group marketplaces.

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policy

Negotiations on the bill have stalled amid disagreements on certain provisions, such as including language barring abortion access as part of a package to stabilize the Affordable Care Act's insurance marketplace.

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policy

This year's report includes the commission’s statutorily required annual analysis of Medicaid disproportionate share hospital payments, as well as chapters on Medicaid managed care and telehealth.

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policy

House Republicans this week hope to bring to the floor a bill to fund the government through the remainder of the fiscal year; America's Essential Hospitals CEO asked to testify during Senate committee hearing on 340B Drug Pricing Program.

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policy

Congress this week is focused on negotiating legislation to stabilize the Affordable Care Act insurance marketplace and efforts to fight the opioid crisis.

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policy

The proposal extends to one year the maximum length of short-term, limited duration plans — up from three months, as mandated by the Affordable Care Act.

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The chief executives of 18 of the nation’s largest hospital systems that care for low-income patients asked congressional leaders for a two-year delay of Medicaid disproportionate share hospital payment cuts.

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The House and Senate tax reform bills would destabilize hospitals that care for those who face financial hardships by triggering deep cuts to social programs.

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policy

The association encouraged the Centers for Medicare & Medicaid Services to ensure that state plans cover essential health benefits and include sufficient access to essential community providers.

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policy

The House passed the Tax Cuts and Jobs Act; the Senate version of the tax reform bill includes a repeal of the Affordable Care Act's individual mandate.

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policy

The Finance Committee's "chairman's mark" is similar to a House bill, but forgoes many House provisions of particular concern to essential hospitals.

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policy

The bill delays disproportionate share hospital payment cuts for two years; House Republicans consider repealing the individual mandate through tax reform.

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The end of cost-sharing reduction subsidies poses an imminent threat to those who depend on marketplace plans. America’s Essential Hospitals thanks Sens. Alexander and Murray for their bipartisan leadership to create more certainty in the individual market.

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policy

The move jeopardizes coverage for millions of working Americans, could substantially raise premiums for those who remain in marketplace plans, and could increase uncompensated care costs at essential hospitals.

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policy

The Congressional Budget Office estimates premiums will increase 20 percent by 2018 and the uninsured population will increase by 1 million; 19 states and the District of Columbia filed a lawsuit arguing that withholding the payments violates current law.

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Ending the government’s cost-sharing subsidies to insurers in the Affordable Care Act marketplace won’t fix the law’s shortcomings or move us closer to a workable alternative. It only will destabilize the insurance market and drive costs higher for patients who can least afford increases.

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policy

The federal fiscal year came to a close Sept. 30, ending a nearly yearlong congressional effort to repeal and replace the Affordable Care Act and bringing tax reform efforts and other health care priorities to the forefront in Congress.

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policy

Reductions to Medicaid disproportionate share hospital (DSH) payments, as mandated by the Affordable Care Act, went into effect on Oct. 1. A total of $2 billion will be cut from Medicaid DSH funding in fiscal year 2018 alone.

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policy

Tuesday's decision effectively ends Congress’ current push to repeal and replace the Affordable Care Act; a letter calling for the delay of Medicaid DSH cuts has garnered nearly 200 signatures in the House.

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We hope the Senate’s decision to stop the rush to a vote on the Graham-Cassidy-Heller-Johnson proposal opens the door to renewed bipartisan talks on ways to fix the Affordable Care Act.

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policy

America's Essential Hospitals continues to advance our opposition to the Senate's Graham-Cassidy-Heller-Johnson proposal.

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policy

The bill would replace Medicaid expansion funding and private insurance subsidies with $1.2 trillion in block grants to states; the Congressional Budget Office is expected to release a score early next week.

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policy

Congress aims to pass legislation by Sept. 30 to stabilize the Affordable Care Act (ACA) insurance markets and reauthorize several health care programs; three senators plan to unveil new ACA repeal legislation.

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policy

Substantial cuts to Medicaid disproportionate share hospital payments are set to begin on Oct. 1; strong and immediate input from essential hospitals is vital to successfully secure another delay.

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policy

After Affordable Care Act repeal efforts collapsed in the Senate, the administration began considering options on cost-sharing reduction payments, but some lawmakers remain focused on repeal.

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policy

Expanded Medicaid access under the Affordable Care Act might have helped patients seek treatment for behavioral health issues, which disproportionately affect low-income populations.

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With the Senate defeat of the repeal bill, America's Essential Hospitals urges lawmakers to turn their attention to averting Oct. 1 cuts to Medicaid disproportionate share hospital payments and to renewing their commitment to CHIP and other elements of the safety net.

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All plans considered so far by Congress would end with the same terrible result: at least 22 million more uninsured people, devastating cuts to Medicaid, and higher costs for patients and taxpayers.

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policy

The Senate approved a motion to proceed, which is needed to open floor debate of a repeal bill; it remains unclear how the Senate will proceed.

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policy

Senate Majority Leader McConnell said he would bring up a repeal-only bill that includes a two-year transition period for replacing the Affordable Care Act, but three Republican senators oppose the plan.

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The repeal-and-delay strategy would leave millions of lives in limbo and create uncertainty that would destabilize insurance markets and paralyze hospitals.

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The revised Better Care Reconciliation Act leaves untouched the most destructive provisions of the original bill: those that would gut the Medicaid program and strip affordable coverage from millions of people.

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webinar

Attendees gained a comprehensive view of legislative and regulatory action in Washington, D.C, a preview of action in the fall, and our recommendations for messaging and strategy during Congress’ August recess.

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policy

Senate Republican leadership continues negotiations with Republican holdouts; a vote on the bill is expected before the month-long August recess.

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policy

Researchers from George Washington University and The Commonwealth Fund found the Better Care Reconciliation Act of 2017 could cause an estimated 1.45 million jobs to disappear by 2026.

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institute

Researchers examined outcomes in Kentucky, Arkansas, and Texas; they found expanding access to health coverage improved care access and affordability.

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policy

Negotiations continue; areas of contention include the Medicaid per-capita cap growth rate and the phase out of Medicaid expansion enhanced funding.

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The Congressional Budget Office score of the Senate's Better Care Reconciliation Act confirms what most observers expected: The bill is as damaging as its deeply unpopular House counterpart, the American Health Care Act.

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policy

A revised draft of the Senate bill was released to address some Republicans' concerns, but it made no meaningful changes to the bill’s Medicaid provisions.

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policy

The brief projects Medicaid disproportionate share hospital payment reductions under the Affordable Care Act and the House-passed American Health Care Act.

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Senate leaders have put ideology ahead of lives with a plan that puts health and home at risk for millions of working Americans.

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policy

Senate Republican leaders aim to submit a draft bill to the Congressional Budget Office early this week and vote on the bill before the July Fourth recess.

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policy

CMS aims to eliminate or change outdated, costly, or inconsistent regulations for marketplaces established under the Affordable Care Act.

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policy

Senate Republican leadership recently indicated the possibility of a vote by the end of July, before the month-long August recess.

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policy

The plan would reduce funding for social and entitlement programs for low-income Americans by $1.7 trillion, including a $610 billion cut to Medicaid.

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policy

The new checklist tool helps states compile the necessary documents to apply to waive ACA provisions and pursue alternative reforms.

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policy

America’s Essential Hospitals provides an overview of community benefit requirements, which hospitals must comply, and the penalties for failure to comply.

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policy

Senate Republicans stay focused on a strategy to repeal and replace the ACA; committees hold hearings on public health, Medicare, and chronic conditions.

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policy

A 13-member Senate working group made up of conservative and moderate Republicans now begins to craft its own version of the legislation.

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policy

Three new amendments garnered enough Republican support to pass the bill in a 217-213 vote; CBO has not scored the bill since the amendments were added.

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The bill the House approved today would leave tens of millions of Americans uninsured and reduce benefits and increase costs for millions more - including the sick.

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The amendment to increase funding for American Health Care Act high-risk pools applies a bandage to a mortally wounded patient and changes in no material way the harm this bill would cause.

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policy

Rep. MacArthur (R-NJ) proposed an amendment to the AHCA that would have allowed states to opt out of several important insurance regulations.

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policy

A vote on the bipartisan bill could come Wednesday in the House, followed by Senate consideration before continuing resolution appropriations expire Friday.

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Attempts to revive the American Health Care Act with changes that make a deeply damaging bill even worse are misguided and disappointing.

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policy

Lawmakers face an extensive agenda of legislative priorities, including health care and tax reform, and most urgent, a continuing resolution to prevent a government shutdown.

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webinar

The policy team at America's Essential Hospitals discussed the regulatory outlook for the next year, including key policy issues on the horizon.

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policy

When lawmakers return, they could attempt to make additional changes to pass the American Health Care Act, legislation to repeal and replace the ACA.

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webinar

Attendees learned how leaders from the University of New Mexico Health System have integrated team-based approaches to overcome challenges and coordinate care.

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policy

Talks of a deal to resurrect the American Health Care Act — legislation to repeal and replace the ACA that was pulled in March — are underway.

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policy

House GOP leadership pulled the bill due to inadequate support; the association now resumes its focus on other hospital-related issues, including DSH cuts.

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Congressional leaders made the right choice today to withdraw their legislation to repeal the Affordable Care Act. With health care coverage for tens of millions of Americans in the balance, this was a sound decision.

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aca
policy

The American Health Care Act's Medicaid cuts would fall heavily on low-income states that expanded Medicaid under the Affordable Care Act.

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House Republican leaders are putting the health of millions of Americans at greater risk with each change they make to placate party holdouts and pass the American Health Care Act.

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aca
policy

Samuel Ross, CEO of Bon Secours Baltimore Health System, testified at an event held by House Democrats on the Republican-proposed bill to repeal the ACA.

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policy

The replacement plan would make steep cuts to Medicaid and leave an estimated 24 million more people uninsured, compared with current law under the ACA.

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webinar

With the surprising and abrupt death of the American Health Care Act, the federal health policy landscape has shifted. We discussed the association’s top advocacy goals as Congress picks up the pieces.

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policy

The letter affirms their desire to improve the Medicaid program and the vulnerable people it serves and to ensure the program provides value to taxpayers.

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America's Essential Hospitals says the cumulative effect of the proposal and the American Health Care Act could be to undermine the ability of essential hospitals to meet their commitment to patients and communities.

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aca, hhs
policy

MACPAC's March report includes analysis on Medicaid DSH and impacts of the ACA on hospitals, as well as recommendations for the future of CHIP.

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policy

The American Health Care Act moves next to the House Committee on the Budget, which is scheduled to mark up the legislation on Thursday.

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policy

The letter encourages states to pursue Section 1332 State Innovation Waivers, especially those including high-risk pool/state-operated reinsurance programs.

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America's Essential Hospitals says the Congressional Budget Office analysis of coverage losses under the American Health Care Act underscores the urgent need for Congress to rethink its strategy on repealing and replacing the Affordable Care Act.

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policy

The committees on Energy & Commerce and Ways & Means passed ACA repeal and replacement bills that could affect coverage and essential hospital funding.

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policy

The House committees on Energy and Commerce and Ways and Means this week released their long-awaited legislation to repeal and replace the ACA.

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policy

The American Health Care Act offers some relief for the safety net, but the association remains deeply concerned about substantial changes to Medicaid.

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policy

America’s Essential Hospitals expressed concerns about proposed changes that could harm the integrity of qualified health plan networks.

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While the House bill would bring welcome relief from damaging cuts to Medicaid disproportionate share hospital payments, the association remains deeply concerned about provisions to end Medicaid expansion and impose per-capita caps on the program.

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policy

Draft GOP text for legislation to repeal and replace the ACA leaks; a Senate committee is poised to vote on the administration's CMS administrator nominee.

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policy

Whether you join us or support the fight from home, urge lawmakers to ensure continued coverage access and stable, equitable, sustainable Medicaid funding.

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policy

The House plan to repeal and replace the Affordable Care Act would rescind Medicaid disproportionate share hospital cuts and impose per-capita caps on Medicaid funding.

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policy

A leaked House GOP plan to repeal & replace the ACA raises concerns for essential hospitals. A Senate committee considered nominee Seema Verma to lead CMS.

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policy

On February 16, a policy brief by House Republicans on how they would repeal and replace the Affordable Care Act (ACA) was leaked in Washington. Learn more about what was included.

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Today's reports of a draft policy brief describing how House Republicans would replace the Affordable Care Act (ACA) raise significant concerns about whether the plan could protect the health of low-income and other struggling Americans.

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policy

Former Rep. Tom Price was confirmed as secretary of HHS; the Senate Committee on Finance will consider the nomination of Seema Verma as CMS administrator.

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If Congress fails to replace the Affordable Care Act (ACA) with a comparable plan, coverage losses and scheduled cuts to hospital funding would total up to $40.5 billion nationally for hospitals that fill a safety-net role, a new analysis shows.

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policy

A House subcommittee marked up two bills focused on income eligibility for Medicaid. The association weighed in on a hearing about the individual mandate.

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policy

The Feb. 7 letter offers recommendations on proposed executive orders, regulations, and legislation that could affect essential hospitals, patients.

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policy

No agreements have been reached about a repeal/replacement plan for the ACA and it appears Republicans in both chambers are far from making final decisions.

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webinar

Attendees heard about the current status of health care legislation, including efforts to repeal and replace the Affordable Care Act.

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policy

The second confirmation hearing was held for Rep. Price as HHS secretary and a House subcommittee held a hearing on the individual mandate's effectiveness.

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policy

A memo instructs all executive departments and agencies to temporarily halt pending regulations until incoming department or agency heads can review them.

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policy

With House and Senate passage of budget resolutions, efforts to repeal the Affordable Care Act now move to committees and toward a Jan. 27 deadline for repeal legislation.

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policy

Debate and amendment votes in the Senate are expected though the weekend. The Senate measure then will go to the House for consideration.

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policy

Hawaii is the first state to receive approval for a Section 1332 waiver, and will be allowed to close its Small Business Health Options Program for five years.

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policy

Essential hospitals can expect the new Congress' Republican leaders to follow through quickly with their pledge to repeal the Affordable Care Act.

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policy

Essential hospitals should be equipped with key information to understand this procedural tool that likely will be used early next year to begin the process of dismantling the Affordable Care Act (ACA).

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policy

America's Essential Hospitals is taking part in the Provider and Hospital Week of Action to promote open enrollment for insurance marketplaces under the ACA.

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policy

The notice contains state-specific FMAPs, used to determine the amount of federal matching funds for state Medicaid programs; and enhanced FMAPs, used to calculate federal funding for the Children’s Health Insurance Program.

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policy

The impending full control of government by Republicans is expected to kick start discussions about repealing the Affordable Care Act and passing entitlement reform.

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policy

CMS will use social video platform Twitch, improve the HealthCare.gov mobile interface, and use #HealthyAdulting to encourage young adults to sign up.

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policy

While details are still being finalized, a continuing resolution to fund the government through early December likely will include funding to combat Zika.

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policy

HRSA is proposing that a decision-making body within the Department of Health and Human Services be responsible for reviewing claims and resolving deputes.

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Essential Insights

Mike King, a reporter for nearly 40 years, profiles three members of America’s Essential Hospitals — Grady Memorial Hospital in Atlanta, Parkland Memorial Hospital in Dallas, the John H. Stroger Hospital of Cook County in Chicago — and other public hospitals across the country.

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institute

With support from Kaiser Permanente and East Bay Community Foundation, America's Essential Hospitals collaborates with NACHC and GW to help providers navigate and adapt to the systemwide policy changes and accountability standards mandated by the ACA.

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institute

The new BMC study underscores “the importance of continued support for safety-net and minority-serving hospitals as national reform unfolds."

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policy

By forming strategic partnerships and using social media, CMS aims to “reach young adults where they are” to facilitate engagement during open enrollment.

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policy

The plan would convert Medicaid to a program managed entirely by states through block grants or per-capita allotments from the federal government.

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Latest member profile from America's Essential Hospitals shows that, despite ACA coverage expansion, uncompensated costs remained high in 2014 at hospitals with many low-income and other vulnerable patients.

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policy

HHS finalizes 2017 Notice of Payment and Benefit Parameters rule and letter to issuers offering qualified health plans on the federally facilitated marketplace.

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Essential Insights

As Jan. 31 open enrollment deadline looms, association spreads the word about ACA coverage options and tools to assess coverage needs and cost.

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policy

Obama touts ACA successes in final address, calls for ongoing support of Medicare, Social Security. House Speaker Ryan prepares ACA replacement plan as GOP continues repeal efforts; Califf wins Senate HELP vote.

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policy

House returns from recess for largely symbolic vote on Senate-passed reconciliation bill that would repeal many ACA provisions, including Medicaid expansion; Senate remains out.

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policy

Guidance builds on 2012 final regulations that outline the process for submission and review of section 1332 waivers, which may begin as early as Jan. 1, 2017.

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policy

Proposals would make required and recommended changes to how qualified health plans operate in Affordable Care Act marketplaces.

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webinar

Join us to review our 2015 federal legislative and regulatory action and preview our 2016 advocacy agenda.

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institute

Essential hospitals 2.67 times more likely than other hospitals to receive penalties under Medicare readmissions program in FY 2016

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policy

Congressional staff continue negotiating omnibus appropriations package, which is expected to go to a vote by Dec. 11; Sen. Wyden asks HHS for update on progress of state 1332 waivers.

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policy

Letter from Senate Finance Committee leaders asks America's Essential Hospitals, other stakeholders, for comment on Medicaid transparency, quality, accountability

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policy

In the Loop, a joint project of Community Catalyst and the National Health Law Program, helps enrollment assisters share experiences and answer questions.

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policy

Model law would update requirements for insurance carriers in the health insurance marketplaces, particularly regarding provider directories, mental health services, telehealth, and nondiscrimination.

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policy

Senate plans to expand House reconciliation bill with full ACA repeal; Rep. Brady named Ways and Means chair; Republicans establish Medicaid task force.

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policy

Open enrollment for ACA marketplaces will last from Nov. 1, 2015, to Jan. 31, 2016, with coverage taking effect as soon as Jan. 1. Previously announced HHS enrollment goals include improving consumer experience, retaining and adding customers.

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policy

U.S. District Court says 2014 HRSA interpretive rule is contrary to plain language of ACA provision that excludes certain hospitals from 340B discounts on orphan drugs.

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policy

Congress will vote to pass legislation to avoid a government shutdown. Meanwhile, House committees are also working to pass budget reconciliation measures that would defund Planned Parenthood and make major changes to the Affordable Care Act.

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institute

Institute researcher discusses the popular and up-and-coming movements in delivery system transformation and alternative payment models.

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policy

The hospital-related NOTICE Act was sent to the president last week. An ACA repeal vote remains likely for fall along with the potential for a government shutdown.

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institute

Articles cover the ACA's Medicaid expansion, Medicaid shortfalls and community benefit funds, and the impact of recent Supreme Court decisions on Medicaid.

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policy

Plans must be budget-neutral and cover as many people as traditional ACA reforms. With these waivers, states may forgo certain ACA provisions including the marketplaces and individual mandate.

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policy

The Senate fails to repeal the ACA but will keep trying. Committees discuss HHS priorities and health care bills, including a bundle of hospital-related bills.

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institute

The new website provides health care providers and policymakers with further information about the National Partnership as well as access to resources for collaboration and tackling health policy issues.

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policy

GOP will weigh procedural tactics to repeal the ACA or propose tax reform; House vote on Cures bill expected.

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policy

The association will use the information gathered to advocate to policymakers the need to continue to support essential hospitals’ mission and service to their communities. This survey focuses on the first quarter of calendar year 2015. We will use aggregate information only.

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policy

Republicans will also continue to develop a strategy for undoing the ACA in light of the Supreme Court's ruling upholding the law last week.

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policy

The Supreme Court ruled in King v. Burwell that the Affordable Care Act makes federal subsidies available to individuals in states that use the federally facilitated marketplace, not just those with a state-based marketplace.

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Essential Insights

The U.S. Supreme Court ruled to keep subsidies for health insurance sold via federally run exchanges

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policy

Six justices ruled in favor of the Obama administration, arguing that the overall structure and purpose of the ACA supports the interpretation that Congress intended subsidies to be available in both federally facilitated and state-based marketplaces.

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Decision maintains access to vital health care services for millions of Americans and supports the hospitals that care for our most vulnerable patients

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policy

CBO also found that if a full ACA repeal took effect on Jan. 1, 2016, the federal deficit would increase by $137 billion between 2016 and 2025.

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policy

The House will vote to repeal two major ACA provisions this week - medical device tax and the IPAB - and consider four Medicare Advantage bills. Health committees are reviewing mental health and HIT.

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webinar

Learn more about how states are negotiating alternative Medicaid expansions.

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policy

America's Essential Hospitals is conducting this member survey to capture the impact of the ACA coverage expansion on essential hospitals.

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policy

The survey focuses on uncompensated care and utilization during the last two quarters of CYs 2013 and 2014. It aims to capture the impact of ACA coverage expansion on essential hospitals.

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policy

Congress will attempt to pass SGR and budget legislation by Friday. The SGR package includes a one-year delay of Medicaid DSH cuts. House Committees will hold hearings on 340B, heroin and prescription drug abuse, and Medicare Fraud. The Senate HELP Committee will hold a hearing on patient research.

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policy

Ruling against subsidies could send ACA into "death spiral," according to RAND report.

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policy

Congress must pass a homeland security spending bill this week, and health insurance marketplaces are under scrutiny as oral arguments in the King v. Burwell Supreme Court case begin.

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policy

Feb. 20 final rule and letter to issuers outline benefit and payment parameters for 2016 health insurance marketplace plans

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policy

Plus, more than 3.3 million people who submitted marketplace applications are eligible for Medicaid or CHIP.

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policy

Also on tap is a Senate vote on homeland security funding that would bar legal status for undocumented immigrants and President Obama's 2016 budget

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policy

Association filed Jan. 28 amicus brief in Supreme Court case supporting insurance subsidies through federally facilitated health insurance marketplace.

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Essential Insights

What are we doing to demonstrate support for ACA insurance coverage subsidies? We filed and amicas brief for King v. Burwell affirming the position. Here's what we said and why.

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policy

In a new policy brief, America's Essential Hospitals describes how billions of dollars in reductions to Medicaid and Medicare funding threaten care at essential hospitals.

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policy

Obama delivers annual address; House considers an abortion ban, natural gas permits, and SGR; and Senate considers the Keystone Pipeline and definition of full time.

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policy

Congress convenes with a new Republican majority in the Senate. The House will vote on the ACA 40-hour work week, veterans legislation and the Keystone pipeline. The Senate will elect committee chairs.

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policy

Final regulations are issued regarding the required community health needs assessment for charitable hospitals and the consequences for failing to satisfy the requirements.

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policy

The association extended the survey deadline to continue to gather information on members' uncompensated care post-ACA.

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policy

The association launched this survey Nov. 10 to capture the impact of the ACA coverage expansion on essential hospitals.

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policy

New association policy brief describes how cost-sharing assistance by hospitals helps vulnerable patients afford health insurance marketplace coverage and access vital health care services

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Essential Insights

Obama's executive action offers new opportunities for immigrants to live and work in the United States, but no relief for lack of health care coverage

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Essential Insights

Essential hospitals face barriers in providing care to immigrant populations. They must find unique ways to address the complexity surrounding immigration status for their patients.

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policy

The survey aims to capture the impact of ACA coverage expansion and add to association advocacy efforts with timely information on members' uncompensated care.

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policy

Oral arguments for this case are scheduled to begin Dec. 17.

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policy

Though the payment bump has reportedly increased access to care in some states, it appears unlikely that this ACA provision will be extended beyond 2014.

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policy

What impact has section 1202 of the Affordable Care Act, also know as the primary care bump, had on your hospital?

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policy

Congress meets this week to extend federal funding through Dec. 11. Other legislative considerations include medical device tax, VA authorities, and the Emergency Medical Services for Children Program. Committees will address CHIP, Ebola, and the ACA.

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policy

This week, Congress will likely consider a CR, allowing non-ACA-compliant group health insurance plans through 2018, extending the Emergency Medical Services for Children Program, and several health-related items.

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policy

The full U.S. Court of Appeals for the District of Columbia will rehear Halbig v. Burwell, one of the two cases with conflicting results on whether ACA subsidies are available in the federally facilitated marketplace.

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policy

Generally, if consumers do nothing, they will be auto-enrolled in the same plan with the same premium tax-credit and other financial assistance as they had in the 2014 plan year.

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policy

Under consideration will be a federal funding extension and a House bill to grandfather non-ACA-compliant group health plans

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policy

Pennsylvania will expand Medicaid through a private option, requiring some enrollees to pay premiums.

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Essential Insights

It is difficult to find creative ways to describe the thoughtlessness of states’ decisions to opt out of Medicaid expansion under the Affordable Care Act. Here is my latest involving a stats website and baseball.

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policy

The final rule updates Medicare payment policies, rates for inpatient stays at general acute care hospitals, and provisions related to quality improvement programs.

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policy

The House and Senate head into August recess after voting to clear a VA assistance bill, sending it to the president on Friday. The Senate couldn't pass border emergency supplemental legislation, while the House passed a less expensive version. CMS faced tough criticism from Republicans about HealthCare.gov contractors.

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Essential Insights

Sixteen members of America's Essential Hospitals from across the Southeast met for our Regional Strategy Meeting that covered direct lobbying, effective communication, and citizen advocacy.

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Association joins lawmakers in call for non-expansion states to 'do the right thing now' and support vulnerable patients and their hospitals.

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policy

The U.S. Court of Appeals for the DC Circuit has ruled that people who purchase health insurance through the federally facilitated marketplace are ineligible for ACA subsidies. The 4th Circuit Court of Appeals in Virginia released a conflicting opinion hours later.

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policy

New interpretive rule will address the 340B orphan drug exclusion.

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policy

House GOP will move forward with a lawsuit against President Obama on the delay of the employer mandate without congressional approval. Energy and Commerce is marking up a variety of bills and holding hearings on the health insurance marketplaces and anthrax.

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policy

CMS announced a second batch of prospective recipients for Health Care Innovation Awards (round 2). The 27 new recipients include four members of America’s Essential Hospitals. Awards will be used to reduce costs and improve care delivery models for Medicare, Medicaid, and CHIP patients.

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policy

White House Council of Economic Advisers released a report describing opportunities missed by states that have not expanded Medicaid under the Affordable Care Act.

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White House report confirms the numerous benefits of Medicaid expansion and demonstrates that state decisions not to expand have far-reaching consequences for our nation's health and economy. Essential hospitals have driven enrollment and need continued financial support to serve their communities.

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policy

CMS outlines three methods for reviewing enrollee coverage eligibility for insurance purchased through the federally facilitated marketplace.

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policy

HHS report announces that 87 percent of individuals who purchased health insurance from the federally facilitated marketplace during initial open enrollment have received premium assistance through federal tax credits. The report also shows that 64 percent of individuals enroll in plans with the lowest premiums, despite higher cost-sharing rates.

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policy

HRSA announced that it plans to stand by its interpretation of the 340B orphan drug rule and will continue to publish updated orphan drug designation lists to assist organizations with compliance with the policy.

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policy

The association submitted comments to the Departments of Labor, Health and Human Services, and the Treasury regarding their request for information on provider nondiscrimination.

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policy

A recent study found that planned reductions in Medicaid DSH payments and ongoing inflation in health care costs will cause debilitating gaps in funding for essential hospitals. Expected system costs to states that do not expand Medicaid will be exacerbated by continued uncompensated care costs and no additional Medicaid funds to offset them.

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policy

Congress continues to address delays in care at VA medical centers. The Ways and Means Committee explores income verification for tax credit eligibility under the ACA, and the Energy and Commerce Health Subcommittee looks at incentives to develop new drugs and devices as well as health care access under the ACA.

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policy

The district court held that the rule was outside the scope of the agency’s rulemaking authority. Because the court vacated the final rule, newly designated 340B entities will not be able to purchase orphan drugs at discounted prices, regardless of whether the drugs are used for their designated purpose or other purposes.

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policy

America's Essential Hospitals describes how provider-supplemented premium assistance for enrollees in the health insurance marketplaces strengthens the marketplaces and furthers the goals of the Affordable Care Act.

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America’s Essential Hospitals urges the Senate to swiftly confirm Sylvia Mathews Burwell as secretary of the U.S. Department of Health and Human Services. Burwell’s confirmation is critical to providing a steady hand to lead the department through the rapid changes occurring in health care coverage and delivery.

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webinar

Government relations staff will share their experiences with Medicaid expansion, including challenges and best practices

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policy

CMS issued a final rule Friday, May 16, on 2015 standards for health insurance marketplaces and the insurance market. Among other provisions, CMS finalized measures for a quality rating system that would require health insurance issuers operating through the marketplaces to collect, validate, and report data on quality metrics for qualified health plans.

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policy

Experts from American Muslim Health Professionals, Million Hearts, and CMS will update health professionals serving minority and undeserved populations on the Affordable Care Act's expansion of health insurance coverage.

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aca
policy

On April 30, CMS issued the IPPS proposed rule for fiscal year 2015. The rule updates Medicare payment policies, rates for inpatient stays at general acute care hospitals, and provisions related to quality improvement programs. CMS will accept comments on the proposed rule through June 30.

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policy

CMS released the FY 2015 proposed IPPS rule April 30. The proposed rule updates Medicare payment policies and rates for inpatient stays at general acute care hospitals, as well as provisions regarding quality improvement programs.

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policy

Congress will begin the appropriations process, but not much is expected to be accomplished since it is an election year. Senate Democrats will bring up a bill to increase the minimum wage but expect Republican resistance. The House will reconsider a bill regarding exemption of expatriate health plans under the ACA.

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policy

CBO estimated 2016 marketplace premiums will be 15 percent less than they were estimated to be in 2009. This should mean the ACA will cost $104 billion less to the federal government over the next decade than previously projected.

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webinar

Members learned about the fundamental challenges driving industry workforce shortages

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policy

In a major victory for essential hospitals, a House committee late last night posted physician payment legislation that includes an additional year delay in Medicaid disproportionate share hospital (DSH) cuts and requires an annual DSH report sought by America’s Essential Hospitals. The changes come in a House Rules Committee bill to extend the current patch

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policy

Health care leaders will discuss efforts to enroll patients in health insurance coverage before March 31. Association President & CEO Bruce Siegel, MD, MPH, along with Vice President Joe Biden, U.S. Department of Health and Human Services Secretary Kathleen Sebelius, and other hospital association leaders will participate in the call.

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policy

House and Senate differ on offsets for SGR repeal and replace; ACA alternative details under wraps

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policy

Health and Human Services Secretary Kathleen Sebelius will testify on the president's budget before two congressional panels this week. Meanwhile, the House will consider a bill to repeal the sustainable growth rate (SGR) physician payment formula. Republicans are expected to tie SGR fix to repeal of the Affordable Care Act’s individual insurance mandate.

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webinar

Government relations experts from essential hospitals shared strategies they have used to move their state toward Medicaid expansion

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Cuts to disproportionate share hospital payments and federal support for hospitals' bad debt, as well as reductions in graduate medical education funding, threaten to hurt the same people who would benefit from tax relief in the administration's fiscal year 2015 budget.

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policy

This week the longest serving member of Congress, Rep. John Dingell, announced he will retire. Dingell served for 29 terms and through 11 different presidents. The House Energy and Commerce Committee will look at the changes CMS is making to Medicare Part D, and House Majority Leader Eric Cantor announced that the chamber would vote on the ACA's 30-hour work week definition.

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policy

Nearly 3.3 million people have selected plans through the marketplaces since they opened Oct. 1, 2013. This number represents 45 percent of the 7.3 million people who were eligible to enroll in a marketplace plan. In addition, 3.2 million people who submitted applications through the marketplaces were determined to be eligible for Medicaid or the Children’s Health Insurance Program (CHIP).

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Essential Insights

Member Maricopa Integrated Health System (MIHS) recently launched CoverMeAZ.org. This purpose-built website explains in plain language Affordable Care Act (ACA) coverage options and helps the MIHS community cut through the clutter that too often surrounds the ACA.

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quality

The Agency for Healthcare Research and Quality's new director, Richard Kronick, PhD, has refocused the agency’s mission to emphasize producing evidence to make health care safer, more accessible, equitable, and affordable.

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policy

Republican House leaders are working on a proposal to replace the Affordable Care Act (ACA). On Wednesday, the House Committee on Oversight and Government Reform will hold a hearing on the risk corridors provision in the ACA. Last week, House Energy and Commerce Ranking Member and Former Chair Henry Waxman (D-CA) announced he would retire at the end of his term this fall.

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policy

The Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act would repeal the Affordable Care Act and replace it with market-based reforms. The plan would keep some ACA provisions. The proposal would end the individual mandate and offer tax credits for individuals unable to afford coverage.

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policy

Association seeks feedback from member hospitals on proposed procedures charitable hospitals must use to disclose and correct failures that are not willful or egregious. The procedures would allow hospitals to meet requirements under section 501(r) of the Internal Revenue Code, an Affordable Care Act provision that imposes additional requirements on charitable hospitals.

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policy

President Obama highlighted early ACA successes, CBO said SGR bills would cost $150.4 billion over 10 years

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aca, hhs
policy

On Jan. 24, the Centers for Medicare & Medicaid Services (CMS) released new resources for implementing hospital presumptive eligibility (PE), including frequently asked questions (FAQs). In the FAQs, CMS clarified that hospitals “may implement PE with the support of third party contractors.”

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policy

A Jan.23 Gallup survey found that the percentage of uninsured adults nationally dropped 1.2 percentage points in January, from 17.3 percent in December to 16.1 percent in January. Gallup said the percentage of uninsured adults for January is “slightly lower than what Gallup has measured in any month since December 2012.”

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policy

New HCAHPS Data Released

Jan. 23, 2014 || Staff

Data has been released for the reporting period of April 2012 through March 2013

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policy

Bill includes provisions to fund the ACA, House held healthcare.gov hearings

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policy

Jan. 13 letter urges Congress to oppose Senate proposal to cut Medicare funding to pay for an extension of unemployment benefits

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policy

Brief reviews regulations that update current rules to allow Medicaid hospitals to make presumptive eligibility determinations

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aca
policy

Association, two other national organizations file amicus brief in support of HRSA interpretation of law

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webinar

Boston Medical Center and University of Washington Medicine share their stories

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webinar

A review of the potential implications for essential hospitals

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webinar

UW Medicine combined four hospitals and prepared its workforce to be mission-focused

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webinar

How one essential hospital improved outpatient care through community partnerships

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webinar

How two organizations aligned their clinical staff with new strategic visions

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policy

Budget bill eliminates FY 2014 Medicaid DSH cuts, delays FY 2015 cuts

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Calls action "important step toward protecting access to vital health care and community services for millions"

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Millions of vulnerable patients "in a terrible bind" with no access to expanded coverage, billions less in funding for their care

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policy

On November 27, the Centers for Medicare & Medicaid Services (CMS) issued the Outpatient Prospective Payment System (OPPS) final rule for calendar year (CY) 2014. Included in the rule are provisions related to the following: payment for hospital outpatient visits data collection in off-campus, provider-based departments Hospital Outpatient Quality Reporting (OQR) Program Hospital Value-Based Purchasing

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policy

America’s Essential Hospitals submitted comments Nov. 25 on the Basic Health Program proposed rule.

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policy

The Affordable Care Act establishes state-based and regional health insurance exchanges

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policy

Medicare DSH payments compensate hospitals for costs associated with low-income patient care

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policy

Hospitals that treat a large share of low-income patients receive add-on payments to the amount designated by IPPS

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policy

Eligibility notices, benefits in alternative benefit plans, appeals process among rule's provisions

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policy

Section 1115 projects give states additional authority to design, improve Medicaid and CHIP programs

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policy

Measures are intended for voluntary use by state Medicaid agencies

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policy

Rule implements proposed provisions in the Affordable Care Act

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policy

Decision suggests hospitals may help patients with financial assistance for plan premiums

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aca, hhs
policy

House passed “Keep Your Health Plan Act,” Senate considered similar bills

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policy

Report includes options for reducing federal budget deficits for fiscal years 2014 to 2023

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aca
policy

846,184 people completed applications through the marketplaces, 106,185 people selected marketplace plans.

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aca, hhs
policy

Coverage renewed for between Jan. 1 and Oct. 1, 2014 will not be considered out of compliance

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aca, hhs
policy

HHS encouraged issuers to reject premium payments from third parties

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policy

Premium tax credits are available to help people with low and moderate incomes afford the cost of health insurance

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aca
policy

Federal anti-kickback statute, which only applies to federal health care programs, will not apply to QHPs.

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aca, hhs
policy

Senate Democrats pressured Obama administration to fix healthcare.gov, SGR agreement gained support

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policy

Congress holds healthcare.gov hearings, committee met on budget agreement

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policy

The rule finalizes a number of provisions regarding health insurance marketplaces

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policy

In the Loop is a private, secure community for people working to help health insurance enrollment

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aca
policy

Analysis finds program is likely to grow in states expanding their Medicaid program

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policy

Lawmakers negotiated potential plans to raise the debt limit

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policy

Analysis evaluated individual plan premiums in the 36 states with a federally facilitated marketplace

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aca, hhs
policy

Congressional leaders stalled on debt limit agreement

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policy

Essential hospitals to play important role with experience caring for the uninsured

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policy

"Navigators" will raise awareness about plan availability and help individuals understand options

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aca, cac
policy

Proposed rule establishes framework for several program elements

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policy

Siegel noted : some plan networks are only covering selected services, offering low rates for essential hospitals

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policy

Siegel, Gremminger highlighted the importance of delaying, reconsidering scheduled Medicaid DSH cuts

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policy

Rule implements the Affordable Care Act's Medicaid DSH cuts for fiscal years 2014 and 2015

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policy

Model combines federal oversight with state say over plan certification, outreach, and enrollment

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aca, cac
policy

House abandoned plans to vote on a bill to extend the continuing resolution

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policy

Limited knowledge of most effective messages, organizations at local level could pose challenges

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aca, cac
policy

Approach gives states most control over governance and requirements for qualified plans

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aca, cac
policy

Bill would halt subsidies until applicant coverage requirements, household income can be verified

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policy

Committee to review groups’ activities, budget, employees and training, and other issues

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policy

Fluctuating income can cause churn between Medicaid and marketplace coverage

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policy

Lawmakers to return to challenge of extending government funding past Sept. 30

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aca
policy

Despite standards, inclusion of essential hospitals and other providers not certain

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Says Bloomberg Government report underscores "uncertain and deeply troubling future for vulnerable patients"

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policy

Letter urges HHS to place a special emphasis on robust essential community provider participation

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policy

Get Covered America aims to raise awareness about plan choices under Affordable Care Act

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policy

Senate Conservatives Fund announced plans to actively campaign against Senate Minority Leader

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policy

Plans must meet standards for quality measures, improvement strategies, consumer information

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policy

Letter suggests security could be compromised by missed IT system deadlines

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policy

Effort will seek to increase understanding of low-income and minority populations’ experiences with exchanges

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policy

Document, released as frequently asked questions, indicates exchanges will use tax filings and Social Security data

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aca, cms
policy

Four cost-sharing levels - bronze, silver, gold, and platinum - available to consumers

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aca
policy

House votes to bar IRS from implementing Affordable Care Act and collecting taxes to fund the law

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policy

Information gathered will inform rulemaking for civil rights provision of the Affordable Care Act

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policy

Qualified health plans must offer coverage in 10 care categories, including ambulatory and emergency

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policy

Households with incomes between 100 and 400 percent of poverty line may qualify for tax credits

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aca
policy

Certain providers may receive drug discounts for uses outside indication associated with orphan designation

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policy

Analysis from the Kaiser Family Foundation Commission on Medicaid and the Uninsured found that 6.4 million people will miss out on insurance coverage if the 21 states not intending to expand their Medicaid program and the six undecided states do not implement the Medicaid expansion.

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policy

Money to 32 centers nationwide will be used to train more than 300 primary care residents

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policy

Series will examine structure, essential benefits, plan types, and other aspects of marketplaces

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aca
policy

Senate to consider changing existing rule requiring a filibuster-proof 60 votes for executive nominations

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policy

In letter, senators demand assurance that exchanges will be self-sustaining

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policy

Money distributed among six states: Colorado, Nevada, New Mexico, Vermont, Virginia, and West Virginia

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policy

Guidance addresses administration decision to delay the Affordable Care Act’s employer mandate

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policy

Health Affairs article questions availability of certain services to existing Medicaid enrollees

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policy

Urges CMS to incentivize states to target DSH at hospitals with high levels of uncompensated care and Medicaid patients

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aca, dsh

Payments even more important as prospects for full expansion dim

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policy

Finds nearly 80 percent of money spent on information technology systems and consulting

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aca, gao
policy

Administration responds to employer concerns about ability to comply with the requirement's complexities

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policy

Part of ACA, Children’s Health Insurance Reauthorization Act money for enrollment, renewal outreach

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policy

Rule states mandate for Medicaid coverage in 10 categories of essential health benefits

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policy

Comments express support for CHNAs, but ask IRS to grant dual-status organizations additional flexibility

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policy

Those without required minimum coverage to face penalties when filing federal income taxes

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aca
institute

Survey of literature and essential hospital experiences, supported by Aetna Foundation

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policy

Regulation finalizes provisions on how eligibility will be determined and hardship exemption certificates granted

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policy

Found that HHS awarded about $3.8 billion in exchange and rate review grants to states by late March 2013

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aca, hhs
policy

Change underscores member hospitals' importance to vulnerable patients, entire communities

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aca, gao
policy

States that opt out could lose $8.4 billion in federal funding, Health Affairs study finds

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policy

Definition in proposed regulation too narrow, essential hospitals say

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aca, irs
policy

Law mandates access to affordable insurance coverage by Jan. 1, 2014

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policy

Rule proposes implementation of the Affordable Care Act's Medicaid DSH cuts

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Renews call for Congress to delay Medicaid DSH cuts to allow time for informed, rational funding discussions

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policy

Letter offers issuers operational and technical guidance on how to successfully participate

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aca, cms
policy

Includes important changes to Medicaid and Medicare of interest to association members

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Notes appreciation of one-year DSH cut delay, but says provision comes at expense of funding later

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policy

Agency also releases FAQ on state-supplied premium assistance option

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policy

Lawmakers turn back governor's plan to accept expansion for three years

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policy

Rule finalizes HHS proposal to make advance payments that total the value of cost-sharing reductions

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aca, hhs
policy

Also releases report that details how rule affects mental health, substance abuse disorder benefits

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policy

Iowa, New Hampshire, Illinois, Arkansas among states pursing partnerships with federal government

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policy

Document addresses questions about federal medical assistance percentages

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policy

Administration official announced that the president would not include Medicaid cuts in 2014 budget

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policy

Report concludes that slowing Medicaid enrollment in 2012 reflected economic recovery

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policy

$1.5 billion in grants to 11 states aim to support affordable health insurance marketplaces

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policy

Commissioners vote unanimously to recommend 1 percent increases for fiscal year 2014

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Effort includes short videos, banner ads, and related website of research, position papers, and other resources

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Achieving reform's goal of broad coverage expansion must remain national priority, association says

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Analysis show impact of Supreme Court decision on hospitals and vulnerable patients

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Estimates show up to 10 million more people will remain uninsured than assumed when ACA passed

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Association says s many as 13.8 million are at risk of going uninsured in non-expansion states

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Decision could "could strand millions of our most disadvantaged people without access to basic health care coverage"

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institute

Insight from Boston Medical Center and Cambridge Health Alliance

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