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CMS wants ACOs to take on more risk. Here's how.

August 13, 2018

CMS is proposing replacing the current Medicare Shared Savings Program tracks with two options that accelerate the pathway for accountable care organizations to transition to two-sided risk models.

CMS proposes methodology to calculate exchange insurers' 2018 risk-adjustment payments

August 13, 2018

CMS says under a newly proposed rule it intends "to adopt the risk adjustment methodology that HHS previously established for the 2018 benefit year which uses the statewide average premium in the payment transfer formula."

Senate Democrats want to rescind Trump's short-term health plan rule. Here's their plan.

August 3, 2018

Senate Democrats plan to introduce a resolution of disapproval that would repeal the Trump administration's final rule on short-term health plans, which they argue "would raise premiums and reduce plan choices for individuals with pre-existing conditions."

Lawsuit claims Trump admin is violating Constitution by 'undermining' ACA

August 2, 2018

Four cities in a lawsuit claim that President Trump and his administration are violating the Constitution by not ensuring the Affordable Care Act is "faithfully executed."

HHS just finalized Trump's rule on short-term health plans. Here's what it does.

August 1, 2018

The Trump administration's final rule will again allow insurers to sell short-term health plans that are valid for up to 12 months and will allow enrollees to renew the plans for up to three years.

KFF: US residents who don't get subsidies are dropping individual health plans

August 1, 2018

New Kaiser Family Foundation data show total enrollment in individual health plans decreased by about 12% from the first quarter of 2017 to the first quarter of 2018—and all of the decline occurred among individuals who had been enrolled in individual health plans that did not qualify for the Affordable Care Act's subsidies.

Sanders' 'Medicare for All' bill would cost $32.6T—and change who is footing the bill

July 31, 2018

An analysis from the Mercatus Center at George Mason University estimates that Sen. Bernie Sanders' (I-Vt.) so-called "Medicare for All" proposal would cost about $32.6 trillion in new spending over the first decade—which observers say is slightly lower than what the United States is projected to spend on health care over the next ten years under its current health care system, though the proposal would shift who pays for the costs.

CMS approves reinsurance programs in two more states

July 31, 2018

Wisconsin Gov. Scott Walker says, under his state's reinsurance program, premiums for individual health plans in the state are expected to be 11% lower than they would have been if the state was not able to implement the program, while Maine officials project that premiums for individual health plans in the state will be about 9% lower than they would have been without its new reinsurance program.

Why CMS lowered star ratings for nearly 1.4K nursing homes

July 30, 2018

CMS says 1,387 of the 15,616 nursing homes in the United States either did not staff the adequate number of registered nurses (RNs) required by the federal government or they failed to supply payroll data that verified they had the required number of RNs.

Why these states are suing the Trump admin over its rule to expand association health plans

July 27, 2018

Democratic attorneys general from 11 states and the District of Columbia are challenging the Trump administration's final rule to expand the types of small employers and self-employed individuals that are permitted to form so-called "association health plans."

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