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Healthcare Reform News Updates
Stay up-to-date on Healthcare Reform.
Below is a summary of recent events to help you stay current on healthcare reform news all in one place. To make your voice heard on these issues, visit OurCareBill.org, a non-partisan movement that lets you share your opinion on healthcare legislation with friends, family, and even Washington D.C.!
Healthcare Reform News Update for August 17, 2022
President Biden Signs Inflation Reduction Act
President Joe Biden signed the Inflation Reduction Act into law on Tuesday. The legislation will impact U.S. healthcare in a number of ways.
- The federal government will be able to negotiate prices for some Medicare prescription drugs. In 2026, Medicare will negotiate the price of 10 drugs; in 2027, 15 more drugs will be added; in 2029, 20 additional drugs will be a part of the process. The negotiations will first apply to drugs covered under Medicare Part D, and later expand to Medicare Part B.
- The cost of insulin will be capped at $35/month for people on Medicare starting in 2023.
- Out-of-pocket spending on prescription drugs will be capped at $2,000 for people on Medicare Part D starting in 2025.
- Affordable Care Act (ACA) enhanced premium subsidies will be extended until 2025.
- If drug companies increase their prices faster than the rate of inflation, they will be penalized starting in 2024.
FDA Expands Access to Hearing Aids
Some hearing aids will be available for purchase over-the-counter (OTC), according to a final rule issued by the U.S. Food and Drug Administration (FDA) on Tuesday.
The rule creates a new category for OTC hearing aids, and it will apply to air-conduction devices intended for people age 18 or older with mild or moderate hearing loss. Consumers will be able to buy them without a medical exam, prescription, or fitting by an audiologist.
The final rule is scheduled to take effect October 15, 2022.
Healthcare Reform News Update for August 4, 2022
Survey: 72% of Employed Adults Desire Health Insurance Guidance
A large majority of employed adults in the U.S. are unclear on various aspects of health insurance and wish someone would tell them what the ideal health plan for their situation is, according to a new survey by Justworks and Harris Poll. The study found that while many employed adults claim to be knowledgeable on health insurance, they may misunderstand certain aspects of it.
The findings also included:
- 75% of employed adults believe or are not sure if they can retain Flexible Spending Accounts (FSAs) even if they leave their current job.
- 63% of employed adults believe or are not sure if they could decide to change their health insurance plan or dependent coverage mid-year after enrolling.
- 59% of employed adults are not aware that they can only enroll in a Health Savings Account (HSA) if they are enrolled in a High-Deductible Health Plan (HDHP).
- 54% of employed adults believe or are not sure if a deductible is how much your insurance will pay for various health services.
Healthcare Reform News Update for August 3, 2022
U.S. Uninsured Rate Hits 8% Record-Low
The percentage of uninsured people in the United States reached an all-time low of 8% in early 2022, according to a new report from the Department of Health and Human Services (HHS). The study found that around 5.2 million people, including 4.1 million adults (ages 18-64) and 1 million children (ages 0-17), have acquired health coverage since 2020.
The findings also included:
- About 5.4% of adults reported having Marketplace coverage in early 2022 compared to 4.4% in 2020.
- Uninsured rates among adults decreased from 14.5% in late 2020 to 11.8% in early 2022.
- Uninsured rates among children decreased from 6.4% in late 2020 to 3.7% in early 2022.
- Changes in uninsured rates from 2020 to 2022 were the largest among people with incomes below 100% of the Federal Poverty Level (FPL) and between 200% and 400% FPL.
Healthcare Reform News Update for July 1, 2022
California Provides Health Coverage Access to Undocumented Immigrants
The state of California expanded healthcare access to low-income California residents aged 26 to 49, regardless of their immigration status, after Gov. Gavin Newsom signed a new budget into law on Thursday. It is the only state in the U.S. to provide coverage at no cost to undocumented immigrants.
Approximately 764,000 people will qualify for coverage. The program will go into effect in 2024.
Healthcare Reform News Update for June 29, 2022
Study: Health Insurance Is Americans’ Third Highest Living Expense
Approximately 10.69% of the average American’s annual salary goes towards health insurance premiums, behind childcare (18.41%) and rent (28.24%), according to a new study by NiceRX. The average annual cost of health insurance across all 50 states is $6,487.20.
The study also found that the highest percentage of salaries goes towards health insurance in West Virginia (20.85%, average cost of health insurance of $9,972), followed by Louisiana (16.05%, $8,736), and Vermont (15.28%, $9,120).
Healthcare Reform News Update for June 23, 2022
HHS Announces New Lower Premium Colorado Health Plan
The U.S Department of Health and Human Services (HHS) approved a state innovation waiver from Colorado, creating a new state-based new health coverage option. Colorado Option health insurance plans will be required to lower premiums by 5% in 2023, by 10% in 2024, and by 15% in 2025.
Additionally, the plans provide coverage for Affordable Care Act (ACA) essential health benefits, primary care, mental health, behavioral health, and prenatal visits. The state estimates that around 32,000 Coloradans will get health insurance by 2027 as a result of this plan.
The Colorado Option will become available to state residents who apply for health insurance on the individual market in 2023.
Healthcare Reform News Update for June 22, 2022
Supreme Court Sides With Health Plan
In a 7-2 decision, the Supreme Court ruled in favor of an employer-sponsored group health plan and against a kidney dialysis provider in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc.
The case involved whether the health policy’s coverage differentiated between individuals with and without End-Stage Renal Disease (ESRD), a potential violation of the Medicare Secondary Payer statue.
The Court found that there was no such violation, and that the plan doesn’t discriminate against patients with ESRD.
Healthcare Reform News Update for June 16, 2022
Survey: 4 in 10 U.S. Adults Have Health Care Debt
One hundred million people in America – or four in 10 adults – have medical debt, according to a new investigation by the Kaiser Family Foundation. That means approximately 41% of adults have debt caused by medical or dental bills.
The findings also included:
- Approximately 1 in 5 adults with healthcare debt believe they’ll never pay it off.
- Half of U.S. adults wouldn’t be able to pay an unexpected $500 healthcare bill.
- One in 7 adults with healthcare debt said they’ve been denied provider care because of unpaid bills.
- 24% of adults say they have medical bills past due or that they’re unable to pay.
- One third of adults with health care debt owe less than $1,000.
Healthcare Reform News Update for May 20, 2022
2020 CMS Medicaid Drug Price Rebate Rule Struck Down
A December 2020 rule finalized by the Centers for Medicare and Medicaid Services (CMS) exceeds the agency’s authority, according to a D.C. federal judge’s ruling. The government intended to require drug companies to use available coupons when calculating the “best price” for a drug.
The Pharmaceutical Research & Manufacturers of America successfully challenged the CMS regulation, claiming the policy was outside of federal Medicaid rebate law.
Healthcare Reform News Update for May 17, 2022
Research: Private Insurance Plans Paid Hospitals 224% More Than Medicare Rates in 2020
Employers and private insurance companies paid 224% more than Medicare would have paid in 2020 for inpatient and outpatient services, according to new research by RAND. This is a 23% decrease from the 2018 study’s percentage.
The findings also included:
- Hawaii, Arkansas, and Washington had relative rates that are about 175% of Medicare rates.
- Florida, West Virginia, and South Carolina had relative rates that were at or above 310% of Medicare rates.
- If the employer and private plans were paying Medicare rates for the same services, they would have saved $49.9 billion.
Healthcare Reform News Update for May 13, 2022
Research: Almost 41 Million Americans Received Mental Health Support Through Employer Coverage in 2020
Approximately 41 million people, or 1 in 4 Americans, received mental health support through their employer coverage in 2020, according to new research by AHIP.
The findings also included:
- Six million children received mental health services and treatment through a parent or guardian’s employer plan in 2020.
- Nearly 40% of psychotherapy visits were held virtually via a telehealth appointment in 2020, a 100-fold increase from 2019.
- Patients spent less than $15 in out-of-pocket expenses for most mental health prescription drugs.
Healthcare Reform News Update for May 11, 2022
Study: American Medical Debt Decreases
The percent of adults under 65 with medical debt dropped from 23.6% in March 2019 to 16.8% in April 2021, according to a new study by the Urban Institute. The report also found that self-reported medical debt and medical debt in collections declined across adults in all age ranges since the start of the pandemic.
The findings also included:
- The number of adults under 65 with difficulties paying medical bills in the past year decreased from 17% to 12.2%.
- The number of adults with credit records who have medical debt in collections decreased from 15.3% in February 2020 to 13.9% in August 2021.
- Medical debt decreased across racial and ethnic groups.
Healthcare Reform News Update for May 5, 2022
30 Million People Uninsured in 2021
Approximately 30 million people across all age ranges were uninsured in 2021 according to a new survey on health coverage conducted by the National Center for Health Statistics.
The findings also included:
- In 2021, across all age ranges, 9.2% were uninsured, 39.5% had public coverage, and 60.4% had private coverage.
- In 2021, 24.5% of adults aged 18-64 with family incomes less than 100% of the Federal Poverty Level (FPL) were uninsured; 23.7% with family incomes from 100% to less than 200% FPL were uninsured; and 8.4% of those with family incomes at or above 200% FPL were uninsured.
- The amount of people under 65 with exchange-based coverage increased to 4.3% in 2021 from 3.7% in 2019.
Healthcare Reform News Update for May 2, 2022
More Than 35 Million People Have ACA Coverage in Early 2022
A record number of people, more than 35 million, have health coverage related to the Affordable Care Act (ACA) as of early this year, according to a new federal report from the Department of Health and Human Services (HHS).
The report also states:
- The uninsured rate for the U.S. population decreased 1.5%, from 10.3% in Q4 2020 to 8.8% in Q4 2021.
- People with incomes above 200% of the Federal Poverty Level (FPL) have the lowest uninsured rate, which decreased from 7.6% to 6.4% in 2021.
- 14.5 million people signed up for marketplace health coverage during the 2022 Open Enrollment Period.
Healthcare Reform News Update for April 14, 2022
Report: Average ACA Benchmark Premiums Declined by 1.8% in 2022
Average Affordable Care Act (ACA) benchmark premiums fell 1.8% between 2021 and 2022, according to a new report from the Urban Institute. It was the third straight year that average benchmark premiums fell. The analysis also found that 32 states had benchmark premium reductions.
Healthcare Reform News Update for April 5, 2022
President Biden Signs Executive Order to Expand Health Coverage
President Joe Biden signed an executive order on Tuesday that directs federal agencies to continue expanding health coverage for Americans.
The order includes the following instructions:
- Make it easier for people to apply for and keep health coverage.
- Help people understand their coverage options.
- Expand coverage eligibility and lower costs for Americans with Affordable Care Act (ACA), Medicare, or Medicaid plans.
- Reduce medical debt for Americans.
Healthcare Reform News Update for March 23, 2022
HHS Analyzes 2022 Open Enrollment Period
The Department of Health and Human Services (HHS) released a new report featuring data on health plans chosen by consumers during the 2022 Open Enrollment Period, which occurred from November 1, 2021, through January 15, 2022, in most states.
Findings from the report include:
- 5 million more people signed up for coverage during the 2022 Open Enrollment Period vs. 2021’s Open Enrollment Period, a 21% increase.
- 3 million people enrolled in health coverage in the 33 states on the federal exchange.
- 3 million people applied for health coverage in the 18 state-based marketplaces.
- 20% more new people signed up for coverage during the 2022 Open Enrollment Period vs. 2021’s Open Enrollment Period, an increase from 2.5 million to 3.1 million.
- The average monthly 2022 premium for enrollees on the federal exchange was $111 after subsidies from the American Rescue Plan Act.
Healthcare Reform News Update for March 21, 2022
Medical Debt To Be Eliminated From U.S. Credit Reports
Credit-reporting firms Equifax, Experian, and Transunion will update their processes for reporting medical debt starting in July 2022.
This summer, these companies will excise medical debt that was paid after it had been sent to collections from consumer reports. In 2023, they’ll take off unpaid medical debts that are less than $500.
The changes to the credit-reporting could make it easier for Americans to borrow and qualify for loans.
A March 2022 Health System Tracker study found that 23 million people owe significant medical debt, with 1 in 10 adults across the U.S. owing at least $250 in medical debt.
Healthcare Reform News Update for February 23, 2022
Covered California Appoints New Chief Executive Officer
Jessica Altman, the insurance commissioner for the Pennsylvania Insurance Department, has been selected as the new Chief Executive Officer for Covered California. The appointment comes after Covered California executive director Peter Lee announced his departure in September 2021.
Altman helmed the launch of “Pennie,” Pennsylvania’s state-based health insurance marketplace, and served in a variety of positions with the National Association of Insurance Commissioners.
Altman will begin the role in March 2022.
Healthcare Reform News Update for February 9, 2022
Idaho Expands Heath Insurance Benefits for Teachers
A new law in Idaho brings health insurance for educators in line with that of state employees. The state will increase its contribution towards teacher health insurance premiums by around $4,000 per teacher.
The legislation establishes a fund for school districts that opt to join the state’s health plan.
Previously, Idaho put $8,400 per year towards teacher health insurance expenses, as compared to $12,500 for legislator health insurance expenses.
Healthcare Reform News Update for February 2, 2022
New York Extends 2022 Open Enrollment Deadline
New York has extended its Open Enrollment Period for residents to apply for Affordable Care Act (ACA) health coverage until February 15, 2022. Coverage will begin on March 1, 2022 for New Yorkers who enroll in an ACA plan between February 1 and February 15, 2022.
Healthcare Reform News Update for January 27, 2022
White House: 14.5 Million Americans Sign Up for ACA Plans
Since November 1, 2021, a record 14.5 million Americans have signed up for Affordable Care Act (ACA) health plans, according to a new statement from the White House.
The federal government also revealed new data from the Centers for Disease Control and Prevention (CDC), which indicates that 1 in 7 uninsured Americans found coverage from the end of 2020 through September 2021.
Federal Open Enrollment ended on January 15, but California, Kentucky, New Jersey, New York, Rhode Island, and Washington, D.C. residents have until January 31 to apply for ACA coverage, while Maryland residents have until February 28.
Healthcare Reform News Update for January 25, 2022
Kentucky, Maryland Extend 2022 Open Enrollment Periods
Kentucky has extended its Open Enrollment Period for residents to apply for Affordable Care Act (ACA) health coverage until January 31, 2022. Coverage will begin on March 1, 2022 for Kentucky residents who enroll in an ACA plan between January 16 and January 31, 2022.
Maryland has also extended its Open Enrollment Period through February 28, 2022. Residents who enroll by January 31 will have coverage beginning on February 1, 2022; for residents who enroll during February, coverage will start March 1, 2022.
Recent reports of consumer technical difficulties and a December 2021 severe weather natural disaster have also led to an extension of Kentucky’s Special Enrollment Period until January 31, 2022. Residents affected by either circumstance can obtain coverage that begins retroactively on January 1, 2022.
Healthcare Reform News Update for January 21, 2022
Mark Cuban Starts Online Prescription Drug Company
Dallas Mavericks owner, “Shark Tank” investor, and entrepreneur Mark Cuban has launched the Cost Plus Drug Company, an online pharmacy that seeks to lower drug prices by negotiating directly with manufacturers and skipping the middleman in the process.
The business will sell generic medications to consumers with a 15% markup and $3 pharmacist fee.
Healthcare Reform News Update for January 3, 2022
New Mexico Adds 2.75% Surtax on Health Insurance Premiums
A bill approved by the New Mexico legislature in 2021 has gone into effect, increasing a health insurance surtax on premiums to 2.75% for state residents as of January 1, 2022. Previously, the surtax was 1%.
The intent of the higher surtax is to help fund health insurance offerings for lower-income New Mexicans beginning in 2023. Some legislators fear that the insurance companies paying the surtax will pass the expense on to businesses and consumers.