July 2017 OCC Advocacy News

Healthcare Reform Battle Moves to the Senate

On June 22, United States Senate Majority Leader Mitch McConnell (R-KY) unveiled the Senate Republican leadership healthcare reform bill – the Better Care Reconciliation Act (BCRA) of 2017. While the Senate bill is slightly more moderate than its House counterpart, the Senate version would still allow states and insurance companies to opt out of many of the ACA patient protections. For example, while the Senate bill bars states from using waivers to charge people with preexisting conditions higher rates, states could still allow insurance companies to drop providing coverage for certain essential health benefit categories such as maternity care, mental health services, or emergency care. In addition, the Senate bill would impose a six-month waiting period when purchasing insurance for individuals whose coverage lapsed for 63 days or more during the previous 12 months.

On June 26, the Congressional Budget Office (CBO) released its estimate of the spending and coverage impact of the BCRA. Among other things, CBO found that: the number of uninsured would increase by 22 million in 2026 relative to current law, for a total of 49 million; about 15 million more people would be uninsured in 2018, primarily due to elimination of the individual mandate; and that average premiums would increase in the non-group market prior to 2020 compared to current law; after that, premiums are projected to be relatively lower, largely due to the reduced actuarial value of the benchmark plans, which will cover a smaller share of health care services than under current law. CBO estimates that fewer low-income people will purchase plans starting in 2020, despite being eligible for premium tax credits, due to higher deductibles and copayments.

At the time of this report, Senate Republican leaders were continuing to revise the legislation in an effort to sway a number of GOP Senators who have formally come out against the bill.

August 30 MEDCAC Meeting on Bariatric Therapies

On August 30, 2017, the Centers for Medicare & Medicaid Services (CMS) will convene a panel of the Medicare Evidence Development &Coverage Advisory Committee (MEDCAC). The MEDCAC panel will examine the scientific evidence for health outcomes resulting from bariatric therapies, including open and laparoscopic surgeries and endoscopic procedures, in the Medicare population with obesity. This meeting will also identify evidence gaps related to treatment of obesity and related co-morbidities with these interventions and discuss efforts aimed at patient-centered care. To learn more about the August 30th MEDCAC meeting and how you can attend this public forum, click here.

Update on Treat and Reduce Obesity Act

Support continues to grow for S 830/HR 1953, the Treat and Reduce Obesity Act (TROA) of 2017, which was introduced by Senators Bill Cassidy (R-LA) and Tom Carper (D-DE) and Representatives Erik Paulsen (R-MN) and Ron Kind (DWI), respectively. At the time of this report, the bill had 91 cosponsors in the House and 7 in the Senate.

This critical legislation will provide Medicare beneficiaries with additional treatment tools to help seniors address their overweight and obesity. Specifically, TROA will provide the Centers for Medicare & Medicaid Services (CMS) with the authority to expand the Medicare benefit for intensive behavioral counseling by allowing additional types of healthcare providers to offer these services. The legislation would also allow CMS to expand Medicare Part D to provide coverage of FDA-approved prescription drugs for chronic weight management.

Update on National Obesity Care Week

OCC continues to urge legislators to support and cosponsor S. Res. 63/H. Res. 142, a congressional resolution, which would proclaim the week of October 29 through November 4, 2017, as National Obesity Care Week (NOCW). Efforts are also underway to secure resolutions in every state across the country to proclaim that week as “Obesity Care Week.”

OCAN and TROA Coalition Efforts to Educate CBO

OCAN and TROA Coalition leaders continued to prepare a presentation for the Congressional Budget Office (CBO) regarding the potential savings that could be achieved should Congress choose to enact the Treat and Reduce Obesity Act. The presentation will focus on a study by Wayne Su with IHS Market Research, which utilizes the firm’s Disease Prevention Microsimulation Model (DPMM). This model allows the firm to accurately account for the economic consequences of more than 30 conditions associated with obesity on an individual basis over multiple year time periods. Wayne Su also worked closely with James Baumgardner of Precision Health Economics who spent more than 20 years at CBO reaching the level of deputy assistant director.

This effort is being generously supported by Novo Nordisk, Inc and Eisai and will be integral to a meeting that the obesity community is hoping to have with CBO staff in August.