Budget Blog

June 17, 2021 - Health Care Issues Update

By Stacey Mazer posted 06-17-2021 02:12 PM

  

Supreme Court Upholds the Affordable Care Act

The U. S. Supreme Court in a 7 to 2 decision today, upheld the Affordable Care Act (ACA), leaving the entire law intact.  In the ruling in the case of California v. Texas, the court ruled that the plaintiffs had not suffered the sort of direct injury that gave them standing to sue. The court heard oral arguments in the case of California V. Texas, the constitutional challenge to the ACA, on November 10, 2020.  In 2017, Congress reduced the penalty for not purchasing health insurance (the individual mandate) to zero in the Tax Cuts and Jobs Act and the question before the Supreme Court was if this action would make the individual mandate unconstitutional and if so, is the individual mandate severable from the rest of the law. The court did not address the larger issues in the case about whether the law could stand without a provision that initially required most Americans to obtain insurance or pay a penalty.

 

MACPAC Releases June Report to Congress

The Medicaid and CHIP Payment and Access Commission (MACPAC) released its June 2021 Report to Congress and recommends that Congress take measures to address the effect of high-cost specialty drugs on state Medicaid programs and take steps that would improve access to mental health services for adults and children and adolescents enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). The report also addresses integration of physical and behavioral health care through electronic health records, the non-emergency transportation benefit in Medicaid, and state strategies for integrating care for people who are dually eligible for Medicaid and Medicare.

 

HHS Provides $424.7 Million to Rural Health Clinics for Testing and Mitigation

The Department of Health and Human Services (HHS) provided $424.7 million in American Rescue Plan Act (ARPA) of 2021 funding to 4,247 Rural Health Clinics for COVID-19 testing and mitigation. Later this summer, the department will issue up to $35.3 million in additional funding to clinics that meet eligibility requirements. A state-by-state funding breakdown can be found here.

 

HHS Revises Reporting Requirements for Provider Relief Fund Payments

The Department of Health and Human Services released revised reporting requirements for recipients of Provider Relief Fund (PRF) payments. The revised requirements expand the amount of time providers will have to report information, reduce burdens on smaller providers, and extend key deadlines for expending PRF payments for recipients who received payments after June 30, 2020. The revised reporting requirements will be applicable to providers who received one or more payments exceeding, in the aggregate, $10,000 from any distribution. The requirements are available here


HHS Proposes to Rescind Final Rule on Insulin and Injectable Epinephrine Costs at Health Centers

The Department of Health and Human Services (HHS) proposes to rescind the final rule, Implementation of Executive Order on Access to Affordable Life-Saving Medications, that was published December 23, 2020 in the Federal Register. According to HHS, the final rule would have required health centers to create and sustain new practices necessary to determine patients’ eligibility to receive certain drugs at or below the discounted price paid by the health center or subgrantees under the 340B Program, resulting in reduced resources available to support critical services to their patients. The Biden Administration delayed the effective date of the rule to July 20 to give officials more opportunity to review the rule and ensure it would not impede immediate priority work of responding to the pandemic.

 

Health Care Policy Trends from the 2021 State Legislative Session

This brief from Manatt Health summarizes actions during state legislative sessions to date in health care. State lawmakers considered and passed a wide range of health care legislation, including coverage expansions as well as strategies to contain prescription drug costs, address health care affordability, advance and expand telehealth, and ensure behavioral health care access.