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Health care coverage and access focus of meetings on Capitol Hill

Health insurance marketplace stabilization and Medicare reimbursement disparity were the focus of a series of meetings last week in Washington, DC, between staff from Wisconsin’s delegation and the Wisconsin Medical Society, Aurora Health Care and Marshfield Clinic Health System.

Lisa Davidson, vice president of advocacy and membership; Rachel Roller, senior vice president of government and community relations for Aurora, and Brent Miller, director of federal government relations for Marshfield Clinic met with staff from the offices of U.S. Reps. Sean Duffy, Mike Gallagher and Glenn Grothman; U.S. Sens. Tammy Baldwin and Ron Johnson, as well as Sen. Charles Grassley, R-Iowa, U.S. Senate Judiciary Committee chair.

The meetings coincided with the release of the long-awaited bipartisan marketplace stabilization proposal by Sen. Lamar Alexander, R-Tennessee, Senate Health Committee Chair; and Sen. Patty Murray, D-Washington, ranking member of the Health Committee. This proposal would extend the Cost Sharing Reductions in the Affordable Care Act for two years and provide greater flexibility to states offering new approaches on health care. The response to the proposal has been lukewarm, and a new proposal was introduced this week by Sen. Orrin Hatch, R-Utah, the Senate Finance Committee chair, and U.S. Rep. Kevin Brady, R-Texas. Similar to the bipartisan Senate bill, the new measure would resume the federal payments to insurers for two years but also would add new elements, such as temporarily eliminating both the individual and employer mandates.

The competing proposals demonstrate there is still no consensus on the next steps in health care reform, and many Congressional leaders are looking to table the topic in order to focus on tax reform. Meanwhile, the 2018 open enrollment period runs November 1 through December 15. Given the different messages emerging, patients may be confused about their coverage options and cost sharing. Information is available at healthcare.gov, as well as the Covering Wisconsin website. Of additional note, patients will qualify for a special enrollment period if they have a plan leaving the Marketplace (Molina, Tradition, Anthem). They will need to put in their application that they are losing their coverage as of 12/31/2017 and then they will qualify for a Special Enrollment Period through 03/03/2017. This will also allow people who are auto enrolled in a plan to change it after January 1.

In addition to discussions about marketplace stabilization, Davidson, Roller and Miller also continued efforts to garner support for legislation that would resolve the geographic disparity in physician reimbursement for Medicare services created by the Geographic Pricing Cost Index (GPCI). This issue requires Congressional action before the end of the year, and both the Wisconsin Medical Society and the Iowa Medical Society will continue to press for this to be included in a broader legislative package by December.

Contact Lisa Davidson, vice president of advocacy and membership, with questions.

Back to October 26, 2017 Medigram