President Scraps Marketplace CSRs- but the Sky Isn’t Falling

Late last week the President announced that HHS won’t make any more subsidy payments to insurance companies that offer plans on the Marketplace.

The subsidy payments (cost-sharing reductions or CSRs) are payments to insurers to reimburse them for discounts they give policyholders with incomes under 250% of the federal poverty line (about $30,000 in income a year) for an individual. The discounts shield lower-income customers (that buy insurance in the Marketplace) from out-of-pocket expenses, like deductibles or copays.

Cutting off these payments to insurers doesn’t mean the policyholders won’t get help. The ACA and insurance company contracts require those discounts be granted by Marketplace insurers.

The decision does mean that insurance companies on the Marketplace will have to figure out how to recover the money they were promised under the ACA.  The two Marketplace insurers in AZ (Blue Cross Blue Shield and Centene Corp’s Ambetter by HealthNet) announced that they’ll have stable premiums next year. They apparently had already assumed that the CSRs wouldn’t be paid because they don’t expect this decision to impact their 2018 rates.

Remember, the cost-sharing reductions are separate from the tax credit subsidies (called advance premium tax credits) that help millions of people pay their premiums.  The premium tax credit is a refundable credit that helps eligible individuals and families cover the premiums for their health insurance purchased through the Health Insurance Marketplace.

People with income between 100-400% of the Federal Poverty Level still qualify for the tax credits, which are calculated depending on income, and help (and will continue to help) families pay their Marketplace health insurance premiums.


Integrated Health Plan for Children in AZ Foster Care?

AHCCCS & Mercer are conducting an analysis of an integrated health plan for children/youth involved in Arizona’s foster care system (e.g. a plan that would cover both acute care and behavioral health services).

Mercer is holding a series of stakeholder sessions – two with providers and two with family members (foster, adoptive, kinship and biological) and youth/young adults currently or previously involved with Arizona’s foster care system to solicit input about the concept. The goal is to gather feedback about the future of AZs health care system for kids in the foster care system

Tuesday, October 24

1 N. MacDonald, 3rd floor Mesa, AZ

Providers:                              10:00 a.m. – 11:30 a.m.

Family/Youth/ Young Adults:   3:30 p.m. – 5:00 p.m.

Wednesday, October 25

400 W. Congress Room 444, 4th floor Tucson, AZ

Providers:                              10:00 a.m. – 11:30 a.m.

Family/Youth/ Young Adults:   3:30 p.m. – 5:00 p.m.

To attend any session by phone, call 1-877-820-7831 and use guest code 679145.


200 Stories: Tucson Healthcare Forum Sunday, October 29

·        Are you concerned about the future of healthcare and health insurance?

·        What will the Affordable Care Act, Medicare and Medicaid look like in the future?

·        Have you had problems accessing affordable medical care, insurance, or medication?

Legislators from Legislative Districts 9 and 10 are hosting healthcare a forum in Tucson on Sunday, October 29.  Senators David Bradley & Steve Farley & Reps. Kirsten Engel, Randy Friese & Pamela Powers Hannley will be there to listen to your concerns and hear your stories about Medicare, Medicaid, the Affordable Care Act, insurance, medical care, drugs, cost and related topics.

Sunday, October 29, 2017 1:30 – 3:30 p.m. Unitarian Universalist Church of Tucson 4831 E. 22nd St.  Here’s the Eventbrite Link to sign up.


WV Medicaid Waiver Could Bode Well for AZ Opioid Treatment

CMS recently approved West Virginia’s proposal to expand Medicaid coverage for substance abuse treatment by lifting a restriction on Medicaid payments for inpatient treatment at large residential facilities. This waiver also allows the state Medicaid program to cover naloxone, peer support services, and methadone.

This approval could be important for Arizona because it signals that CMS is receptive to these kinds of waiver requests- and a similar recommendation was made in ADHS’ September 5 Opioid Action Plan.


2018 Public Health Law Conference

The Network for Public Health Law will be holding next year’s national Public Health Law Conference in Phoenix on October 4 – 6, 2018. They’re already accepting abstracts for panels and individual presentations.

They’re soliciting abstracts related to this year’s Conference theme,Health Justice: Empowering Public Health and Advancing Health Equity, as well as abstracts on other timely public health law topics. Deadline for abstract submission is December 15, 2017.  Here’s theSave-the-Date and Call for Abstracts.


Retail Marijuana & Opioid-Related Deaths in Colorado, 2000–2015

Researchers in Colorado did an interesting study recently that was published in the November American Journal of Public Health. They looked to see whether Colorado’s legalization of recreational cannabis had an impact on deaths from opioids in CO.

They used what’s called an interrupted time-series design (2000–2015) to compare monthly opioid-related deaths before and after Colorado stores began selling retail marijuana.  creational cannabis.

Interestingly, they found that opioid related deaths were reduced by 0.7 per month after retail sales of marijuana became legal. This is not a huge reduction by any means, but it was statistically significant.  Here’s what the authors described in the section labeled Public Health Implications:

“Although we found an apparent public health benefit in a reduction in opioid-related deaths following recreational cannabis legalization in Colorado, we note that expanded legalized cannabis use is also associated with significant potential harms. For policymakers to balance the potential beneficial and deleterious effects of these laws, researchers must continue to examine the full range of health effects in both clinic- and population-level research.”