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D. C. Week: GOP-Led Congress Scuttles Individual Mandate

D. C. Week: GOP-Led Congress Scuttles Individual Mandate

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WASHINGTON — With the holiday recess looming, Congress raced to pass a tax bill to kill the individual mandate and a funding bill to save the Children’s Health Insurance Program (CHIP) — for now.

Congress Passes Tax Bill, Axes Obamacare Mandate

The House of Representatives approved the landmark GOP tax reform bill that eliminates, starting in 2019, a key provision of the Affordable Care Act (ACA) — the penalty for individuals not buying health insurance.

An earlier version had passed the House on Tuesday, but it turned out to violate Senate rules and had to be tweaked. The altered bill passed the Senate earlier on Wednesday and the House voted again in support. The final tally in the re-vote was 224-201, with 12 Republicans voting against the measure and no Democrats voting in favor.

Experts from both left and right on the political spectrum have predicted that ending the so-called individual mandate will lead millions to drop health insurance, though they disagree on whether that will be good or bad for the country.

At bottom, the issue is how the per-capita $10,000 cost of healthcare in the U.S. should be paid for — and in particular, to what extent those with lesser projected healthcare needs should help subsidize those who are needier.

House, Senate Pass Funding Bill with CHIP Provision

The House and Senate each passed a funding bill Thursday that would keep the federal government running until Jan. 19 and provide $2.85 billion to prop up the Children’s Health Insurance Program (CHIP) for a few months.

The House bill passed on a vote of 231-188, while the Senate approved the bill by a margin of 66-32. President Trump signed the bill on Friday before heading to Florida for the holidays.

Although the CHIP funds were included in the bill, some experts say that a short-term patch may not be enough. “It is our understanding that the intent is to get states through at least February, but we have not arrived at a final conclusion about its adequacy,” said Tricia Brooks, senior fellow at Georgetown University’s Center for Children and Families. “That said, this continuing to kick the can down the road on CHIP is hugely problematic.”

Gene Therapy for Inherited Retinal Dystrophy Gets FDA Clearance

The first gene therapy for a specific mutation leading to disease was approved by the FDA, the agency announced Tuesday.

Spark Therapeutics’ voretigene neparvovec-rzyl (Luxturna) is now the first gene therapy approved to treat those with confirmed biallelic RPE65 mutation-associated retinal dystrophy, a type of Leber congenital amaurosis. This is a rare disease affecting approximately 1,000-2,000 patients in the U.S. A loss of vision often begins during childhood, with certain patients turning completely blind over time.

The therapy uses an engineered adeno-associated virus as vector to deliver a working copy of the RPE65 gene directly to retinal cells. It is administered via subretinal injection by a surgeon. Each eye must be treated at least 6 days apart.

GOP Senators: No Obamacare Fixes in 2017

Republican senators are sending two bills intended to help stabilize the individual insurance market to the sidelines until next year.

“Rather than considering a broad year-end funding agreement as we expected, it has become clear that Congress will only be able to pass another short-term extension to prevent a government shutdown and to continue a few essential programs,” said Senators Lamar Alexander (R-Tenn.) and Susan Collins (R-Maine) in a joint press statement.

Fearing the spectre of a shutdown, the two senators asked Majority Leader Mitch McConnell (R-Ky.) to delay a vote on the Alexander-Murray bill and the Collins-Nelson bill.

Medicare Payment Advisors OK Two New APM Models

Two new payment models, a capitated model for primary care and one for end-stage renal disease (ESRD), made their way to federal healthcare officials this week.

The Physician-focused Payment Technical Advisory Committee (PTAC), a group of policy experts and physicians tasked with identifying new Medicare payment models that reward value rather than volume, recommended the two proposals to the U.S. Department of Health and Human Services (HHS).

An episode payment model submitted by the Renal Physicians Association (RPA) targets the first 6 months of dialysis for ESRD patients, and was given a full recommendation.

The global or capitated payment model from the American Academy of Family Physicians (AAFP) was recommended for limited-scale testing.While PTAC’s recommendations will be sent to HHS, the office of HHS secretary remains vacant. Former HHS Secretary Tom Price, MD, resigned in September, and President Trump named Alex Azar, JD, as a replacement. Azar has yet to be confirmed.

Next Week

Congress is on recess. Happy holidays.


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