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Increasing the Advantage of Medicare Advantage: Decoding President Trump’s Medicare Executive Order

On October 3, President Donald Trump signed an executive order (EO) focused on the Medicare program, titled, “Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors.” The EO offers expected political...more

Health Insurers Win Important Ruling on Payment of ACA Cost-Sharing Reductions (CSR)

A federal judge has ruled that health insurers under the Affordable Care Act are entitled to unpaid cost-sharing reduction (CSR) payments from the government. Insurers sued following the Trump administration’s October 2017...more

Federal Trial Court Strikes Down Entire Affordable Care Act

A federal district court in Fort Worth, Texas struck down the entire Affordable Care Act (ACA) last Friday in a ruling that’s prompting questions about whether its legal reasoning will withstand further scrutiny, and whether...more

Requiring a Price Tag in Drug Commercials: Furthering Consumer Transparency or Government Overreach?

The Trump Administration released a draft regulation published in the Federal Register on October 18, 2018, which proposes to require drug manufacturers to include a drug’s list price in its direct-to-consumer (DTC)...more

American Patients First: The Trump Administration's Blueprint to Lower Drug Prices

On Friday, May 11, 2018, President Trump delivered a highly anticipated speech addressing high drug prices and unveiling his administration’s blueprint to lower drug prices and reduce out-of-pocket costs. American Patients...more

ACA Litigation Update: Will More Insurers File CSR Lawsuits in 2018?

On October 12, 2017, the Trump administration announced that it would immediately stop making cost-sharing reduction (CSR) subsidy payments under Section 1402 of the Affordable Care Act (ACA). CSRs allowed — and in fact...more

ACA Risk Corridors Update: Trump Administration Releases 2016 Amounts, Paving the Way for Litigation Over Amounts Owed

On November 13, 2017, the Centers for Medicare & Medicaid Services (CMS) announced its Risk Corridors payment and charge amounts for the 2016 benefit year. This event is significant in that it both acknowledges and quantifies...more

A Step Toward ‘Replace' Without the ‘Repeal': The Trump Administration Re-Regulates Obamacare

On Friday, October 27, the Centers for Medicare and Medicaid Services (CMS) published its draft annual Proposed Notice of Benefits and Payment Parameters for Calendar Year 2019. This proposal follows on the heels of a Request...more

CSR Litigation Update: California Court Denies States' Motion for Preliminary Injunction – What Does This Mean for Health...

On October 25, 2017, in the case State of California v. Trump, the U.S. District Court for the Northern District of California denied a motion brought by 17 states seeking to order the Trump administration to resume...more

What Can Health Plans Do Now That the Trump Administration Has Stopped Making CSR Payments?

On October 12, 2017, the Trump administration announced that it will immediately stop making cost-sharing reduction (CSR) subsidy payments, which allow health insurers to defray out-of-pocket costs to insure low-income...more

What Can Health Plans Do if the Trump Administration Stops Making CSR Payments?

Amid assertions that the Affordable Care Act (ACA) should be allowed to fail, the Trump administration has indicated that it may stop paying subsidies that are central to ACA markets. At the core of these subsidies are...more

Two States Make Strong Statements About Their Obamacare Markets

Since last November’s election, the future of the Affordable Care Act (ACA) has been very much in doubt. It can be debated whether the health insurance exchanges (Exchanges) are in a “death spiral” as President Trump...more

Market Stabilization Rule: Assessing the Trump Administration's First ACA Market-Related Regulation

On April 13, 2017, the Centers for Medicare and Medicaid Services (CMS) finalized its Marketplace Stabilization Rule. This is the first Trump administration regulation that applies to the health insurance markets remade by...more

Side by Side Comparison – The Affordable Care Act and the American Health Care Act

The House plans to vote on the American Health Care Act (AHCA) on Thursday. While this is only the beginning of the political and legislative process for the so-called Obamacare repeal bill, it’s important for health care...more

House Moves Forward With Its ACA Repeal Bill – What You Need to Know

After months of intense debate, raucous town hall meetings and a fair share of leaks, House Republicans on Monday officially released their bill to repeal the Affordable Care Act (ACA) and to reform the Medicaid program—less...more

President Trump Props Up the ACA: A Summary of the New Administration's ACA Market Stabilization Regulation

On February 15, President Trump and new Department of Health and Human Services (HHS) Secretary Tom Price released their first proposed regulations addressing the Affordable Care Act (ACA). While remaining committed to...more

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