96 letters of support | OIC takes on parity, adequacy (part 2) | Halbig, John Roberts and the Voting Rights Act

The dog days of August are almost here. With Puget Sound close to its longest heat wave on record, I’m hopeful that you’ll spend less time worrying about health care markets and policy, and more time outdoors. But, if you find yourself looking at a screen rather than a scene, we’ve got a few things you might keep an eye on.

DJ 5 things updated

1. Healthcare: broken, like “banking, energy, transit”

From a recent article: “Obama called the 2008 recession ‘the worst since the Great Depression.’ It wasn’t; by most measures – jobs, wages, exports – it was the worst since 1982. The valid comparison to the 1930s is that now as then all our vital institutions are broken. Our healthcare, banking, energy and transit systems are badly broken. Our defense policy is obsolete. Politics is a cesspool. Oddly, the one system working relatively well, public education, is the object of our only sustained reform effort.”

The article has colleagues from both sides of the political spectrum in the NY-DC media and policy worlds nodding heads. When the problems in healthcare are equated to “banking, energy and transit” by reputable opinion makers, that is a level of distrust and anger towards healthcare that the system may not be able to overcome on its own (ie: don’t be surprised by more major healthcare legislation if either party takes over both the White House and Congress).

2. Action on two key OIC draft rules: parity and adequacy

In the last week, the OIC has released two notices of possible rule making activity for review and comment.  One is an update to the provider network adequacy rules from last April.  The announcement is relatively broad, which comes as a bit of surprise to some.  Given the work in the spring on the updated provider network rule – which drew more comments than any other OIC rule in recent memory – one could have assumed this next rule would be narrow in scope.  That’s not the case, however, suggesting that the Commissioner could re-open parts of the earlier rule to make changes as necessary.

The other activity is an exposure draft of a potential new rule on mental health parity.  It was distributed last week for stakeholder review and comment.  It’s a complex subject area with a host of opportunities for missteps.  The OIC, however, has taken two years in the development of the draft rule, and is actively soliciting feedback and review from interested parties.

3. ICYMI: Inland Northwest Topical Agenda is out

Just in case you missed it, we released the Topical Agenda for our Inland Northwest State of Reform Health Policy Conference in Spokane – now just under two months away!

Our Convening Panel has been and continues to be a big help with the agenda.  Putting these events together are organic, iterative processes which rely in large part on stakeholder engagement.  So, if you have thoughts about speakers or how best to frame some of the topics we’re putting together, drop me a note.  I always appreciate your feedback!

4. 96 letters of support for state’s $92m ask of CMS

Gov. Inslee announced the submission of the State Innovation Plan grant application to CMS.  In the complete application, the state asks for $92.4 million and expects it will generate $1.05 billion in cost savings over four years.

Another impressive number is 96:  that’s the number of organizations which submitted letters of support, which were included in the application materials to CMS.

5. Halbig: John Roberts has changed his mind before

No one knows what the Supreme Court will do.  But one thing many expect it to do is to take up the Halbig and King cases, which provided contradictory opinions about the validity of exchange subsidies on federal exchanges.

Some now think it possible that the Court will reopen the entire Affordable Care Act.  After all, Chief Justice John Roberts, who re-wrote the ACA to “save” it, did something similar with a key provision of the Voting Rights Act – only to strike it down later when the Act came back to the Court in a different matter.  Recall also that Roberts appeared to have changed his mind on the ACA between the majority decision and the decision going to print.