5 Things Washington: ACA ruling, Early Bird Registration, Proposed rate increases

One of the most important members of our team at State of Reform is Emily Boerger. She helps write our 5 Things and is a member of our executive team here at State of Reform. She is also now our first ever Managing Editor, taking on even more leadership for our content team of 6-7 folks.

She is a rock star, and I am honored to work with her every day. Thanks for your smart contribution to this effort, Emily!





With help from Emily Boerger

1. Murray laying the groundwork for public option

US Senator Patty Murray, Chair of the Senate Committee on Health, Education, Labor and Pensions (HELP), recently sent out a letter asking for public input on how to structure legislation to develop a public health insurance option. Murray and Rep. Frank Pallone Jr. laid out a series of 8 key questions they are trying to answer via public input.

The questions touch on eligibility, how the public option’s benefit package should be structured, and how the public option should interact with public programs like Medicaid and Medicare. The letter points to a recent Morning Consult poll which found that nearly seven in ten Americans, including 80% of Democrats and 56% of Republicans, support a public health insurance option. Murray and Pallone Jr. are requesting that input be directed to committee staff by July 31, 2021.

2. Early Bird Registration is open

Early Bird Registration is now open for the 2021 Inland Northwest State of Reform Health Policy Conference coming up on September 9th! A big thank you to our Convening Panel who got together last week to talk through the issues and topics that will be teed up for discussion at the event. We’ll release the product of that meeting, our Topical Agenda, in a few weeks’ time, so if you have any topics, speakers, or content ideas, we would love to hear them.

We are also continuing to gather feedback on whether you think this event should be held in person or not in September. This is the second iteration of our survey, so if you took this once before, we would still love to have your input here again. Your responses to this 5-question survey will be immensely helpful as we build the conference experience ahead of fall.


3. This may be the calm before the storm

Today was the last day the US Supreme Court had scheduled to release opinions in its current term. You’ll recall the Texas v California case on the constitutionality of the ACA is before the Court. What is left on the calendar is the release of orders.

My guess now is that the Court will likely release its decision on the case on Monday June 28th at 9:00 EDT. That is the last day of it’s term, the day it usually reserves for the most controversial decisions. Moreover, because currently only orders are scheduled to be released, that tells us something about what the Court might have in store. Orders have a directive associated with it, meaning it will be ordering someone or something to do something. Sometimes orders direct in the affirmative — meaning “go do this, as directed under the law.” Perhaps more often, orders direct in the negative, as in “stop doing this thing.”

Anyone who tells you they know what’s coming should probably not be listened to, including me. But, for what it’s worth, I’d offer this is not a binary moment — as in keep or repeal the ACA. The range of options which may be on the table for the justices to land a majority on is wide. Like the first NFIB case, expect the unexpected. You can read my break down of the Texas case from 2019 here, or my half correct prediction of the 2012 NFIB case (and subsequent explanation of Roberts’ creative opinion here).

4. 15 insurers propose 5.47% rate increase

The Insurance Commissioner’s office announced last week 15 insurers have filed an average proposed rate increase of 5.47% for Washington’s individual market. The rate changes range from a 5.76% decrease proposed by PacificSource Health Plans to a 28.98% increase proposed by Premera Blue Cross.

Four of the 15 plans have proposed decreases, two proposed increases of less than 1%, and the other 9 proposed larger rate increases. A full breakdown of the proposed 2022 health insurers and plans by county is available here.


5. Major health reforms absent in Biden’s budget

President Biden’s first budget submission is surprising in what it omits, says State of Reform Columnist Jim Capretta. Several of the high-profile health proposals from the 2020 campaign – like the public option and Medicare eligibility at age 60 – are mentioned in the budget’s text, but are not tied to specific funding proposals or plans in the budget.

“Perhaps the most glaring omission in the budget,” says Capretta, “is the absence of any proposals to change what Medicare pays hospitals, physicians, and other medical service providers.” Without this, he says Congress will find it difficult to advance cuts as potential offsets for legislation that adds spending elsewhere. Capretta reasons that the lack of detail in the budget for major health policy changes are a signal that Biden has “made the political calculation that it is not possible to get most of them enacted in this Congress.”