Overnight Healthcare

OVERNIGHT HEALTHCARE: Two states win approval for ObamaCare backup

Both Delaware and Pennsylvania have won approval from the federal government to pursue backup plans to save their ObamaCare subsidies if the healthcare law loses in court this month.

The two states have been “conditionally approved” to set up their own healthcare marketplaces, the Centers for Medicare and Medicaid Services (CMS) announced late Monday.

It is the administration’s biggest step to date related to contingency planning for the high-stakes court case, and sends an important signal to the dozens of other states that may consider setting up an exchange in order to save their subsidies.

{mosads}Delaware and Pennsylvania are among the estimated 34 states that stand to lose healthcare subsidies if the Supreme Court rules against ObamaCare this month in King v. Burwell. They are the only two states to have submitted contingency plans for the ruling.

If the Obama administration loses in the case, any state that does not run its own marketplace – also known as an exchange – would no longer be able to hand out subsidies to people buying healthcare. Read more here

HILLARY PROPOSES OBAMACARE FIXES Hillary Clinton says she will propose fixes for ObamaCare over the course of her presidential campaign, even as she strongly defends the law as a whole. 

In an interview with The Des Moines Register published on Sunday, she cited the “family glitch,” which prevents some low-income families from qualifying for subsidies under the law as one example of something she would seek to fix.

Some low-income families don’t qualify for subsidies because the definition of “affordable” employer-based coverage only takes into account the cost of individual plans and not family plans. 

She also called for fixes to “deal with the high cost of deductibles that put such a burden on so many working families,” as well as to deal with “the exploding cost of drugs, particularly the so-called specialty drugs.”

The law’s high deductibles — the amount one has to pay before insurance kicks in — have been a source of criticism. 

An analysis from the consulting firm HealthPocket found that last year the average deductible for a silver plan was $2,907, more than twice as much as the average deductible in an employer-sponsored plan.

In pointing to specialty drugs, aimed at serious, complex conditions, Clinton also raises a point on which some have sounded the alarm. There has been much attention, for example, on Sovaldi, a new cure for hepatitis C that costs $1,000 per pill, or $84,000 for a 12-week treatment. Read more here.  

FORMER HHS OFFICIALS PRESENT BACKUP PLAN: If the Supreme Court rules against ObamaCare this month, there’s a good chance that Congress and the administration won’t agree on a way to keep those subsidies flowing.  

Instead, a group of former Bush officials are putting forward the terms of what they think could be a grand bargain for states to keep subsidies while also demanding changes to ObamaCare rules.

Notably, the group of officials – led by former Health and Human Services Secretary Michael Leavitt – say it’s not an option to let states go without subsidies. 

All states should find ways to restore that federal aid, even if it means launching a state-run exchange, the officials wrote.

“Doing nothing has both political and humanitarian consequences that should be unacceptable to public officials,” the group writes. Read more here.

SCOTUS WON’T REVIEW MANDATORY ULTRASOUND LAW: Justices said Monday that they will not challenge previous courts’ decisions to strike down a North Carolina law requiring women to “listen to the heartbeat of the unborn child” before receiving abortions.

The law, which was passed in 2011 over the veto of the governor, was considered the most extreme mandatory ultrasound law in the country. Nearly a dozen other states have laws encouraging ultrasounds, though only three require the scan before an abortion. Read more here


Tuesday’s schedule

House committee leaders will hold a press conference on the 21st Century Cures Act.

Sens. Chuck Grassley (R-Iowa) and Michael Bennet (D-Colo.) will deliver remarks as part of the Children’s Hospital Association’s Family Advocacy Day.

State by state

Oklahoma GOP officials defend healthcare program they once opposed Medicare panel: Ease rehab coverage for seniors 

What we’re reading

Vast data warehouse raises health overhaul privacy concerns 

The voice of opposition past, Justice Kennedy may save ObamaCare now 

CVS Health buys Target Pharmacy Business for $19B 

What you might have missed from The Hill

GOP governor: States can’t plausibly save ObamaCare subsidies 

Poll: 81 percent satisfied with ObamaCare plans

Please send tips and comments to Sarah Ferris, sferris@thehill.com, and Peter Sullivan, psullivan@thehill.com. Follow on Twitter: @thehill, @sarahnferris, @PeterSullivan4 

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