Thursday Thoughts

David Ermer–Uncategorized–

Well it certainly has been Congressional Budget Office week at the FEHBlog. Yesterday, it was the CBO’s Medicare for All report. Today’s it’s the CBO’s updated report on the budget impact of the Administration’s proposed rule to eliminate prescription drug rebates in the Medicare and Medicaid effective January 1, 2020. It’s much more FEHB relevant read than the M4A report.

Yesterday, the States challenging the constitutionality of the Affordable Care Act and the federal government filed their briefs with the U.S. Court of Appeals for the Fifth Circuit. The FEHBlog shelled out $9 to download the principal briefs from both sides which are available at this link. The Fifth Circuit has accelerated oral argument to mid-July 2019 which presents the distinct possibility that the Supreme Court will hear and decide the case before the national election next year. In the FEHBlog’s view, the Supreme Court will take the case only if the Fifth Circuit sides with the the trial court’s decision that Congress’s decision to zero out the ACA’s individual mandate penalty brought down the whole law. In the FEHBlog’s opinion that the parties defending the law’s constitutionality have the stronger argument.

Sen. Charles Grassley (R NE) announced today that his Finance Committee will hold a hearing next week on the 2017 law popularly known as MACRA that changed the way that Medicare Part B pays doctors.

“I was pleased to support MACRA in 2015. It ended the perpetual cycle of Congress temporarily heading off cuts to Medicare payments to physicians under the flawed Sustainable Growth Rate system, and serves as proof that Congress can tackle big challenges in a bipartisan way. The legislation also reformed how Medicare pays by establishing incentives to reward physicians for providing the best possible care to seniors. This hearing will give senators a chance to hear about how those incentives have been implemented and how well they’re working. Hearing from physicians on the front lines of providing care will be especially helpful in determining what else Congress can do to achieve MACRA’s goals,” Grassley said.

The hear will be held next Wednesday May 8 at 10;15 am on Capitol Hill.

This Robert Wood Johnson Foundation announcement caught the FEHBlog’s eye.  The author who is concerned with rural health care, writes in pertinent part as follows:

At a time when we are trying to understand how ZIP codes influence our health and quality of life, rural people have lessons to share about what it takes to build equity and opportunity in their communities.

Here are lessons I’ve learned in my work with the Robert Wood Johnson Foundation:

  • Work with and through local and regional intermediaries. When it comes to making change in rural communities, you have to start with the schools; community-based organizations; regional health centers; faith-based institutions; and small businesses. Small businesses, for example, play a vital role in rural America, creating roughly two-thirds of new jobs and supporting the economic and social well-being of their communities.
  • Grow and engage leaders of different kinds and at different levels to get the work done together. This isn’t about another leadership training, but about finding champions in each community and helping them develop the skills they need to facilitate change. In Well-Connected Communities, volunteer leaders are helping their neighbors be healthier at every stage of life by coming together. In Athens, we are learning how to engage new messengers in small and big ways. At our quarterly Civic Saturdays, readers and speakers are strategically selected to bring new voice and experience to our civic rituals.
  • Connect people within and across sectors and geographies for peer learning and collective action. When you bring a diversity of perspectives to the table, you are more likely to generate the right energy and strategy around the solutions rural communities need most. Within our own Rural Assembly, we represent a diversity of cultures, geographies, and ethnicities, as well as a diversity in interests and expertise for our hometowns and communities. These range from climate and energy solutions to creative placemaking initiatives, from economic transitions to restoring our democracy.
  • Develop and strengthen the infrastructure for local, state, regional and national resource and information-sharing. Urban and rural boundaries are porous and our residents are itinerant; the roads leading in and out carry people, goods, and ideas without regard to ZIP code, making the futures of rural and urban places intertwined.