RISE summarizes recent regulatory headlines.

CBO: Lowering age of Medicare eligibility would increase federal budget deficits by $155B

A new report by the Congressional Budget Office (CBO) and the Joint Committee on Taxation looks at the budgetary effects of lowering the age of eligibility for Medicare to 60. The report also describes the resulting changes in the number of people with health insurance coverage and the sources of that coverage.

Among the findings:

  • Lowering the age of Medicare eligibility to 60 would increase federal budget deficits by $155 billion over the 2026–2031 period through the effects of that policy on federal revenues and mandatory spending.
  • In 2031, about 7.3 million more people would be enrolled in both Medicare Part A and Medicare Part B as their primary source of coverage.
  • An estimated 3.2 million fewer people would have employment-based insurance as their primary source of coverage; most of those people would enroll in Medicare.
  • About 1.8 million fewer people would have Medicaid as their primary source of coverage; almost all of them would enroll in Medicare.
  • About 2 million fewer people would be enrolled in nongroup coverage, and almost all of them would enroll in Medicare instead.
  • About 0.4 million fewer people would be without health insurance.

The CBO said the increase to federal deficits would be due to the fact that the federal government would pay for a larger share of health care spending than employers, some people projected to be uninsured or enrolled in unsubsidized nongroup coverage under current law would instead have health insurance coverage subsidized by the federal government, and federal costs for people with Medicaid coverage under current law would increase, primarily because of greater spending on health care for people dually eligible for Medicaid and Medicare and because a greater share of those costs would be paid for by the federal government rather than state governments. The CBO said that those costs would be partially offset by reductions in Medicaid spending for people who would lose their eligibility for Medicaid under the policy.

HHS announces Becerra tests positive for COVID while abroad

U.S. Health and Human Services Secretary Xavier Becerra tested positive for COVID-19 after taking a PCR test prior to attending a G7 meeting for health ministers in Berlin. Becerra is fully vaccinated and boosted against COVID-19 and is experiencing mild symptoms, according to Sarah Lovenheim, assistant secretary for public affairs. He will continue to perform his duties as HHS Secretary working in isolation. "HHS has consulted with, and taken every step advised and required by, the Centers for Disease Control and Prevention (CDC) and German public health authorities,” Lovenheim said.

"Secretary Becerra most recently visited the White House last week on Thursday and President Biden is not considered a close contact as defined by the CDC. He remains fully engaged with the duties of HHS Secretary while in isolation in Berlin, and looks forward to resuming in-person meetings, as soon as possible," she said.

CMS revamps Medicare website

The Centers for Medicare & Medicaid Services (CMS) has updated the Medicare.gov website to make it easier to navigate and access information to compare and select health and drug coverage and find providers. The updated website, based on consumer feedback, features timely initiatives and messages on the homepage and highlights key tasks and information most frequently sought by people with Medicare, people nearing Medicare eligibility, and their families.

The latest updates include a redesign of the Medicare.gov home page and more detailed pricing information about Medicare Supplement Insurance (Medigap) Policies that give individuals the information they need to compare Medigap plan costs and coverage options. CMS plans additional improvements in the next few months to streamline the Medicare Plan Finder landing page and the Medicare Account landing page and align the look and feel with the new home page.

HHS extends telehealth services in risk adjustment program due to COVID

The Department of Health & Human Services’ (HHS) Centers for Medicare & Medicaid Services Center for Consumer Information and Insurance Oversight in late April said in a memo that it is extending telehealth services to the 2022 benefit year data submissions for the HHS-operated risk adjustment program.

The agency said that it recognizes the continued need to provide certain telehealth and telephone-only services in the risk adjustment program.

CMS extends Medicaid, CHIP coverage for 12 months postpartum in Tennessee, South Carolina

The Centers for Medicare & Medicaid Services (CMS) announced last week that Tennessee and South Carolina can begin offering Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months postpartum to an estimated 22,000 and 16,000 pregnant and postpartum individuals, respectively, through a new state plan opportunity via the American Rescue Plan. These states join Louisiana, Michigan, Virginia, New Jersey, and Illinois in extending Medicaid and CHIP coverage from 60 days to 12 months postpartum. CMS is also working with nine states and the District of Columbia to extend postpartum coverage for 12 months after pregnancy, including California, Indiana, Kentucky, Maine, Minnesota, Oregon, New Mexico, Pennsylvania, and West Virginia. CMS said that because of these efforts, as many as 720,000 pregnant and postpartum individuals across the United States could be guaranteed coverage for 12 months after pregnancy.

KHN report on why more US seniors won’t get a COVID booster

Approximately one in three Americans 65 and older who completed their initial vaccination round still have not received a first booster shot, according to the Centers for Disease Control and Prevention (CDC). The numbers have dismayed researchers, who note this age group continues to be at the highest risk for serious illness and death from COVID-19.

People aged 65 and older account for about 75 percent of U.S. COVID deaths. And some risk persists, even for seniors who have completed an initial two-dose series of the Moderna or Pfizer vaccine or gotten one dose of the Johnson & Johnson vaccine. Among older people who died of COVID in January, 31 percent had completed a first vaccination round but had not been boosted, according to a KFF analysis of CDC data.

The failure to boost more of this group has resulted in the loss of tens of thousands of lives, Eric Topol, M.D., founder and director of the Scripps Research Translational Institute, told Kaiser Health News. “The booster program has been botched from day one,” Topol said. “This is one of the most important issues for the American pandemic, and it has been mismanaged.”

“If the CDC would say, ‘This could save your life,’” he added, “that would help a lot.”

Click here to read the full KHN report.

AHIP releases policy roadmap to make health care more affordable and accessible

AHIP this week released a policy report, Healthier People through Healthier Markets, that outlines legislative and regulatory enforcement actions to increase competition in health care, drive down costs, and improve health care access for patients. The actions are based on improving patient choice; protecting patients, consumers, and businesses from overpaying for care; improving transparency; and stopping drug pricing and patent games by Big Pharma. The suggestions include:

  • Support consumer-centric expansion of home-based advanced care through value-based care and payment models–an alternative that can offer patients better, more convenient, and more affordable care outside of the hospital.
  • Advance site-neutral payments to defend consumers against having to pay more for the same services depending on the site of care.
  • Support patients’ choice of telehealth, when clinically appropriate, as a less costly and more convenient method of care by removing government impediments, modernizing network adequacy regulations, and guarding against regulatory structures that reduce telehealth’s competitive benefits.
  • Accelerate the availability of prescription drug biosimilars to ensure that the pace of access matches the pace of innovation. 
  • Reform the system for provider-acquired drugs, which has resulted in ever-escalating prices for such drugs.