Wynne Health In Print

Medicare Direct, A Blueprint For Public Option Waivers, Part 3: Waiver Design, Legal Authority, And Conclusion

Through a combination of existing waiver authority under sections 1332 and 3021 of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) may approve state-initiated waivers to introduce these plans in their health insurance exchange markets. In previous posts, I detailed the administration, financing, benefits, provider network, and reimbursement levels for the Medicare Direct program. In this post, I explain the legal and policy foundation of the waivers necessary to execute it. ...
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Medicare Direct, A Blueprint For Public Option Waivers, Part 2: Benefit Design, Provider Networks, And Reimbursement

In my first post of this series, I outlined the rationale, administration, and financing terms for a state-initiated, Medicare-based public option waiver program that I call Medicare Direct. In this post, I will address the core design components identified above. In the final post, I will present the key elements and legal basis for the combination of waivers that would allow states to proceed with the program without the need for congressional action. ...
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Medicare Direct, A Blueprint For Public Option Waivers, Part 1: Introduction, Administration, And Financing

In the absence of federal legislative action, states have an opportunity to advance the concept’s core principles—lower-cost, higher-quality coverage delivered via a trustworthy, public-interested platform—using a unique combination of waiver authorities permitted under current law. I suggest such a program be titled Medicare Direct. ...
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A Tell-All on Telehealth: Where Is Congress Heading Next?

The Centers for Medicare and Medicaid Services (CMS) recently enacted modest but important expansions in Medicare’s telehealth policy. Telehealth, which uses telecommunications to support virtual health care delivery to improve access to and quality of health care, is moving from promise to reality. The benefits are appealing: Patients can interact with their providers remotely, which improves access to care and can help providers manage chronic conditions from afar....
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Public Option 1.0: Washington State Takes An Important Step Forward

On Sunday, the Washington State legislature passed a bill to create standardized health plans in the state’s Exchange and establish new public option-ish plans that contract directly with its Health Care Authority, which operates the state’s Medicaid program. The hallmark of these new plans, and the foundation of their claim to the title “public,” is they are required cap provider reimbursements at Medicare-based levels....
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The Drug Pricing Debate: Sizing Up Recent Actions and What May Come Next

What goes up must — or rather, should — come down. Such is the thinking of the Trump administration when it comes to prescription drug pricing, at least. Over the past five years, 12 of the 20 most commonly prescribed brand-name drugs have seen price increases of more than 50 percent. To date, most of what we’ve seen from the federal government is messaging and some initial proposals, with the majority coming from the administration. Congress, for its part, has initiated a series of drug pricing hearings and begun introducing meaningful legislation. The result is a wide array of policy alternatives, some of which stand a chance of being enacted....
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Medicare For All Can Begin In 2021: Here’s How

While Democratic presidential candidates and the newspaper headlines hash out the ideological nuances of a Medicare-based single payer coverage scheme, work is underway to consider how coverage can be expanded to those in need within a realistic timeframe at minimal cost or disruption to the existing system....
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What to Expect in Health Policy Under a Divided Congress

The 2018 midterm elections were powered by a “blue wave” that flipped control of the House of Representatives from the GOP to the Democrats but left the Senate in Republican hands, meaning the two chambers of Congress will be divided at least until 2020. In the Senate, Republicans have a 53 to 47 majority and will continue to be led by Senator Mitch McConnell of Kentucky, while House Democrats gained a 235 to 199 majority....
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What the 2018 Midterm Elections Means for Health Care

The fundamental shift in the balance of power in Washington will have substantial implications for health care policymaking over the next two years. In this post, I’ll take a look at which health care issues will come to the fore of the Federal agenda due to the outcome Tuesday, as well as state expansion decisions. And it should of course be noted that, in addition to positive changes Democrats are likely to pursue over the next two years, House control will allow them to block legislation they oppose, notably further GOP efforts to repeal the Affordable Care Act (ACA)....
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The 660-Page Opioids Bill Is Now the Law. Here’s What’s in It.

Opioids killed an estimated 49,000 Americans in 2017, including nearly 2,200 Californians. They harmed many more, including children forced into the foster care system, babies born with neonatal abstinence syndrome, young adults who overdosed from dangerous new street drugs like fentanyl, and countless others who became addicted to opioids while trying to manage chronic pain....
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Immigrants and the New Proposed “Public Charge” Rule

On September 22, the Department of Homeland Security (DHS) released the text of highly anticipated proposed changes to “public charge” rules that could disqualify many immigrants from gaining permanent residency in the US. Public charge is the determination that evaluates whether someone is likely to become reliant on public benefits, and consequently whether he or she may enter the country or modify his or her immigration status to become a permanent resident (a “green card” holder). ...
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Creating Medicare Advantage Premium Support For All, Part 5: Which Proposal Is Actually Medicare?

With the burgeoning debate around single payer, primarily oriented around "Medicare for All," CEO Billy Wynne takes a look under the hood of Sen. Bernie Sanders' "M4All" proposal and discovers it is not actually based on Medicare. He also continues his inquiry into what bona fide Medicare for All would actually look like, in this case by explaining the basics of the Medicare Advantage program, which covers 33% of Medicare enrollees this year....
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