In­sur­ers win and lose in om­nibus spend­ing bill

Modern Healthcare - - Late News - —Su­san­nah Luthi

Pres­i­dent Don­ald Trump on Fri­day grudg­ingly signed a $1.3 tril­lion, two-year om­nibus spend­ing bill that came af­ter days of wran­gling be­hind closed doors over con­tentious poli­cies that in­cluded an em­bat­tled sta­bi­liza­tion pack­age for the in­di­vid­ual mar­ket that would fund cost-shar­ing re­duc­tion pay­ments and a $30 bil­lion rein­sur­ance pool. So who won and who lost?

Win­ners:

In­sur­ers that fought to keep a new pol­icy that cuts their share of the cost of pre­scrip­tion drugs not cov­ered by Medi­care while rais­ing it for drug­mak­ers.

The Na­tional In­sti­tutes of Health, which re­ceived a $3 bil­lion boost in fund­ing.

Opi­oid ad­dic­tion abate­ment ef­forts, which re­ceived $735 mil­lion to de­velop al­ter­na­tive pain med­i­ca­tions, sup­port treat­ment pro­grams in ru­ral ar­eas and ex­pand ac­cess to nalox­one. In to­tal, HHS re­ceived $3.6 bil­lion to fight drug abuse.

Ru­ral com­mu­ni­ties, with HHS’ spend­ing on ru­ral ar­eas to­tal­ing $290.8 mil­lion.

Providers, get­ting $182 mil­lion to re­duce a back­log of more than 500,000 Medi­care ap­peals.

Pe­di­a­tri­cians, who will ben­e­fit from a $2.4 bil­lion in­crease in the Child Care and De­vel­op­ment Block Grant.

Losers:

In­sur­ers, fol­low­ing failed ef­forts to in­clude CSR pay­ments and rein­sur­ance. The Af­ford­able Care

Act, which now faces sev­eral at­tempts to limit data or grant op­por­tu­ni­ties re­lated to the leg­is­la­tion.

Drug­mak­ers, who wanted to off­load some of their new­found fi­nan­cial li­a­bil­ity for the Medi­care Part D donut hole back to in­sur­ers.

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