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For the second year in a row, HFA’s Patient Fly-In took place as a virtual event. Two dozen community members together with HFA staff made forty (!) Zoom visits with Congressional offices during the week of November 15th. The timing of the Fly-In – always a bit of a gamble – ended up being very lucky. H.R. 5801, a bill protecting patients from copay accumulator adjusters, had just been introduced in the House, and advocates were able to talk to their lawmakers about why the bill’s protections are so urgently needed. The massive budget reconciliation bill (aka the “Build Back Better Act”) was also nearing a vote in the House; Fly-In participants urged their lawmakers to support provisions in the reconciliation bill extending the ARPA-enhanced subsidies that make Marketplace insurance more affordable, and closing the coverage gap for low-income adults who live in Medicaid non-expansion states.

A common thread runs through both these policy “asks.” We are asking Congress to uphold and build on the ACA’s promise of meaningful health insurance for all Americans, regardless of people’s health status, income, or state of residence. Health insurers have been exploiting copay accumulator adjusters to duck their obligation to cover people who live with serious and costly health conditions – and H.R. 5801 would close that loophole. Similarly, the coverage expansions in the budget reconciliation bill would eliminate barriers that exclude millions from accessing vital health insurance.

Beyond the Zoom visits, HFA’s Legislative Action Center provided a vehicle for additional community members to make their voices heard on these important issues. We are thrilled to report that well over 100 individuals have done so. Thank you to all who participated! And please know that it is not too late to make your voice heard. If you didn’t communicate with your lawmaker earlier in the month, you can still do so.

Connect With Your Lawmakers TODAY!

You can also view a recording of HFA’s November 16th Congressional Conversations, featuring remarks from the two lawmakers who received 2021 Champion Awards, U.S. Senators Warnock (GA) and Murkowski (AK).

Quick Hits:

  • On November 19, 2021, the U.S. House of Representatives passed the budget reconciliation bill, H.R. 5376, on basically a party-line vote. The bill that emerged from the House includes a broad range of health provisions: an extension to the enhanced ACA premium subsidies and a temporary fix to the Medicaid coverage gap (see above), but also a Medicare hearing benefit; limited Medicare drug price negotiation; a redesign of the Medicare Part D drug benefit, including a true cap on out-of-pocket spending; lengthened postpartum coverage in Medicaid; a provision for (partial) paid family and medical leave; and more. The bill now moves to the U.S. Senate.
  • Open enrollment for ACA health insurance began on November 1st. If you are in the market for health insurance, please be sure to check out HFA’s Open Enrollment guide – and make sure you select a plan by December 15th to have coverage in place as of January 1, 2022. A word of caution: please DON’T rely on Google or on calls from telemarketers! These sources will direct you to non-ACA health plans – often misleadingly advertised – that fail to provide the health benefits and financial protections that you need. Instead, start your search at healthcare.gov to make sure the plans you’re looking at will cover prescription drugs and other essential health benefits. Remember that premium subsidies – tax credits that can save you substantial amounts on the cost of your insurance in 2022 – are ONLY available for ACA Marketplace plans.
  • On November 12, 2021, President Biden nominated Robert Califf to serve as Commissioner of the Food and Drug Administration. Dr. Califf served a previous term in that role from 2016-17. Dr. Califf’s nomination proceeds to the Senate for consideration.
  • The Biden Administration issued an interim final rule requiring payers, employers, and other group health plan sponsors to report prescription drug and health coverage costs for consumers. This regulation – the fourth in an ongoing series of rulemakings implementing the 2020 surprise billing law – will eventually require health plans to report on some of the most frequently dispensed prescription drugs, as well as the prescription drugs that account for the highest overall spending, and the drugs that account for the greatest increase in annual plan spending. The Administration announced a grace period until December 2022, allowing time for health plans to come into compliance with the new requirements.
  • DeGette and Upton formally introduced legislation to build on the 21st Century Cures Act, legislation that they shepherded to passage in 2016. The new bill, “Cures 2.0,” aims to accelerate the development and delivery of new treatments by: creating and funding a new biomedical research agency, the “Advanced Research Projects Agency for Health,” tasked with finding cures for diseases such as cancer and Alzheimer’s; easing some Medicare and Medicaid telehealth requirements; directing FDA to improve clinical trial design; funding pandemic preparedness; and more.
  • The U.S. Centers for Medicare and Medicaid Services (CMS) announced that Medicare Part B premiums will experience the largest increase on record next year, rising from $148.50 to $170.10 per month in 2022. This increase is largely attributable to the possible projected costs of covering a new Alzheimer’s drug that the FDA approved in 2021. While the 14.5% hike in Part B premiums is substantial, CMS officials pointed out that the Social Security cost-of-living adjustment for 2022 is large enough that most Social Security recipients will see an increase in their monthly checks, even after accounting for and deducting the higher Part B premiums.

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