Washington Wire: September 2022

facade of building

HFA Fly-In and Week of Advocacy

HFA was excited to return to in-person meetings for its ninth annual Patient Fly-In this year, after two years of virtual events.

Twenty community members from 10 different states came to Washington, D.C. for policy and advocacy briefings, followed by meetings on Capitol Hill with 35 Congressional offices. Advocates asked members of the House to support H.R. 5801, the HELP Copays Act, a bill protecting patients from copay accumulator adjusters and copay maximizers. This bipartisan legislation would require health plans to count the value of drug copay assistance toward patient cost-sharing requirements – protecting people with bleeding disorders (and other serious health conditions) who rely on copay assistance to afford their life-saving medications.

Participants also asked their lawmakers to provide a pathway to coverage for over 2 million low-income Americans who are trapped in a "coverage gap." These individuals are ineligible for Medicaid under the laws of their home states but, counterintuitively, earn too little to qualify for premium tax credits that help with the purchase of ACA insurance. Low-income individuals living with bleeding disorders are at great risk if they lack health coverage.

For those who couldn't come to Washington, D.C., HFA also hosted an online Virtual Week of Advocacy. Over 150 community members so far have used the HFA Legislative Action Center to make their voices heard on these important issues. The link is still live, so if you didn't write to your lawmakers earlier in the month, please do so! Connect with your lawmakers today.

Quick Hits:

  • A ruling on September 7 by a federal district judge in Texas could significantly undermine access to ACA-required cost-free coverage for preventive services as recommended by the U.S. Preventive Services Task Force. Individuals will not immediately lose access to these preventive services because the court has not yet ruled on the scope of relief or remedy. The U.S. Department of Health and Human Services is expected to appeal the court's decision. HFA and 25 other patient groups issued a statement opposing the court ruling and reiterating the groups' commitment to ensuring access to care.
  • The House of Representatives by voice vote on September 13 passed a bill to reform the prior authorization process for Medicare Advantage plans. The Improving Seniors' Timely Access to Care Act (R. 3173) seeks to reduce prior authorization delays by requiring insurers to use electronic processes. It also takes aim at inappropriate denials of prior authorization requests (responding to an HHS Office of Inspector General report which found that 13 percent of Medicare Advantage denials involved requests that met Medicare coverage rules). The bill now heads to the Senate, where a companion bill (S. 3018) has widespread support.
  • On September 27, the U.S. Centers for Medicare & Medicaid Services (CMS) published 2023 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs. The standard monthly premium for Medicare Part B enrollees will be $164.90 for 2023, a decrease of $5.20 from $170.10 in 2022. The annual deductible for all Medicare Part B beneficiaries is $226 in 2023, a decrease of $7 from the annual deductible of $233 in 2022.
  • HFA joined with 11 other patient groups in an amicus brief urging the U.S. Supreme Court to uphold the right of Medicaid enrollees to sue to protect their rights to Medicaid benefits or coverage under federal civil rights laws. The groups urge the Court to recognize that Medicaid beneficiaries need to have recourse when their Medicaid rights have been violated.
  • CSL Behring and Grifols prevailed in their lawsuit challenging a U.S. Customs and Border Protection (CBP) rule change that limited the ability of Mexican nationals to cross the border to donate plasma at U.S. collection centers. The temporary injunction in favor of the companies allows Mexican donors with valid B1/B2 visas to resume donating plasma at U.S. collection centers.
  • On September 8, the Biden administration reversed a 2019 "public charge" rule that allowed the U.S. Department of Homeland Security (DHS) to count use of public benefits, including health programs such as Medicaid, against lawful immigrants seeking green cards or entry to the U.S. While the 2019 rule had been vacated by a federal court, it nonetheless has had a chilling effect on people and families seeking care. The new rule clarifies that DHS will not classify non-citizens as "public charges" based on their use of health-related benefits and government services