Payer Roundup—CMS takes $168M cut in House funding bill; ACA lawsuit could impact employer coverage

Calculator on American flag
CMS saw a small budget cut in a House funding bill issued this week. (Getty/MrLonelyWalker)

CMS gets dinged in 2019 appropriations bill

The House Appropriations Committee hasn't changed its tune much from last year regarding Medicare and Medicaid funding.

Draft legislation for fiscal year 2019 includes $3.5 billion for the Centers for Medicare & Medicaid Services, about $168 million less than 2018, a less than 5% cut.

And like 2018's bill, it does not include additional funding to implement Affordable Care Act programs and prohibits funds for the “Navigators” program and the collection of user fees from the Health Insurance Exchanges.

Additionally, the bill did not include funding for risk corridor payments, which a federal appeals court recently ruled the government is not required to pay. (Bill [PDF])

Employer coverage caught in ACA lawsuit crosshairs

While the primary focus of the GOP's latest attempt to dismantle the Affordable Care Act has focused on the individual market, employer plans could be hit just as hard.

If the Texas lawsuit brought by 20 attorneys general succeeds, those who get insurance through their employer would no longer have key protections under the ACA. Insurers could once again require lengthy waiting periods for new hires or decline to cover a new hire's medical condition, The Wall Street Journal reports.

“Anyone who just thinks this is just impacting the 12 to 15 million individuals with individual coverage is wrong,” said Timothy Jost, an emeritus law professor at Washington and Lee University. (The Wall Street Journal)

Senior DOJ attorney resigns after ACA decision

A longtime Justice Department attorney submitted his resignation on Friday, the morning after the agency announced it would not defend the ACA against a legal challenge.

Joel McElvain's departure, a senior official with 20 years at the agency, is a sign of internal frustration at the DOJ, sources told the Washington Post. McElvain was awarded the Attorney General's award in 2013 for defending the ACA in court. (The Washington Post)

90% oppose Alabama work requirements

Alabamians overwhelmingly oppose their state's proposed Medicaid work requirements, according to comment letters.

In total, the Alabama Medicaid Agency received about 800 public comments on its proposed work requirements for able-bodied parents; 90% were in opposition to the policy, as reported by

Researchers at the Georgetown Health Policy Institute have found that combining the state's strict eligibility requirements and minimum wage with a work requirement would cause many people to earn too much money to qualify for the program. (