Payer Roundup—Americans think U.S. is behind in healthcare; CMS approves Maryland reinsurance waiver

Stethoscope on wooden table with American flag reflected on the wood
Only 27% of Americans think healthcare is better in the U.S. than in similar countries. (Getty Images/Feverpitched)

Poll: Americans feel U.S. healthcare is worse than in other countries

A majority of Americans think the U.S. provides more individual freedom, more opportunities to get ahead and a higher quality of life than other industrialized nations do, according to a new Gallup poll.

On healthcare, though, the U.S. doesn’t do so well. 

Of those polled, 45% said the American healthcare system is the worst or below average compared with similarly situated countries. Only 27% said it is the best or above average.

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Fewer people responded favorably about the healthcare system than any other measure in the poll. This trend held true across Republicans, Democrats and independents alike.

Debates about how to solve healthcare problems in the U.S., especially high costs, have long drawn comparisons to healthcare in other industrialized nations. (Poll results)

CMS gives Maryland green light for reinsurance program

The Centers for Medicare & Medicaid Services (CMS) approved a 1332 State Innovation Waiver on Wednesday that will allow Maryland to establish a reinsurance program.

The state expects the program to decrease 2019 individual market premiums by 30% and to increase enrollment by 6%. It will also help 250,000 Marylanders maintain their coverage, according to Maryland House of Delegates Speaker Michael Busch.

Valued at $462 million, Maryland’s reinsurance program will be the largest in the nation yet. (Release)

CMS provides states grants to improve exchanges

CMS awarded $8.6 million in grants to 30 states and the District of Columbia on Monday for the purpose of strengthening their commercial insurance markets. These grants can be used, for example, to conduct market scans or to analyze the availability of substance-use disorder treatment coverage.

This funding stems from the State Rate Review Grants authorized in the Affordable Care Act (ACA). Perhaps ironically, CMS Administrator Seema Verma decried the ACA when announcing the funds, saying they give states “the tools and flexibility they need to help people struggling to afford the year over year premium increases caused by Obamacare regulations.” (Release)

Democrats nervous after Collins-Kavanaugh meeting

Sen. Susan Collins (R-Maine) spoke positively of her meeting with Supreme Court nominee Brett Kavanaugh, raising concerns among some Democrats.

Collins, a pro-choice Republican who is considered a swing vote in Kavanaugh’s confirmation, said the two spoke “at length” about judicial precedent, including the landmark abortion case Roe v. Wade. She has said she looks for nominees who respect “settled law,” including in Roe.

But “everything the Supreme Court decides is settled law until it unsettles it,” said Senate Minority Leader Charles Schumer (D-N.Y.).

Echoing this sentiment, Ilyse Hogue, president of NARAL Pro-Choice America, said settled law "means nothing."

"It is a bunch of code words, long used by many conservative judges, meant to hide their real beliefs and anti-choice record," she said. (The Hill article)

Kasich touts Medicaid expansion on his way out of the governor’s office

More than 650,000 Ohioans have gained healthcare coverage through Medicaid since Republican Gov. John Kasich expanded the program in 2014. But as his term comes to a close, he and his cabinet are trying to make sure the next administration maintains the status quo.

Kasich has been helping to tell the stories of people who benefited from the expansion, and the Ohio Department of Medicaid released a detailed analysis of the expansion (PDF) this month.

The Republican candidate for governor, Attorney General Mike DeWine, has long said the program was unsustainable. Now, however, he says he would keep it, but change it by adding a work requirement or wellness program.

Kasich says he’s worried about his replacement “nickeling and diming it away,” but he thinks the next governor will “be for it.” (NPR article)