In an Inside Health Policy article published yesterday, Thorn Run Partner’s Senior Vice President Shea McCarthy offered his take on the role of conservatives in the House — namely the Republican Study Committee (RSC) and the House Freedom Caucus — in looming negotiations between the two chambers as lawmakers continue to digest the Senate’s healthcare reform bill. McCarthy noted that while it was expected that the Senate’s version was always expected to be more centrist than the House’s American Health Care Act (AHCA), key questions remain as to whether or not Senate conservatives — such as Senators Ted Cruz (R-TX) and Mike Lee (R-UT) — will support a more moderate package. “Cruz in particular still carries a lot of weight with the RSC and the Freedom Caucus,” said McCarthy in the interview prior to the Senators’ opposition of the current bill. “Assuming Cruz and Lee ultimately sign off on the Senate’s version, signaling that the bill goes ‘far enough,’ it’s hard to envision enough conservative House members casting votes to sink the package.”

In an Inside Health Policy article published last week, Thorn Run Partners Senior Vice President Shea McCarthy noted that he has heard rumblings within the GOP that the Senate could get rid of the community rating waiver in the House's American Health Care Act. “Early reports indicate that the Senate plans to keep the House’s waivers allowing states to opt out of the ACA’s essential health benefits and age-rating band requirements, but that they plan to eliminate the waiver that would allow states to skirt the ACA’s requirement that insurers must offer coverage to people with pre-existing conditions," noted McCarthy. "The waiver from the pre-existing condition protection — the so-called “community rating” policy — has been subject to deep criticism from those who fear costs could skyrocket for many patients in states that seek the waivers. Conservatives would prefer to keep the waiver, and this issue hasn’t necessarily been settled.”  McCarthy also mentioned that a tax credit could be available for those making less than 250 percent of the poverty level, and that additional funding may bue dedicatyed for people aged 50-64. 

This morning's "Morning Money" piece from Politico featured comments from Thorn Run’s Jason Rosenstock, who offers his take on the current state of play between both parties on the debt limit. “Democrats whose history under the Gephardt Rule shows they never wanted to make this a public issue, and who are tired of having to supply the votes and the campaign fodder for Republicans, have almost no incentive to bail out the GOP majority,” noted Rosenstock. “Republicans, in control of all three branches of Government for the first time during one of these crises, know that they can’t escape the blame for any repercussions from the stock market for failing to raise the debt limit. While few are publicly talking about it, the stars may be aligning so that this next extension is the final time Congress deals with this issue.”

In an op-ed published in RealClearHealth, TRP's Billy Wynne touches on the latest Congressional Budget Office (CBO) score of the American Health Care Act (AHCA).  The article highlights the key developments of the score pertaining to cuts to Medicaid and the replacement of ACA's premium subsidies with new tax credits, and touches on the future of the bill now that it is under consideration in the senate. Wynne notes that"Senate Republicans now face a fundamental choice. Do they take seriously their assertions, made over the last seven-plus years, that they have a way to strengthen our health care system? Or do they go the way of AHCA, which gives scant regard to that pursuit in favor of an ideology willing to sacrifice protections for the most vulnerable in order to redistribute wealth to the powerful." He also goes onto criticize the AHCA for c"utting coverage from our most vulnerable to fund tax cuts for the wealthy."

In an Inside Health Policy article published yesterday, Thorn Run Partners’ Senior Vice President Shea McCarthy weighed in the potential auto-enrollment of individuals into health plans, an idea spearheaded by Senators Bill Cassidy (R-LA) and Susan Collins (R-ME) in their healthcare bill entitled The Patient Freedom Act. “Aside from helping Republicans improve the dismal coverage numbers estimated for House bill, auto-enrolling people in low-cost plans could also help keep the individual market balanced,” noted McCarthy. “Assuming some logistical concerns could be assuaged, insurance carriers would have plenty of incentive to participate in a market where the federal government were directly enrolling healthy people who might not otherwise purchase coverage — potentially reducing premiums for other enrollees. The policy could ultimately be a more powerful tool than the individual mandate to bring younger and healthier individuals into the market.” McCarthy also acknowledged that while the rollout of an auto-enrollment policy would likely be challenging, there are avenues that can be explored to make the process feasible. “States could supplement federal data by requiring residents to say whether they are insured when they pay state taxes or renew their driver’s license. The states also could allow hospitals and physicians to identify uninsured patients to be enrolled into no-premium plans.”

Today, Thorn Run’s Billy Wynne published a post on the Health Affairs blog gleaning lessons from the demise of American Health Care Act and envisioning steps forward.

The blog post challenges the narrative of inevitability on repeal and replacement of the Affordable Care Act (ACA), considers the essential role of stakeholders, looks at the ACA’s original incorporation of some conservative ideas, and highlights how the locus of control is gravitating to Secretary Tom Price and the Department of Health and Human Services’ regulatory authority. Finally, the post suggests possible bipartisan approaches — both legislative and regulatory — that could chart a path forward on health policy.