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Three Damaging Health Regulations Put Access to Care and Coverage at Risk

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As the end of the Trump presidency nears, his administration continues to try and push through last-minute regulations that could have sweeping effects on access to health care and coverage. These regulations affect Medicare, Medicaid, and the Affordable Care Act, putting millions of older adults, people with disabilities, and families at risk.

The first such regulation has already gone into effect and has reduced access to Medicaid coverage for people who become eligible for Medicare. In March, Congress passed a law that required states to maintain coverage and access to benefits for people with Medicaid for the duration of the COVID-19 public health emergency. In exchange, states would receive enhanced financial help from the federal government. In late 2020, however, the administration began interpreting this straightforward statute in a way that would allow states to terminate comprehensive Medicaid coverage for people with Medicare if they are eligible for any other assistance, even if that would mean a sharp increase in their out-of-pocket expenses and a reduction in their benefits. We oppose this deeply flawed interpretation and urge the administration to reverse course.

In September, Medicare Rights commented in opposition to a proposal in Georgia that would eliminate residents’ access to HealthCare.gov as a one-stop source for information on insurance coverage. Rather than rejecting  this flawed proposal, the Trump administration approved it and went a step further by proposing in its annual Notice of Benefit and Payment Parameters (NBPP) that all states have the same option to deny residents the ability to shop for coverage from an unbiased, comprehensive site. Instead, under the proposed rule, residents would be forced to rely on commercial sources of information, including those with financial incentives to steer potential enrollees into inappropriate or inadequate coverage. As with Georgia’s request, we expressed our strong disagreement with this NBPP proposal. People must retain access to objective,  comprehensive, and conflict-free sources of information.

Finally, the administration is attempting to create a significant new administrative burden on federal health agencies, requiring them to review existing regulations again and again in order to prevent the rules from  automatically expiring. This proposal, called the Securing Updated and Necessary Statutory Evaluations Timely (SUNSET) rule, would lead to chaos for Medicare beneficiaries, providers, and payers and would force federal agencies to engage in hundreds of hours of pointless busywork each year, reducing their capacity to manage other, more critical issues like ensuring access to care and coverage in a pandemic. We oppose this ill-conceived and destructive proposal and urge the administration to withdraw it in its entirety.

Importantly, the incoming Biden administration will can impact some or all of these regulatory actions, including delaying or withdrawing proposals that have not yet gone into effect and issuing new rules to counter harmful regulations that are already in place. The election results from Georgia also make Congress more likely to step in and eliminate some existing regulations using authority from the Congressional Review Act.

Read Medicare Rights’ comments on the fourth COVID Interim Final Rule.

Read Medicare Rights’ comments on the NBPP.

Read Medicare Rights’ comments on the SUNSET rule.

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