"Eighteen million Americans, including 350,000 Tennesseans – songwriters, farmers, and the self-employed – do not get their health insurance from the government or on the job, which means they must buy insurance in the individual market. My goal by the end of September is to give them peace of mind that they will be able to buy insurance at a reasonable price for the year 2018." 

— Senator Lamar Alexander (R-TN)

• Fearing Sabotage, Groups Prepare Obamacare Blitz The Hill by Rachel Roubein and Jessie Hellmann — State and local groups that help support Obamacare are springing into action ahead of an enrollment period they fear could be sabotaged by the Trump administration. Their marketing efforts are expanding, their advertisements are starting earlier, and those that fought repeal are shifting their focus to spreading the word about open enrollment, which begins Nov. 1.  But President Trump is openly hostile to the law, and few expect that the latest sign-up period will receive heavy promotion from his administration.  That's leaving local groups, called navigators, to fill the gaps. The Trump administration has made no formal announcement about the grants, and CMS would not comment on whether they would continue. But more than a half dozen groups contacted by The Hill said all signs point to receiving the last round of funding in September.
  
  

• Medicaid Directors See Boon in Newfound Public Awareness Bloomberg News by Victoria Pelham — Medicaid directors are seeing a newfound public awareness and appreciation of the safety-net health insurance program in the wake of failed Obamacare repeal-and-replace efforts. That's critical for Medicaid's future, Matt Salo, executive director of the National Association of Medicaid Directors, told Bloomberg BNA Aug. 18. Now the real work will move back to the states, which can push bids to bolster the program to be more value-driven, holistic, and better coordinated for the most needy beneficiaries, he said.  Hannah Katch, senior policy analyst with the Center on Budget and Policy Priorities, called the response to possible Medicaid overhauls "unlike anything" she has ever seen. "It really goes to show how well Medicaid works and when there was a real threat to the future of Medicaid, we saw people stand up and talk about how important it was for them and their families," she told Bloomberg BNA.

• Congress Facing Deadline to Renew Health Care for Children The Hill by Rachel Roubein and Nathaniel Weixel — Congress is approaching a healthcare deadline with enormous stakes for millions of people — and this time it isn't about Obamacare. Federal funding for 9 million low- and middle-income children is set to expire at the end of September, setting up a crucial deadline for a Congress already grappling with other high-stakes battle. The looming deadline for the Children's Health Insurance Program has been overshadowed by the GOP effort to repeal Obamacare, and lawmakers left town for the summer without addressing the issue.  The stakes are high, and the uncertainty has states worried. The longer Congress waits to renew the program, the more likely it will be that they have to impose enrollment slowdowns or even cancel policies.

• Senate Panel to Hold Hearings on Health Insurance Reform USA Today by Michael Collins — Senators looking for ways to stabilize the individual health insurance market will hear from governors and state health insurance commissioners at their first bipartisan hearings next month. The hearings, set for Sept. 6–7, will focus on stabilizing premiums and helping people in the individual market in light of Congress' failure to repeal and replace the Affordable Care Act, or Obamacare. "Eighteen million Americans, including 350,000 Tennesseans — songwriters, farmers, and the self-employed — do not get their health insurance from the government or on the job, which means they must buy insurance in the individual market," said Sen. Lamar Alexander, the Tennessee Republican who chairs the Senate Health, Education, Labor and Pensions Committee. "My goal by the end of September is to give them peace of mind that they will be able to buy insurance at a reasonable price for the year 2018," Alexander said.
  
  

• Bipartisan Health Care Plan Could Come in a Week The Hill by Peter Sullivan — Ohio Gov. John Kasich (R) and Colorado Gov. John Hickenlooper (D) are working on a bipartisan proposal to stabilize Obamacare that they say could be unveiled as soon as a week from now. "We're getting very close," Kasich said in a joint interview with Hickenlooper on Colorado Public Radio. "I just talked to my guys today, and men and women who are working on this with John's people, and we think we'll have some specifics here. John, I actually think we could have it within a week." Kasich and Hickenlooper, members of opposing parties, have been doing a series of interviews calling for a bipartisan approach on health care to stabilize insurance markets.

• Ohio Insurer Fills Obamacare's Last 'Bare' County Politico by Paul Demko — Every county in the country will now have at least one insurer selling Obamacare plans next year. CareSource agreed to offer coverage in Paulding County, Ohio, a rural area along the Indiana border that was the country's last remaining bare county, the Ohio Department of Insurance announced this morning. Despite President Donald Trump's claims that Obamacare is "dead" and repeal efforts in Congress, the Ohio announcement is the latest evidence that the health care law's insurance markets are proving to be resilient. The Trump administration has repeatedly cited dwindling competition as evidence that Obamacare is failing and must be scrapped. Nearly half of the counties nationwide, predominantly in rural areas, will only have one insurer next year.

• Medicare to Divulge When a Doc's Patient Is in an ACO Modern Healthcare by Virgil Dickson — The Centers for Medicare and Medicaid Services (CMS) is making a more concerted effort to make sure doctors know which patients they're responsible for in Medicare accountable care organizations (ACO). The CMS has updated the Medicare website to allow a beneficiary to list his or her primary-care doctor. If that doctor is in an ACO, the beneficiary would be assigned to both that provider and their ACO starting next year. There currently are 480 shared-savings Medicare ACOs serving over 9 million beneficiaries. "With the old methodology, the ACO and the physician did not have a real benchmark to measure their performance against," said Dr. Sanjay Seth, chief operating officer of HealthEC, a population health management company that works with ACOs to track patient care. "It was always a moving target." The new patient selection option on the Medicare website will help eliminate the uncertainty now faced by clinicians over how they'll be assessed by the CMS, Seth said.
  
  

• Health Care Organizations Ask CMS to Harmonize Electronic Health Records Requirements Modern Healthcare by Rachel Z. Arndt — Health care organizations praised the CMS for proposing greater flexibility in electronic health record requirements under the Merit-based Incentive Payment System track of MACRA and asked the agency to standardize EHR requirements across incentive programs. The Healthcare Information and Management Systems Society, the American Hospital Association, the American Health Information Management Association and others supported CMS' proposed 2018 performance year rule's change that would allow clinicians to continue to use 2014 edition certified EHRs for another year, potentially saving them the effort of updating and installing new software.  Praising the CMS's "flexibility" in its new EHR requirements, they said in comments on the rule that the agency is appropriately easing the burden on providers at a time when there are few 2015 edition certified EHRs available.

Editor: Peter Van Vranken