WHAT COMES NEXT FOR THE ACA — Buoyed by Obamacare’s newfound safety, liberal health policy experts are pressing the Biden administration to patch longstanding holes in the law flaws they worry have pushed up claim denials and narrowed provider networks, POLITICO’s Susannah Luthi reports. A report earlier this year found that insurers on the Obamacare markets denied an average of 17 percent of submitted medical claims in 2019, though that number ranged widely depending on the state. It’s a problem that advocates warn could worsen unless the government takes a harder line with insurers — and one they argue deserves more scrutiny, now that it’s clear the law is here to stay. Among the options policy experts have proposed: an HHS audit of health plans’ claims denials and new standards that would ensure patients can see doctors without traveling too far or waiting too long. There is also growing concern over the prices insurers are charging for their plans, with advocates pointing to the record-breaking rebates likely to be paid for a third straight year by companies that didn't funnel at least 80 percent of customers' premiums toward paying for medical claims. And HHS has also committed to investigating whether insurers have been adding enough providers to their networks. But that won’t happen until next year. A spokesperson added the department is “always looking for ways to improve oversight” in the meantime, but offered few specifics. THE BREWING RED-STATE VACCINE SHOWDOWN — An executive order in Arizona and a bill in Florida have banned universities from mandating that students show proof of their vaccination status before returning to campus. And a group of Indiana University students are suing over that school’s vaccine requirement. It’s the latest partisan flashpoint in the pandemic, POLITICO’s Ben Leonard reports. As many as 16 states have imposed some form of ban on government vaccine mandates, disputes that could also hamper efforts to boost the nation’s overall vaccination rate as the Biden administration struggles to convince younger adults to get their shots. The American College Health Association has backed the mandates, and most colleges have long required students to get other vaccines. But after Arizona State University rolled out its vaccination plan earlier this month, GOP Gov. Doug Ducey issued an executive order blocking its requirements. Florida Gov. Ron DeSantis moved even faster, signing a ban on mandates at both private and public colleges and universities in May. The fight over IU is ongoing, though after state Attorney General Todd Rokita warned its planned mandate could violate the law, the school announced it would only require students to self-attest that they’d been vaccinated. — Listen: On today’s POLITICO Dispatch , Adam goes deep into what’s driving the vaccination slowdown, and why the Biden administration is likely to miss its Independence Day goal of partially vaccinating 70 percent of all adults. FIRST IN PULSE: LAWMAKERS BRING BACK MEDICAL TEST REGS OVERHAUL — A bipartisan, bicameral group is reintroducing tweaked legislation Thursday that would overhaul how the FDA oversees laboratory-developed tests and diagnostics, POLITICO’s David Lim reports. The VALID Act would regulate both lab tests and diagnostics under a new framework clarifying the responsibilities of the FDA and CMS. Reps. Larry Bucshon (R-Ind.) and Diana DeGette (D-Colo.) are backing the bill in the House, with Sens. Michael Bennet (D-Colo.) and Richard Burr (R-N.C.) sponsoring the Senate version. “We can’t allow an outdated and inefficient system to hold us back when trying to respond to an emerging threat, such as the coronavirus,” DeGette said in a statement. The effort follows scrutiny over how the government regulates medical tests, after the Trump-era HHS last year tried to limit the FDA’s oversight of certain tests developed and used by individual labs. But it could take months for legislation to find its way to the floor. Multiple congressional aides told David that it’s more likely the bill would be included in FDA user fee reauthorizations that will come up in 2022. |