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Tag: Stabilization

The Incredible Self-Destructing Healthcare Marketplace

Too frequently what gets overlooked in policy making are the regulations that implement or update legislation.  As Henry Mintzberg observed over 30 years ago policy is oftentimes formed without being formulated.  For example, the Congress did not define the most important provision in MACRA.  The Congress simply defined financial risk under an Alternative Payment Model (APM) as monetary losses in excess of a nominal amount.  It was CMS that determined via regulatory rule making specific revenue and benchmark-based standards.  While the focus has largely been on Congressional Republican efforts to repeal the ACA, three weeks ago the Trump administration recommended regulatory changes, via a proposed “market stabilization” rule, that will likely, should it as anticipated go final this month or next, have a more near term negative effect on state marketplaces.     

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