Health Plan Weekly

CVS Health Corp. announced on Aug. 1 an initiative to provide timely excessive heat alerts and outreach to at-risk members of Aetna health plans. CVS is focusing on people “most vulnerable to extreme weather events that can worsen existing chronic conditions,” according to a press release. This fall, it will expand to people who are susceptible to reduced lung function, asthma and cardiac problems. CVS plans to make the service available eventually to its MinuteClinic and CVS Pharmacy locations. CVS said care managers have worked with “hundreds of at-risk patients” in 20 states since launching the initiative two weeks ago. 

Eleven Democratic Senators on July 23 introduced a bill, the Stop Corporate Capture Act, that would overturn the Supreme Court’s rulings last month that effectively repealed Chevron deference, a legal precedent that gave agencies broad leeway to interpret laws. Sen. Elizabeth Warren (D-Mass.), one of the bill’s sponsors, said in a statement that the act “will bring transparency and efficiency to the federal rulemaking process, and most importantly, will make sure corporate interest groups can’t substitute their preferences for the judgement of Congress and the expert agencies.” A July 23 Reuters article noted the bill “has slim chances of passing in an election year in the Senate, which the Democrats only narrowly control.” Reuters also reported that a similar bill is pending in the House of Representatives.  

With Vice President Kamala Harris now poised to get the Democratic nomination for president, Wall Street analysts have been busy prognosticating what that means for the array of for-profit health care firms they cover — including health insurers. 

So far, select analysts are predicting that Harris’ ascendence will give Democrats a greater chance of winning the election, which would be bad news for Medicare Advantage-focused insurers but good for those more focused on Medicaid and the Affordable Care Act exchanges. 

Molina Healthcare, Inc. has agreed to pay $350 million to acquire ConnectiCare, a subsidiary of EmblemHealth that covers about 140,000 medical livesa in Connecticut. The July 23 announcement occurred one day before Molina reported second-quarter earnings results that beat Wall Street analysts’ projections. The ConnectiCare deal is expected to close in the first half of next year and is subject to regulatory approvals. 

Fellow insurer Centene Corp., meanwhile, reported second-quarter financial results on July 26 that underscored the elevated cost trends it’s seeing in its dominant Medicaid segment. Like other insurers, Centene is feeling the effects of a higher-acuity risk pool created by the exodus of millions of people from the Medicaid rolls since states restarted routine eligibility checks last spring. Still, other positive developments for Centene led one Wall Street analyst to declare its quarterly performance “mixed.” 

CMS on July 19 took new steps to protect Affordable Care Act marketplace enrollees from unauthorized plan switching — moves that were applauded by the independent broker industry. One policy expert says the new policies are welcome and should help with unauthorized plan switching, but she suggests that more must be done to prevent unauthorized plan signups. Meanwhile, a new Senate bill and industry efforts could make a difference in unauthorized signups. 

In a July 19 press release, CMS said it would make notable changes in the way it processes plan switches on HealthCare.gov, including: 

Legal experts during a recent panel discussion said federal agencies and lawmakers have new uncertainty around health care regulation in the aftermath of the Supreme Court’s decision to end a legal concept that gave agencies broad leeway when they issued rules.  

In its rulings in Relentless v. Department of Commerce and Loper Bright Enterprises v. Raimondo, the Supreme Court effectively repealed Chevron deference, a legal precedent that is more than 40 years old. The idea behind it is that agency staff have subject matter expertise that Congress is unlikely to share, and Congress couldn’t be expected to continually update statutes to address every emerging issue of importance to a specific sector of the economy.