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HHS Presses on with Regulatory Reforms

By Christopher Cheney  
   April 03, 2017

With no new healthcare law in place or in sight, President Trump's efforts to recast healthcare reform are in the hands of Tom Price and Seema Verma.

Legislation to repeal, replace, or repair Obamacare has stalled in Congress, but the Trump administration has launched regulatory efforts to transform the federal government's role in the healthcare industry.

Last week, the Department of Health and Human Services published an online summary of the how the Trump administration is crafting its regulatory approach to the Patient Protection and Affordable Care Act until the law can be changed.

"This is the first shot. It may be the only shot, but they are outlining several things that they are going to do with what they consider to be their regulatory power," says Merrill Matthews, PhD, resident scholar at the Irving, TX-based Institute for Policy Innovation.

Providing more flexibility to states in the implementation of reforms and running the Medicaid program are apparently top priorities for Secretary of Health and Human Services Tom Price and Administrator of the Centers for Medicare & Medicaid Services Seema Verma, he says.

"They are going to try to be as flexible as they can possibly be under the law—even to the point where they might get challenged in court."

HHS highlights five regulatory focal points:

  1. Backing state-driven Medicaid reforms, including increased cost-sharing for patients
  2. Supporting state innovation such as initiatives designed to strengthen the individual insurance market
  3. Allowing patients to keep pre-PPACA health plans without facing penalties
  4. Easing insurer preparation for the HIX market in 2018 such as extending health-plan filing deadlines
  5. Changing health-plan requirements on the PPACA exchanges to lower premiums such as allowing insurance carriers to offer skimpier coverage and narrower provider networks


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Christopher Cheney is the senior clinical care​ editor at HealthLeaders.

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