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Sen. Charles E. Grassley (R-Iowa) said this week that Republicans will not try to repeal the Affordable Care Act if they retake the Senate in November’s midterm elections, the latest signal that the GOP is abandoning its long-running effort to scrap the health-care law also known as Obamacare. Grassley, 88, was among the most vocal opponents of the law when it was being debated by Congress more than a decade ago. Back then, some Republicans had falsely claimed a provision in the ACA would create “death panels” that would decide whether older Americans should live or die. At the time, Grassley did not push back against those claims and told Iowans that they had “every right to fear” the health-care law. (Sonmez, 4/13)

The average premium on the Affordable Care Act’s exchanges fell by 1.8% in 2022, declining for the third straight year, a new report finds. A report released Tuesday by the Urban Institute found more insurers joining the exchanges if the state expanded Medicaid or had a state-run exchange. The exchanges saw record enrollment of 14.5 million in 2022 thanks largely to enhanced subsidies that lowered insurance costs. (King, 4/13)

What a difference a bad year makes. President Joe Biden's last special enrollment period for the health insurance exchanges led to a flood of sick, costly customers signing up for coverage. Health plans aren't sure they want more of this type of member. A potential new pool of enrollees is headed their way because of a second pandemic-related special enrollment period and because states are due to restart Medicaid eligibility redeterminations, which is likely to result in people transitioning to the individual market. (Tepper, 4/13)

Many small companies are expected to face double-digit hikes to their health insurance premiums next year — increases that would add to the broader strain on the take-home pay and budgets of millions of American workers, families, and small business owners. Health insurance brokers, consultants, and benefits advisers told STAT that health care premiums for a lot of smaller employers likely will rise by at least 10% to 15% for 2023. The pandemic is contributing to that, creating headaches for insurance actuaries who are trying to estimate how much care people will get while a deadly virus keeps circulating. (Herman, 4/14)

So many people have been "rushed to the hospital because their appendix burst or because they took a nasty fall and who are still paying off the bill years later," Harris said in remarks at the White House. "Parents who have sat in a hospital parking lot, afraid to bring their child through those sliding glass doors of the emergency room because they knew if they walk through those sliding glass doors, they may be out thousands of dollars that they don't have. "The administration's new actions could help ease the burden of medical debts that Americans already have – they do less to prevent Americans from being saddled with high medical bills they can't pay in the first place, says Jenifer Bosco, a staff attorney at the National Consumer Law Center, a nonprofit organization that advocates for economic security for low income people. (Simmons-Duffin, 4/13)

Health systems and payers eager to trim costs think the answer lies in a small group of patients who account for more spending than anyone else. If they can catch these patients — typically termed “high utilizers” or “high cost, high need” —  before their conditions worsen, providers and insurers can refer them to primary care or social programs like food services that could keep them out of the emergency department. A growing number also want to identify the patients at highest risk of being readmitted to the hospital, which can rack up more big bills. To find them, they’re whipping up their own algorithms that draw on previous claims information, prescription drug history, and demographic factors like age and gender. (Ravindranath, 4/13)

When a California Democrat in Congress recently engaged in an extended conversation with Sen. Dianne Feinstein, they prepared for a rigorous policy discussion like those they’d had with her many times over the last 15 years. Instead, the lawmaker said, they had to reintroduce themselves to Feinstein multiple times during an interaction that lasted several hours. Rather than delve into policy, Feinstein, 88, repeated the same small-talk questions, like asking the lawmaker what mattered to voters in their district, they said, with no apparent recognition the two had already had a similar conversation. (Kopan and Garofoli, 4/13)