Updated guidance issued last year by the departments of Health and Human Services and Treasury for states seeking a Section 1332 waiver of certain Affordable Care Act requirements qualifies as a rule under the Congressional Review Act of 1996, the Government Accountability Office ruled yesterday. The CRA requires regulatory agencies to submit a rule to both chambers of Congress and the comptroller general. Senate Finance Committee Ranking Member Ron Wyden, D-Ore., and House Energy and Commerce Committee Chairman Frank Pallone, D-N.J., requested the GAO opinion. A majority vote in both houses could overturn the guidance. The House in May passed AHA-supported legislation (H.R. 986) that would rescind the guidance.
 
In other news yesterday, the Centers for Medicare & Medicaid Services released additional details on the four waiver concepts introduced shortly after the release of the updated guidance. Included in the new materials are detailed descriptions of the waiver concepts, as well as model application templates for states. The new waiver concepts include options for states to design new subsidy structures, provide financial assistance for non-qualified health plans, and implement risk stabilization strategies to address high cost enrollees.     

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Elrod at the end called the appeal a “very complex case,” and so predictions are even harder than usual. There is no deadline for the court’s decision.