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3. Political Cartoon: 'Open Sesame'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Open Sesame'" by Bill Schorr, Cagle Cartoons.

Here's today's health policy haiku:

TO PAY FOR SUBSIDIES OR NOT TO PAY FOR SUBSIDIES ... THAT IS THE QUESTION

Cost-sharing payments:
Trump must decide whether to
Ensure disaster.

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Summaries Of The News:

Health Law

4. Last-Minute Tweak To GOP Health Bill Does Little To Ease Intraparty Standoff

Republicans add language to create a risk-sharing fund, but both sides that have been fighting over the legislation say the change is not enough. Yet, House leadership tells members that they could be called back from recess early if a health plan deal is reached.

The Associated Press: GOP Health Bill In Shambles, House Commences Two-Week Break
The Republican health care bill remained in shambles Thursday as House leaders threw up their hands and sent lawmakers home for a two-week recess. GOP chiefs announced a modest amendment to curb premium increases, but internal divisions still blocked their promised repeal of former President Barack Obama's law. (Fram and Alonso-Zaldivar, 4/6)

The New York Times: Trying To Revive Health Bill, G.O.P. Adds $15 Billion For Sickest Americans
Under intense pressure from President Trump, House Republicans took a small step Thursday to revive legislation to dismantle the Affordable Care Act, adding a $15 billion fund to help insurers pay claims for their sickest customers. Speaker Paul D. Ryan orchestrated a broad show of Republican support for the proposal, conceived as an amendment to the repeal bill that collapsed on the House floor two weeks ago. (Pear, 4/6)

The Wall Street Journal: GOP Leaders Add A Carrot To Health Bill
The new provision would create a fund of $15 billion over the next decade to reimburse insurers for patients with costly pre-existing conditions. House leaders had planned to add it to legislation to replace the ACA, which they pulled just hours before a planned vote last month due to a lack of support. ... The amendment’s co-sponsor, Rep. David Schweikert (R., Ariz.), believes it can pull in “every member who was concerned that we weren’t seeing enough premium efficiency.” It was unclear whether the provision persuaded any Republicans who opposed the overhaul plan to change their minds. (Hackman and Andrews, 4/6)

Bloomberg: To Revive Health Bill, GOP Adds An Obamacare-Like Subsidy 
Called the Federal Invisible Risk Sharing Program, the Republican proposal would give health insurers $15 billion over nine years to subsidize the care of high-cost patients. It’s similar, though less generous, than Obamacare’s three-year-long reinsurance program, which gave insurers $7.9 billion for 2014 and $7.8 billion for 2015, according to data from the Kaiser Family Foundation, and is intended to pay out $4 billion for 2016. (House, Tracer and Edney, 4/6)

The Hill: GOP Amendment Would Give $15 Billion To Insurers To Cover High-Cost Patients 
The idea, modeled after a program in Maine, appears similar to the “reinsurance” idea from the first three years of ObamaCare. That program gave insurers $7.9 billion for 2014 and $7.8 billion for 2015. But experts say $15 billion is not enough to bring down premiums. "$15 billion over 9 years is definitely not enough to make a meaningful difference in premiums or market stability," tweeted Larry Levitt, senior vice president of the Kaiser Family Foundation. (Hellmann, 4/6)

The Hill: GOP Leader Suggests House Could Be Called Back From Recess To Vote On Health Bill
House Majority Leader Kevin McCarthy (R-Calif.) told Republicans as they departed Washington on Thursday that their recesses could be cut short if a deal is reached on legislation to repeal and replace ObamaCare. Such a compromise between the centrist and conservative factions of the House GOP remains a long way off. But McCarthy warned lawmakers they might have to return early if negotiations prove fruitful in the next two weeks. (Marcos, 4/6)

Politico: Frustration Mounts, Careers Jeopardized Over Obamacare Failure
Tempers are flaring at the White House over House Republicans’ failure to repeal Obamacare. But that hasn’t changed the reality on the ground: As Congress skips town for a two-week recess, Speaker Paul Ryan and his team are no closer to approving legislation. In fact, some Ryan allies worry that the White House involvement has only set GOP leaders back further. (Bade and Haberkorn, 4/7)

The Hill: Repeal Push Complicates State Efforts To Get ObamaCare Waivers 
A number of states are readying blueprints for substantial changes under an ObamaCare waiver program, but a renewed push to repeal the law is complicating their plans. The Affordable Care Act’s 1332 State Innovation Waiver lets states skip some of the law’s regulations if their healthcare plan covers a comparable number of people without increasing the federal deficit. States can apply for the waivers starting this year. But a revived attempt to repeal the health law is throwing a wrench in those plans, since states don’t know what a new bill will entail. (Clason, 4/6)

5. Striking Three Things From Health Bill Would Win Over Freedom Caucus

Rep. Mark Meadows (R- N.C.) said the caucus would support the legislation if it did away with essential health benefits; community rating, which says insurers can't charge sick people more for insurance; and guaranteed issue, which says insurers must cover people with pre-existing conditions.

The Hill: Meadows: Freedom Caucus Would Back Bill That Got Rid Of 3 ObamaCare Regs 
The majority of the House Freedom Caucus would vote for a healthcare bill that gets rid of three of ObamaCare's insurer regulations, the group’s chairman, Rep. Mark Meadows (R-N.C.), said Thursday. The caucus has withheld its support from the GOP's ObamaCare repeal bill last month, saying it does nothing to drive down insurance premiums. (Hellmann, 4/6)

6. Aetna Exits Iowa's Health Law Exchanges, Saying Moves To Stabilize Marketplace Not Enough

The decision comes on the heels of Iowa's other major insurer -- Wellmark Blue Cross and Blue Shield -- announcing it will no longer sell plans on the health law marketplace.

The Washington Post: Another State Is At Risk Of Having Only One Obamacare Health Insurer
Two insurers announced this week that they would pull out of Iowa's Affordable Care Act exchanges next year, raising worries that the decisions could be the leading edge of a trend. Insurers face approaching deadlines and major uncertainties about the short-term viability of the exchanges, and beyond, because of politicians' inability thus far to move a specific repeal and replace plan forward. (Johnson, 4/6)

The Wall Street Journal: Aetna To Exit Iowa’s Affordable Care Act Insurance Marketplace In 2018
Aetna said its move in Iowa came “as a result of financial risk and an uncertain outlook for the marketplace” and it was “still evaluating Aetna’s 2018 individual product presence in our remaining states.” Aetna currently offers exchange plans in four states -- Iowa, Delaware, Nebraska and Virginia -- a sharp reduction from its presence last year. It has more than 30,000 enrollees in Iowa. (Wilde Mathews,, 4/6)

Des Moines Register: Aetna To Stop Selling Iowans Individual Health Insurance Plans
Aetna’s brief statement didn’t detail its reasons. But the national carrier already had stopped selling such policies in 11 other states for 2017, citing turmoil in the wake of the Affordable Care Act. Wellmark cited similar reasons, plus the inability of Republicans controlling Congress to replace the Affordable Care Act with a plan that could provide more stability for the market. (Leys, 4/6)

The CT Mirror: Aetna To Quit Iowa’s ACA Exchange, May Leave All Others
Anthem said steps to stabilize the marketplaces, including eligibility verification, more rigid special enrollment periods, and shortening of premium grace periods are steps in the right direction, but not enough. The insurer has a deadline of July 1 to make up its mind whether to continue to sell policies on Access Health. (Radelat, 4/6)