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The new rule would allow officials to deny permanent legal status to immigrants who are likely to need public assistance, like Medicaid or food stamps. In the past, only substantial and sustained monetary help or long-term institutionalization counted against applicants.
CMS Chief Seema Verma is finalizing a plan to allow states the flexibility to convert their Medicaid programs into block grants. While supporters of the idea say that gives states the freedom to find cost-saving measures, critics warn that it incentivizes states to cut coverage for a vulnerable population. In other Medicaid news: care coordination, coverage for kids, minimum wage increases, and managed care companies.
More than half a dozen states are considering legislation that would penalize doctors for performing certain treatments for transgender patients. The speed and number of state bills has mobilized activists, suicide prevention groups and civil rights organizations. In 2018, the American Academy of Pediatrics released a policy statement that recommended giving youths “access to comprehensive gender-affirming and developmentally appropriate health care,” while noting the benefits and risks of using hormones that delay puberty.
The Blue Cross Blue Shield Association and 18 of its member organizations are teaming up with Civica Rx, a nonprofit that is already selling drugs used in hospitals to health systems. The move comes not long after California Gov. Gavin Newsom floated a similar proposal, in which the state would contract with outside manufacturers to sell generic drugs under a California label.
The funding for Texas was cut during the Obama administration after the state Legislature excluded Planned Parenthood from the Healthy Texas Women program. Other conservative states are watching the outcome of the decision as they consider excluding abortion providers from their programs as well.
“At the right time, we will take a look at that. You know, that’s actually the easiest of all things, if you look,” President Donald Trump said in response to a question whether cuts to programs like Medicare and Social Security were on the table. The statement was a departure from the last election when Trump tapped into the popularity of the two programs while wooing voters.
Had the Supreme Court granted the House Democrats and states defending the law a quick court date, a ruling may have been issued before the 2020 elections that could have done damage to President Donald Trump and other Republicans. With the law’s growing popularity, it’s widely viewed as a winning topic for Democrats.
Approving state waivers to change Medicaid funding to block grants would be among the Trump administration’s most controversial moves to reshape Medicaid. While supporters of block granting say it gives states more flexibility, critics warn that it creates incentives for states to cut aid for its most vulnerable populations. Meanwhile, Medicaid expansion advocates are frustrated by the last remaining red-state holdouts.
The gene therapy, which isn’t officially priced yet, was extremely successful in trials. Its maker says that insurers seem on board with paying somewhere between $2 million and $3 million for the drug, which would break the previous record held by Novartis’ spinal muscular atrophy drug. Experts warned when Novartis’ drug was approved at its $2.1 million price that it was setting a bad precedent. In other pharmaceutical news: more updates from the JP Morgan conference, the science behind the Ebola vaccine, a diabetes pill, and more.
Nebraska wants to create a “prime” tier for those meeting work requirements and a more “basic” tier for those who aren’t. The model might allow the state to implement work requirements while alleviating courts’ concerns about people being dropped from enrollment. Medicaid news comes out of California, Missouri and Ohio, as well.
“I thought, ‘What if people out there don’t know that they have the right to tell those people to screw off?’” said Shaunna Burns, whose TikTok video helped a 22-year-old woman get her hospital bill reduced to zero.
UnitedHealth executives said they added 370,000 Advantage members during the open enrollment period that ended Dec. 7, which reflects growth of about 140% over the prior annual enrollment period. As the program grows in popularity, insurers clamor for a piece of the lucrative marketplace.
“Medicare for All” has been a hot topic throughout the 2020 Democratic primary race even as its popularity ebbs and flows. Now, as early voting states prepare to head for the polls, advocates hope to bolster sometimes-flagging support for the proposal.
A new study finds that coverage gains made in the early years of the health law are slipping. Researchers blame the shift largely on continued lack of coverage for adults in the 15 states that hadn’t expanded Medicaid.
Sen. Ron Wyden (D-Ore.) and Rep. Frank Pallone Jr. (D-N.J.) say Tennessee’s proposal would create a financial incentive for the state to cut coverage benefits for consumers, because it’s allowed to keep some amount of any of the unspent federal funds it’s awarded. Medicaid news comes out of Kansas and Ohio, as well.
Although the domestic agenda was somewhat anchored by discussion of health care, the topic didn’t take center stage like at previous debates. Sen. Bernie Sanders (I-Vt.) focused on the cost of the status quo while moderates like Sen. Amy Klobuchar (D-Minn.) made the argument that debating “Medicare for All” is a pointless since many in Congress don’t support it.
President Donald Trump defended his administration’s efforts to protect health coverage for Americans in response to presidential hopeful Michael Bloomberg’s ads, but fact checkers and other experts were quick to point out that Trump has gone to great lengths to weaken the health law and its popular provisions throughout his presidency. “That tweet is so far inconsistent with the direction of their policy push,” said Linda Blumberg, a health policy analyst at the Urban Institute. “It’s just astounding to me.”
Pharmacy benefits managers, the controversial middlemen in the drug pipeline, are a favorite target to blame for higher prescription drug costs. A Supreme Court decision on how much oversight states can place on PMBs could send shock waves through the debate over health care costs. In other pharmaceutical news: genetic testing and proprietary data, lax oversight of the 340B drug program, a startup with the possible answer to high drug costs, and more.
Democrats had urged the Supreme Court to take up the case in the current term as it is unlikely otherwise to be decided upon before the 2020 elections. The Republicans, including the Trump administration, were given until Friday to respond. They said there’s no need to rush the case through the system.
The federal government is arguing that insurers received increased subsidies when they raised premiums, which more than compensated their losses. Judges in the U.S. Court of Federal Claims have so far sided with insurers and ruled that their strategies to mitigate losses from CSR payments do not affect their eligibility for repayment. Meanwhile, states report their health law enrollment numbers.