Latest Morning Briefing Stories

UnitedHealth Reverses Course, Approves Coverage For $2.1 Million Gene Therapy For Family Racing Against Clock

KHN Morning Briefing

Lauren Sullivan had been trying to appeal UnitedHealth’s initial refusal of the drug for her 21-month-old daughter, Daryn. The girl was running out of time to receive the treatment before her second birthday in October, when the drug has to be administered. The company also approved claims for three other patients. In other news, UnitedHealth beats expectations for the quarter, prompting company to boost earnings guidance.

Biden, Sanders Duke It Out Over Health Care In Public Scuffle That Highlights Party Tensions Over High-Profile Issue

KHN Morning Briefing

Presidential hopefuls Sen. Bernie Sanders (I-Vt.) and former Vice President Joe Biden would take separate paths on how to address health care, with Sanders going for an overhaul approach and Biden favoring building on what exists. The two philosophies have come to divide a crowded pack of Democrats as the election season starts kicking into gear, and in the past few days Sanders and Biden have been publicly swiping at each other over the issue. Meanwhile, governors are particularly worried about candidates’ rhetoric about getting rid of private insurers.

‘Cadillac Tax,’ Once A Key Provision Of Health Law, Dealt Near-Certain Death Blow By Unlikely Foe: Democrats

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The “Cadillac tax,” which never went into effect, was intended to help control costs by putting a brake on the value of health insurance plans and avoid having insurers and employers shifting more costs to policyholders. Its implementation has been delayed for years, and House Democrats voted to repeal it once and for all. It still needs to go to the Senate, but in all likelihood the upper chamber will eagerly follow suit, as Republicans didn’t like the provision.

Negotiations About Overhaul Of VA Health System Stand In Way Of Debt-Limit Deal

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House Speaker Nancy Pelosi (D-Calif.) wrote a letter to Treasury Secretary Steven Mnuchin requesting $22 billion over two years to cover the cost of a revamp of the VA health-care program signed into law last year. She said that the funding for the program should be in addition to the equal increases she is seeking for nonmilitary and military funding. Lawmakers are trying to get an overall deal done before the House leaves for August recess.

‘If You Like Your Plan … You Can Keep It’: Biden’s Blast-From-The-Past Promise Highlights Pros, Pitfalls Of His Health Strategy

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Former Vice President Joe Biden made a similar vow to voters at an AARP/Des Moines Register forum that then-President Barack Obama made as he was touting the health law. The echo from years past highlights Biden’s strategy of building upon the system already in place that has only grown in popularity in recent years. But it could put him out of step with the mood of the party. “Politically, Biden is trapped by his old job,” said Scott Jennings, an appointee in former President George W. Bush’s administration.

At First AARP Forum, Presidential Candidates Talk Compensation For Caregivers, Age Discrimination And Drug Prices

KHN Morning Briefing

All four of the participants at the first of five presidential candidate forums that AARP and the Des Moines Register are sponsoring in Iowa favored a more moderate expansion of health care coverage over progressive “Medicare for All” proposals. Monday’s forum in Des Moines featured former Vice President Joe Biden, Sens. Cory Booker (N.J.) and Amy Klobuchar (Minn.) and former Colorado Gov. John Hickenlooper.

Appeals Court Delivers Blow To Trump Administration As It Upholds Decision To Block Contraception Exemptions

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Judge Patty Schwartz, writing for the 3rd U.S. Circuit Court of Appeals in Philadelphia, said the Affordable Care Act plainly states that women must be provided preventive health services. The Trump administration’s rules that would allow employers to deny workers insurance coverage for birth control due to religious or moral objections sparked an immediate court challenge when rolled out in November.

Affordable Care Act 2.0: Biden Unveils Plan To Expand Health Law, Sharpening Dividing Line Between Candidates

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Former Vice President Joe Biden rolled out his health plan Monday morning following a weekend of trading jabs over “Medicare for All” with Sen. Bernie Sanders (I-Vt.). Biden’s plan would include the creation of a public option as well as the elimination of the existing cap on health care tax credits to make coverage more affordable. The proposal solidifies Biden’s stance as one the health law’s biggest defenders in a race where health care has become a dividing topic between the candidates.

PBMs Breathe Sigh Of Relief As Trump Kills Drug Rebate Proposal And Pharma Companies Become Next Likely Target

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President Donald Trump’s drug pricing strategy received its second major blow this week on the announcement that the proposal to eliminate drug rebates in Medicare and Medicaid plans will be withdrawn. In January, HHS Secretary Alex Azar said that the proposal had “the potential to be the most significant change in how Americans’ drugs are priced at the pharmacy counter, ever.” But the changes met significant pushback from insurers and hospitals who worried the proposal wouldn’t force drugmakers to lower prices and would likely see higher profit margins from it. Looking forward, Trump will be left considering ideas that are more popular with progressives than his party.

Family Races Against Ticking Clock To Get Coverage Approval For $2.1M Gene Therapy

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A pricey treatment offered hope to a family with a daughter with a rare defective gene that causes spinal muscular atrophy. The therapy must be administered before the age of 2, but the family is locked in a fight with its insurance company over coverage. In other pharmaceutical news: the use of PrEP in the fight against AIDS, Massachusetts’ governor’s drug plan, clinical trial data, and more.

California Expands Medi-Cal To Cover Young Adults Living In Country Illegally As Issue Gains Traction In 2020 Race

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California already covers low-income children regardless of immigration status, but now has become the first state in the country do go further to young adults. Meanwhile, the Democratic debate thrust the issue into the national spotlight after the candidates showed support for expanding health care coverage for everyone in the country. Meanwhile, border arrests are finally dropping, but still remain high.