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Sen. Bob Casey (D-Pa.) wants CMS regulators to look into Medicaid managed care companies that he says are prioritizing profits over patients. After meeting with Centene, the nation’s largest Medicaid managed care company, Casey was appalled. “I thought they would try to persuade me that they were going to do better, but they didn’t seem interested in that at all,” he said. Meanwhile, advocates fear that if an Obama-era rule is dropped from Medicaid there won’t be enough providers to care for the low-income patients.
Along with the opioid guidance, CMS also is directing states to design and implement a program to track and manage the prescribing of antipsychotic medications for children in Medicaid. Other Medicaid news comes out of New York, Louisiana and Kansas, as well.
The new trend of relying on those strategies for those who are underinsured ends up giving an advantage to those with more resources, larger social networks and stories better suited to dramatic online appeals. “We shouldn’t be the solution,” said GoFundMe Chairman Rob Solomon. “We know we’ve become a kind of de facto safety net.… But we’re only scratching the surface of all the need out there.”
In 1949, then-President Harry Truman promised that under his plan for a national health system “patients will remain free to choose their own doctors,” and it “will not require doctors to become employees of the government.” The decades-old vows echo campaign arguments from today’s presidential candidates, in a sign of just how hard it is to rework such a complex and important part of American life. Meanwhile, the candidates tout their health plans at a labor forum in Nevada.
The industry is even outpacing others when it comes to profit growth, and UnitedHealth and Anthem, the two largest insurers, each beat Wall Street estimates with their second quarter results. Other health industry news looks at medical device litigation, a lab’s court challenge of a multi-billion dollar Medicare cut, hospices, and more.
In the past couple of years, Democrats have found health care to be a winning issue for them politically. But as the candidates edge toward “Medicare for All” and public option plans, the issue could once again become a weak spot. And outlets take a look at which issues were missing from this week’s debates.
A main component of Georgia’s plan had been to request that the federal government fund 90% of the cost to expand Medicaid in the state. But the big federal funding bump looks unlikely: the Trump administration this past weekend rejected a conservative proposal for Utah with limits similar to Georgia’s. Medicaid news comes out of New Hampshire, Louisiana, Florida and Utah, as well.
Health insurers could be effectively eliminated under some of the Democratic plans, and, in general, the companies are a primary target of candidates’ fiery rhetoric over health care costs. But they have to be careful in fighting back too hard: highlighting the issue risks signaling to investors that the Democratic plans could actually come to pass.
Medicare is popular among its 60 million beneficiaries, but the program also has limitations, and it is certainly not “free.” The New York Times takes a deep dive into the federal program that’s such a hot topic of conversation in the 2020 race. Meanwhile, the support from moderates for a public option shows just how far the party has come on health care.
White House advisers are eager to protect President Donald Trump from a repeat of the blue wave that took the House in 2018. It was widely believed that their health care message played a large part in the Democrats regaining the lower chamber. As part of the push to craft a strategy, the White House has prepared executive orders shoring up Medicare and requiring price transparency from hospitals.
Health care once again took center stage at the second night of the latest round of 2020 Democratic presidential debates. Front-runner candidates former Vice President Joe Biden and Sen. Kamala Harris (D-Calif.) scuffled over their health plans — with Biden arguing that the Affordable Care Act should be built up while Harris backed a more progressive expansion of Medicare. Their arguments echo a larger fight within the party over where to go next with health care. Media outlets offer in-depth coverage of the debate night from fact checking dubious figures to taking a look at where the other candidates stand on the issue.
On the first night of the latest 2020 Democratic debates, front-runners and progressive Sens. Elizabeth Warren (D-Mass.) and Bernie Sanders (I-Vt.) bore the brunt of the attacks over their health care plans, which were slammed by moderates as “fairy tale” policy. Warren and Sanders both stood their ground and avoided going after each other. “I don’t understand why anybody goes to all the trouble of running for president of the United States just to talk about what we really can’t do and shouldn’t fight for,” Warren said. “I’m ready to get in this fight. I’m ready to win this fight.” Media outlets offer a broad range of coverage on the nuances of what was argued last night, including insight on middle-class taxes, private insurers, a public option, and a look at where each candidate stands on the issue.
U.S. District Judge James E. Boasberg said “we have all seen this movie before” and criticized HHS Secretary Alex Azar for acknowledging the potential impact of the Medicaid work requirements without analyzing it. “Are the coverage losses in Arkansas likely to be replicated in New Hampshire? We have no idea, since the approval letter offers no hints,” Boasberg said. Medicaid news comes out of Utah, Florida, Missouri, Oklahoma and Minnesota, as well.
In cities, “a public option could come in and soak up all of the demand of the ACA. market,” said Craig Garthwaite, a health economist at Northwestern University. And in rural markets, insurers that are now profitable because they are often the only choices may find it difficult to make money if they faced competition from the federal government. Meanwhile, a new poll finds support is slipping for “Medicare for All.”
“Medicare for All” plans have become something of a litmus test among progressive voters, but a look at how Medicare currently operates–and the treatments it does and does not cover–reveals the pitfalls that await if a proposal like that is ever passed. Meanwhile, candidates get tripped up by private insurers’ role in a new health system. And while many are painting the picture of a health system in crisis, the numbers provide a more nuanced reality.
Sen. Kamala Harris (D-Calif.), a 2020 presidential hopeful, splits the difference between the plans from rivals Sen. Bernie Sanders (I-Vt.) and former Vice President Joe Biden. Her plan would give consumers a choice of joining a government plan modeled on Medicare or choosing from insurance policies modeled on those in Medicare Advantage, and would be run by private insurers rather than the government. “If they want to play by our rules, they can be in the system. If not, they have to get out,” Harris said of the insurance companies. Her shifting position on whether they would be included in her health plan has brought her criticism in the past.
The company’s medical-loss ratio, which represents the share of premiums paid out in claims, was 86.7% in the quarter, higher than the 85.8% that a consensus of analysts had anticipated, according to their research notes. In other health industry news: a social care network from CVS and Aetna, Tenet’s decision to spin off as a separate company, Bayer’s legal mess, and more.
“There are a significant number of investors who are completely on the sidelines from the industry,” SVB Leerink biopharma analyst Geoffrey Porges said. “And you can pick your ‘until’: until the proposed rule on Medicare international reference pricing is announced, or until the next Democratic debate, or until the election. There’s a lot of ‘until’s.”
Although Senate health committee Chair Lamar Alexander (R-Tenn.) had previously said he hoped to get something out before recess, it’s now looking like the measure won’t be done until lawmakers come back after August.
The Washington Post Fact Checker blasts the claim. While President Donald Trump’s 2020 budget did propose reductions in anticipated spending on Medicare, it was completely unrelated to the tax cut passed by Congress in 2017. In other news, HHS Secretary Alex Azar suggests that Medicare Advantage plans could see pay boosts.