Latest Morning Briefing Stories
The report comes amid the state’s struggle to contain costs for its Medicaid program. Medicaid news comes out of Kentucky, Maine and Wisconsin, as well.
The letter prompted the recipients to sign up for health coverage to avoid penalties, which in turn prevented premature deaths that would have occurred without it. It was essentially the first rigorous experiment to find that health coverage leads to fewer deaths, a claim that politicians and economists have fiercely debated in recent years
South Bend Mayor Pete Buttigieg drew fire on the presidential campaign trail for his consulting work for McKinsey. Buttigieg says he “never worked on a project” inconsistent with his values, and maintains that although he worked with Blue Cross Blue Shield of Michigan during his tenure, he focused on expenditures like rent, utilities and company travel. Two years after he worked on the case, the insurer cut up to 1,000 jobs.
The government promised to cushion the blow for some insurers if they entered the health law marketplace, but then Congress stripped the money out of the budget. The insurers say they are owed $12 billion. From the questions during the oral arguments it seems like the Supreme Court justices may agree, though both Chief Justice John Roberts and Justice Samuel Alito were skeptical of some of the insurers’ points.
Union workers, which can be a powerful voting bloc for Democrats, are concerned that a “Medicare for All” plan will upend the hard-won coverage they’ve negotiated for themselves. “What you’ve got is something I want to see replicated all across America,” Sen. Elizabeth Warren (D-Mass.) said. But she didn’t answer how she would protect their coverage.
Instead of playing by the rules of the traditional health system, primary care doctors are charging patients a set fee per month to cover a range of basic services. This lets them spend more time with patients and avoid the headache of dealing with insurers.
“This combination will expand the innovative specialty pharmacy and infusion solutions OptumRx can offer to the consumers and clients we serve,” said John Prince, the chief executive of OptumRx, a division under UnitedHealth. In other health industry news: cigarette stocks rebrand, a former executive pleads guilty to fraud, Banner Health agrees to a settlement over a data breach.
The “risk corridor” program was the financial carrot to get insurers to participate in the marketplaces. But Republicans stripped most of the money from the program in 2014. Now insurers say the government owes them $12 billion. “At its core, this isn’t really a case about health policy,” said Christen Linke Young, a fellow at the Brookings Institution. “It’s a case about whether or not the government keeps its word.”
Efforts to address surprise medical bills had stalled until a bipartisan agreement emerged over this past weekend. The White House praised lawmakers’ “delicate work” to reach a deal, which is a compromise between two other strategies for dealing with the costs. But even with the White House’s support, question marks remain about whether the deal can be pushed through both chambers and sent to President Donald Trump by the end of the year.
Meanwhile, more than 1,000 employers, insurers, unions and other groups are urging lawmakers to kill the unpopular provision, which sets up a tax on expensive employer-sponsored health plans.
And Medicare officials hinted Friday that they would be amenable to providing a window for beneficiaries who are worried about their plans. Other news on Medicare focuses on: prescription drug prices, hospital and hospice payments, and increasing costs.
“Medicare for All” has tripped Sen. Elizabeth Warren (D-Mass.) up in recent weeks. Now in Iowa, Warren is treading lightly on the issue. Meanwhile, black voters support a single-payer system more than any other group, but they still support former Vice President Joe Biden over the more progressive candidates.
Tackling surprise medical bills was touted as an issue that might actually make it through the severely divided Congress, but then talks broke down earlier in the year when it came time to choose a strategy to move forward with. Now a proposal from key House and Senate leaders, built on the idea of a dispute resolution system, could be gaining traction.
Eliminating the increase would produce cost savings for Medicare without hurting access to care or the willingness of ambulatory surgical centers to deliver services to Medicare beneficiaries, the Medicare Payment Advisory Commission ruled. In other news, Saturday is the deadline for Medicare enrollment, but some advocates are calling for flexibility because of the difficulties some beneficiaries have encountered while trying to sign up.
But while the growth in health care usage slowed last year, larger hikes in prices more than offset it. Overall, national health care spending rose to $3.65 trillion in 2018, up 4.6% from 2017, according to an annual report by nonpartisan economic HHS experts. Retail prescription drug prices dipped by 1%, the first drop since 1973.
The method that Reps. Joe Morelle, (D-N.Y.), Donna Shalala (D-Fla.) and Van Taylor (R-Texas) are trying to build support for is favored by many providers. Although many lawmakers want to address the issue of surprise medical bills, debate has raged over who gets stuck with the cost at the end of the day. Other news on health care costs focuses on: expensive emergency room visits, value-based care, hospital closures, and more.
Although the work requirements played a key role in getting state Republicans to buy in to the idea of expanding Medicaid in Virginia, Democrats recently won control of the Legislature. Now, Democratic Gov. Ralph Northam has directed his administration to “pause” any of those efforts.
Former Vice President Joe Biden pitched a tax plan that includes a more moderate corporate tax increase in contrast with his progressive rivals. Biden “is committed to being transparent with the American people about the smart and effective ways he’d pay for the bold changes he’s proposing,” his campaign said. In other news, “Medicare for All” continues to be a landmine for Democrats. How did it get that way?
Opinion writers and editorials explore these and other health care issues.
A new study found that states that used “silver-loading” or “silver-switching” strategies to compensate for the cost-sharing reduction payment cuts offered lower premiums for subsidized enrollees. The Trump administration has solicited feedback on potentially banning silver-loading in 2021. In other insurance and costs news: bundled payments, penalties, health care sharing ministries and more.