Latest Morning Briefing Stories
Some American cities with high HIV rates already have programs that pay the costs of PrEP for the uninsured, but the new program — called Ready, Set, PrEP — marks the first time the government is supplying the drug to patients not enrolled in Medicaid, the Veterans Health Administration or any other federal health program.
Michigan Gov. Gretchen Whitmer, a Democrat, is worried about coverage losses seen in other states. But the Republican-controlled Legislature would have to agree to the pause.
The revelation that lobbyists helped draft or made edits to the lawmakers’ opinion pieces shows that critics of “Medicare for All” are investing time and energy beyond the presidential debate over the policy issue.
The public option, of course, would be less disruptive than getting rid of private insurance all together, but an inexpensive and attractive plan could still shake up the industry landscape. Meanwhile, former Vice President Joe Biden says 2020 rival Pete Buttigieg “stole” his health care plan.
CMS has been vocal in encouraging states to create more restrictions on their Medicaid programs. Many looked to work requirements, but those plans have faced major legal setbacks in courts. Tennessee could be leading the way on a new path. Medicaid news comes out of Missouri and New York, as well.
Sign-ups tend to dip over the holidays, so it’s likely that next week the reported numbers that include Thanksgiving, will be lagging behind once more. Sign-ups overall are expected to be slightly lower this year.
Sen. Elizabeth Warren (D-Mass.), known for having a plan for everything, started the race by signing onto Sen. Bernie Sanders’ (I-Vt.) “Medicare for All” proposal. That decision has left her entangled with an issue that seems to be sinking her polling numbers and leaving both progressives and moderates unsatisfied, even though it wasn’t her policy to start with.
Media outlets report on news from Puerto Rico, U.S. Virgin Islands, Maryland, New Hampshire, Minnesota, District of Columbia, Florida, Wisconsin, Georgia, Ohio and California.
Veterans Affairs has rolled out a telemedicine app, offers services online and in rural areas is opening telehealth clinics at VFWs. State restrictions were dropped for the VA, allowing VA physicians and nurses to administer care to veterans via telemedicine across state borders, regardless of state licensing. Other news on veterans is on treatment for toxic exposures and a tragic discovery.
Before schools weren’t allowed to bill Medicaid, but that changed in 2014. By billing the program, schools say they will be able to help students manage chronic conditions such as asthma, diabetes and food allergies; offer mental health and addiction treatment; and provide dental, vision, hearing and speech services more effectively. Medicaid news comes out of Louisiana, New Hampshire and Idaho, as well.
U.S. District Court Judge Michael Simon said there was no national security or foreign relations justification for the sweeping change in immigration law, and thus the policy violated the Constitution’s separation of powers.
Politico reports on the escalating feud between HHS Secretary Alex Azar and CMS Administrator Seema Verma and the disruptions people close to the situation say it has caused. Privately, Azar’s and Verma’s camps are pointing the finger at one another, and disclosures about Verma’s use of highly paid consultants to raise her personal profile exacerbated the tensions.
Reports that Brigham Young University-Idaho wouldn’t accept Medicaid as acceptable insurance for students prompted an outcry of criticism. The university had claimed the change was due to the impracticality for the local medical community to provide for the health care needs for the students, but local providers disputed that reasoning.
CMS revamped its system to help beneficiaries navigate Medicare enrollment, but the newly redesigned tool has been causing confusion for many instead. The flawed results being shown include inaccurate premium estimates, incorrect prescription drug costs and inaccurate costs with extra help subsidies.
While many in Congress are agreed that something must be done to address surprise medical bills, the lawmakers have been split over which of a handful of strategies to choose in moving forward. In other health industry and insurance news: record-high debt, gender pay gaps, state health exchanges, and more.
Warnings are being issued at all levels of the party–from union members to candidates running in swing states. “We won in Kentucky and Louisiana, barely, in part, because we won on health care. I don’t think we can afford to lose on health care,” Gov. Gina Raimondo (D-R.I.) said. Meanwhile, industry opponents for “Medicare for All” are starting to go after the moderates’ health plans as well. In other election news, Sen. Kamala Harris (D-Calif.) has a plan to expand mental health treatment.
A so-called “public option” would allow people to buy a government-run health plan that competes with the private marketplace. In previous years, the policy was considered extreme, while now it’s starting to sound like the moderate option in the current political landscape. Meanwhile, Politico takes a look at the army being built to fight “Medicare for All.”
During open enrollment season, health experts say to watch out for “junk” insurance plans that were expanded under the Trump administration and don’t have to meet standards set by the Affordable Care Act. Meanwhile, investors are betting that the Supreme Court rules in favor of insurers in a case over “risk corridor” payments.
Even those who have been prioritized with the most need are facing a daunting wait-list for care. “We need to help legislators understand in the long run it’s better to support these individuals now,” said Erin Suelmann, executive director of the Down Syndrome Association of Greater St. Louis. “It’s a moral issue, too. These are our most vulnerable population and we need to be caring for them.” Medicaid news comes out of Ohio, Colorado and Pennsylvania, as well.
The Medicare plan finder’s issue stems from a significant change the agency made for 2020. The plan with the lowest premium now gets automatically placed on top, with the monthly premium displayed in large font. Medicare’s previous plan finder automatically sorted plans by total cost, not just premiums, because they are only one piece of information. Meanwhile, a new study shows that Medicare prescription plans are slower to cover new generics than private plans.