Latest Morning Briefing Stories

Guidance To Allow States To Request Block Grant Waivers For Medicaid Programs Expected Soon

KHN Morning Briefing

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.

A Record That Keeps Getting Broken: Hemophilia Treatment Poised To Become Most Expensive Drug In World

KHN Morning Briefing

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.

Betting On Medicare Advantage Pays Off Big For UnitedHealth

KHN Morning Briefing

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.

Health Care Takes Back Seat To Foreign Policy, Gender Politics At Democratic Debate As Candidates Cover Well-Trodden Ground

KHN Morning Briefing

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.

Experts Debunk Trump’s Claims That He Saved Pre-Existing Conditions Coverage

KHN Morning Briefing

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.”

Supreme Court Agrees To Hear Potentially Monumental Case Over Extent To Which States Can Regulate PBMs

KHN Morning Briefing

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.

Appeals Court Judges Seem Disinclined To Let Insurers Recoup Loses From Cut To Cost-Sharing Reduction Payments

KHN Morning Briefing

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.

Local Officials Across Country Push Back Against Federal Policy Barring Pre-Trial Inmates From Medicaid Benefits

KHN Morning Briefing

“Just because you’ve been in jail for a short period of time, that shouldn’t automatically knock you off the [Medicaid] rolls,” said David Davis, the Democratic sheriff of Bibb County, Georgia. “You then have to go through enrollment all over again.” The disruption in enrollment can often negatively effect an already vulnerable population of people. Other Medicaid news comes from Iowa, Kansas, Missouri, Georgia, California and the South.

Bundled Payments Fall Short Of Expectations In Cutting Spending, Improving Quality

KHN Morning Briefing

The federal government, hospitals and physicians have been gravitating toward bundled payments, but new studies challenge the belief that they help achieve cost savings. Meanwhile, CMS is proposing changes to Medicare Advantage payments for 2021, including an increase in the percentage of patient “encounter data” used to calculate payments.