This week, a bipartisan bill emerged to stabilize the ACA insurance market. It remains unclear whether this compromise proposal will enjoy enough support to pass.
“Alexander said the deal he struck with Murray would extend CSR payments for two years and provide states ‘meaningful flexibility’ under the ACA, allowing them to make changes to insurance offerings as long as the plans had ‘comparable affordability,’ which is a slightly looser definition than the existing one…The framework would also allow insurers to offer catastrophic insurance plans to consumers aged 30 and older on ACA exchanges, while maintaining a single risk pool…”
Sarah Kliff at Vox.com gave the shortest, quickest rundown of the different ACA insurance subsidies, and exactly how the recent Trump executive order would change things:
“The Trump administration is not ending insurance subsidies. Instead, they have created a policy where they spend more money to insure fewer people — something you probably won’t see on the president’s Twitter feed.”
Continue reading Health Policy Updates: October 22 2017
Vox.com runs down the recent Trump executive order on health care:
“The ultimate impact will depend on any new regulations written as a result of the order, but overall, the Trump administration could make cheaper plans with skimpier benefits more available — and experts worry that will damage the ACA’s marketplaces.”
More on the White House’s efforts to undermine Obamacare in absence of a Congressional repeal bill:
“But Trump administration officials say that with insurance premiums soaring in many states, consumers should be able to buy less comprehensive, less expensive coverage as an alternative to conventional plans…That has some insurance experts worried. The influx of a set of plans exempt from the Affordable Care Act rules will essentially divide the market and make it increasingly unstable, said Rebecca Owen, a health research actuary with the Society of Actuaries.”
The NYTimes is keeping track of all the ways the White House has been sabotaging the health care law.
Continue reading Health Policy Updates: October 15 2017
Another frantic news week in health care policy, with the demise of both the Graham-Cassidy Obamacare repeal bill, and of Tom Price’s tenure as HHS secretary.
With passage of Graham-Cassidy looking doubtful, a revised draft of the bill was crafted over last the weekend. This version not-so-subtly moved additional funds to those states with “hold out” GOP senators; this move suggesting something of a vote-buying effort:
“The favoring of certain states over others in the new version of the bill, presumably to please Senators representing the favored states and obtain their votes, raises serious constitutional issues. Law Professor Brian Galle has argued that it would violate the Constitution’s Uniformity Clause, which prohibits laws specifically favoring particular states.”
The overall structure of the bill, including steep Medicaid cuts and a return of pre-existing condition exclusion, remained intact:
“Like the earlier version, the latest draft allows states that obtain block grants to waive certain consumer protections contained in the ACA…As with the earlier draft, however, the consumer protections that the bill does allow states to permit insurers to waive makes protection for people with preexisting conditions very tenuous.”
Continue reading Health Policy Updates: September 30 2017
The Cassidy-Graham Obamacare repeal bill that is currently under consideration in the Senate would be a big step towards allowing insurance companies to once again exclude people on the basis of pre-existing conditions:
“The bill says states cannot tether an individual’s premiums to ‘sex or membership in a protected class under the Constitution of the United States.’ Anything else — a cancer diagnosis, a history of breast cancer, a mild case of asthma — is fair game. In states that did pursue and receive these waivers, health plans would have full authority to charge sicker patients higher premiums to offset their costs.”
Continue reading Health Policy Updates: September 23 2017
There were a couple of great articles in JAMA Internal Medicine this week on cancer drug development and pricing.
The first, discussed in this NYTimes article, did a thorough job of tallying the total R&D cost to bring a new cancer drug to market. The study authors ended up with a significantly lower number than has been reported in the past.
“Following approval, the 10 drugs together brought in $67 billion, the researchers also concluded — a more than sevenfold return on investment. Nine out of 10 companies made money, but revenues varied enormously. One drug had not yet earned back its development costs.”
Continue reading Health Policy Updates: September 16 2017