Tag Archives: financial toxicity

Health Policy Updates: February 25 2017

An analysis describing the developing Republican proposals for ACA/Obamacare replacement were leaked to the media last week. Vox.com’s Sarah Kliff describes the results that these plans would have if enacted.

“The analysis includes graphs on what the Republican plan to overhaul Obamacare’s tax credits, generally making them less generous, would do. They are based on the recent 19-page proposal that Republican leadership released about their plan to repeal and replace Obamacare…In the individual market, enrollment would fall 30 percent… “

Continue reading Health Policy Updates: February 25 2017

Health Policy Updates: December 3 2016

Health care journalist Sarah Kliff at Vox.com recently started a brand new (and yet to be named!) podcast. The first episode was out last week, and covers the politics of why the US has much high prescription drug costs than other wealthy countries. I can’t really add anything to her excellent coverage and explanation of the issue, and will just say that I HIGHLY recommend taking a listen. I am eagerly awaiting episode #2!

Continue reading Health Policy Updates: December 3 2016

Health Policy Updates: November 26 2016

It is important to remember that rising insurance costs are not a phenomenon limited to the Obamacare exchange plans. Health care costs continue to rise overall, and insurance companies have to charge higher premiums and copays to keep up. Employment-based health insurance plans will be costing 5.5% more, and employee out-of-pocket costs continue to increase even faster and have now nearly doubled since 2009.


A recent study in JAMA Oncology highlighted an important point regarding the “financial toxicity” of cancer care – having Medicare coverage is often not enough to protect from catastrophic costs. 10% of Medicare patients with a new diagnosis of cancer will spend two-thirds of their annual income on health care bills.

“Beyond highlighting the need for innovative initiatives for delivery of care, the high level of hospital-associated OOP costs may also demonstrate potential adverse consequences of Medicare’s current design of benefits…Assigning beneficiaries such a high responsibility of cost sharing for inpatient care may not be an effective use of cost sharing, as hospitalizations are usually not at the discretion of beneficiaries.”


A conversation on the potential for Obamacare repeal, from The Incidental Economist bloggers Aaron Carroll and Austin Frakt.

“They’re actually in a tough policy spot. They’ll get the blame if they don’t fix or repeal the A.C.A., and they’ll get the blame if they don’t replace it with something people like better. Health policy is a very difficult and thankless task. I think they’ll opt for something they can call repeal and replace, but they could also just let Obamacare struggle and die. Neither looks good.”


In order to convince health insurance companies to engage in the ACA/Obamacare exchanges, the law included a provision known as the “risk corridors.” In sort, if insurance companies ended up losing money because they insured sicker-than-average patients who incurred higher-than-average health care costs, the risk corridor system would give them money to recoup the losses. So, insurance companies joined the ACA exchanges. And they dutifully lost money. However, Congress did not appropriate money for the risk corridors, so these insurers are still short billions of dollars that was promised to them, and are suing the government to get it.

Nicholas Bagley reports on the debacle at the NEJM.

“For now, the Justice Department is fighting the lawsuits. But the insurers’ legal arguments have considerable force. Indeed, HHS has openly acknowledged that risk-corridor payments are ‘obligation[s] of the United States for which full payment is required.'”


Surgeon General Murthy on ending the opioid epidemic.

Health Policy Updates: November 19 2016

Soon after the election, Donald Trump is already backpedaling from his prior promises to repeal the ACA/Obamacare in its entirety, signaling that he may be open to keeping several of the popular aspects of the law. The problem? The unpopular parts he wants to get rid of aren’t there for no reason – they are needed to make the popular parts work.

“The pre-existing conditions policies are very popular…Those policies that make the insurance market feel fairer for sick Americans who need it can really throw off the prices for everyone else. That’s why Obamacare also includes less popular policies designed to balance the market with enough young, healthy people.”

Continue reading Health Policy Updates: November 19 2016

Health Policy Updates: November 6 2016

A couple studies came out recently looking at the impact of the ACA/Obamacare’s Medicaid expansion. The first, published in JAMA, found that Medicaid expansion reduces the amount of uncompensated “charity care” that hospitals have to provide, reducing their operating expenses and improving profitability. Blog commentary here.

“…as we debate policy as to whether it’s “worth it” to expand Medicaid, it’s worth nothing that the data arguing that it might be bad for hospitals not only isn’t lacking, it’s somewhat refuted.”

And, this piece out in the NEJM showed some very clear and convincing charts that the numbers of uninsured people have been dropping in Medicaid expansion states, in contrast to those that did not expand Medicaid: nejm-medicaid-expansion
Continue reading Health Policy Updates: November 6 2016