Tag Archives: Tom Price

Health Policy Updates: September 30 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

Health Policy Updates: May 14 2017

With the AHCA’s passage of the House, the Senate remains a serious hurdle. Some members have made it clear that the senate will start from scratch, and not base any of their health care reform plans on the House AHCA bill. How this will move forward, and play out in a hypothetical future reconciliation process, is yet to be seen.

“On the Senate side, where several Republicans have long been deeply skeptical of the House effort, the bill is expected to undergo sweeping changes that might leave it unrecognizable — perhaps stripping away some of the provisions that helped earn the support of hard-right House members and ultimately secure its passage.”

Continue reading Health Policy Updates: May 14 2017

Health Policy Updates: February 11 2017

The idea of “block granting” Medicaid has become increasingly popular in Republican circles, as a way to constrain cost growth in the program. Vox.com’s Sarah Kliff recently interviewed Phil Roe, a Republican Congressman who supports block granting, about the feasibility of this approach.

“Block grants usually mean something else: a massive cut to Medicaid spending that could throw tens of millions of people off the program. And the politics of that — just at the moment that Obamacare added millions of people to Medicaid — are, as Roe acknowledged, tricky.”

Health policy blogger and expert Aaron Carrol also gave an outline of how block granting works, and what the effects of Republicans’ current block granting proposals would be.

“From states’ point of view, whether they are reimbursed by a block grant or a percentage of coverage doesn’t really matter as long as the amount is enough. Almost no block grant plan allows for this, though. Planned cuts are how block grants make future federal budget projections look so good.”
Continue reading Health Policy Updates: February 11 2017

Health Policy Updates: February 5 2017

With each news story being rapidly overshadowed by the next, discussion of ACA/Obamacare repeal has given way to rapid developments ensuing from executive actions on immigration. If you are a reader of this blog, you certainly do not need me to explain what these actions are. Actions do have unintended (are they unintended?) consequences, however, which I will highlight here (links in the text):

“The American Association for the Advancement of Science, the world’s largest general science society, also issued a statement warning that the ban would prevent the international collaboration that characterizes most science today, and would hurt the United States’ ability to attract talented researchers from around the world.”

As the story of a Cleveland Clinic doctor forced to leave the U.S. thanks to the Trump White House’s move swept the nation, hospitals and academic medical centers braced for potential damage to future staffing and recruiting of medical researchers, educators and clinicians.”

“Since the restrictions, some institutions, including the University of Pennsylvania and the University of California system, have advised students or faculty members from Iran, Iraq and the other affected countries not to travel overseas until further notice…The order could prevent many foreign researchers from making short-term trips to attend conferences and other scientific meetings overseas for fear of not being able to return.”

Continue reading Health Policy Updates: February 5 2017

Health Policy Updates: January 21 2017

News surfaced this week raising serious conflict-of-interest and corruption concerns regarding Trump’s nominee to head the department of Health and Human Services, Tom Price. It seems that he bought shares in a device manufacturer immediately before introducing legislation to protect reimbursement for the use of such devices, maintaining demand for the company’s products.

“After Price offered his bill to provide Zimmer Biomet and other companies relief from the CMS regulation, the company’s political action committee donated to the congressman’s reelection campaign…The issue has become a major liability for the congressman after The Wall Street Journal reported last month that he traded roughly $300,000 in shares over the past four years in health companies while pursuing legislation that could impact them.”

Margot Sanger-Katz of the NYTimes walks through exactly what the ACA/Obamacare does, which provisions are likely to go or stay if repeal happens, and what that would mean.

“When Republicans talk about repealing Obamacare, they tend to focus on the parts of the law that expanded insurance coverage and regulated health insurance products, not these ancillary parts. That means that portions of the Affordable Care Act that people don’t associate with the word “Obamacare” are likely to endure.”

Donald Trump continues to double-down on promises to “cover everyone” with his health insurance plan, and also drastically lower drug prices. This is in contrast to the leading Republican plans for ACA replacement, which do neither of these things.

“The objectives of broadening access to insurance and lowering health-care costs have always been in conflict, and it remains unclear how the plan that the incoming administration is designing — or ones that will emerge on Capitol Hill — would address that tension.”

The Congressional Budget Office has run the numbers on Obamacare repeal and found that it would add an additional 23 million Americans to the uninsured roles over the next 10 years. Will whatever “replacement” plan that ends up surfacing be able to make up that difference?

“The agency put up a blog post that said it won’t let Republicans count especially skimpy coverage as health insurance. It argued that health insurance needs to provide ‘financial protection against high medical costs’ for CBO to count the people who buy it as covered. Republicans hadn’t even submitted a replacement plan yet, at least not publicly. So it seems notable that CBO proactively decided to go ahead and lay down the ground rules for scoring in a very public way.”

A slew of papers came out in JAMA journals last week, focusing on the issue of conflicts of interest in medicine. Propublica summarizes.

“‘The very way we all think about disease — and the best ways to research, define, prevent, and treat it — is being subtly distorted because so many of the ostensibly independent players, including patient advocacy groups, are largely singing tunes acceptable to companies seeking to maximize markets for drugs and devices,’ researchers Ray Moynihan and Lisa Bero wrote in an accompanying commentary.”