Our Scorecard ranks every state’s health care system based on how well it provides high-quality, accessible, and equitable health care. Read the report to see health care rankings by state.
"What we tried to do was do it all in the House bill with repeal and replace….That would have been the biggest entitlement reform bill ever passed by Congress. So what are we doing? We're going back and doing it incrementally. Going back at incremental health-care reform and other entitlement reforms so we can chip away at this problem." — Speaker Paul Ryan (R-WI)
Trump Wants to Overhaul America's Safety Net With Giant Cuts to Housing, Food Stamps, and Health CareWashington Post by Tracy Jan, Caitlin Dewey, Amy Goldstein and Jeff Stein — The budget that President Trump proposed Monday takes a hard whack at the poorest Americans, slashing billions of dollars from food stamps, public health insurance and federal housing vouchers, while trying to tilt the programs in more conservative directions. The spending plan reaches beyond the White House's own power over the government social safety net and presumes lawmakers will overhaul long-standing entitlement programs for the poor in ways beyond what Congress so far has been willing to do. The changes call on lawmakers to eliminate the expansion of Medicaid under the Affordable Care Act and transform the rest of that program into a system of capped payments to states; convert food assistance into a hybrid of commodity deliveries and traditional cash benefits; and expand requirements that low-income people work to qualify for federal assistance.
Drug Industry Scrambles After Rare Loss in Budget DealThe Hill by Peter Sullivan — Pharmaceutical companies are pushing to repeal or roll back a provision in last week's budget deal that delivered a rare loss to their industry, according to two lobbyists familiar with the situation. A provision included in the budget deal approved last week raised the share of costs that drug companies have to pick up as part of closing the "donut hole," a gap in drug coverage for Medicare Part D beneficiaries. Drug companies are quickly mobilizing to try and undo the change, or at least roll it back in some fashion. The most likely avenue is the long-term government funding bill that Congress is expected to pass in March, the lobbyists said.
Trump Calls for $18 Billion Cut to HHS FundingModern Healthcare by Virgil Dickson — President Donald Trump on Monday unveiled his $4.4 trillion fiscal 2019 budget proposal that includes sharp cuts for Department of Health and Human Services (HHS) funding. Trump's proposed budget allocates $68.4 billion to HHS, a 21 percent decrease or $17.9 billion less than what the agency received in fiscal 2017. It's unclear if the proposed cuts, or any of the proposals outlined in the budget documents released Monday, will be enacted given that Congress just passed a two-year budget bill. The plan received immediate praise from HHS Secretary Alex Azar on Monday.
Budget Undercuts Trump Focus on Mental Health, School SafetyAssociated Press by Ricardo Alonso-Zaldivar and Danilova — President Donald Trump is calling for a focus on mental health and school safety in response to shootings like the one that took 17 lives in Florida, but his budget would cut funding in both areas. Trump's latest budget would slash the major source of public funds for mental health treatment, the Medicaid program serving more than 70 million low-income and disabled people. The budget also calls for a 36 percent cut to an Education Department grant program that supports safer schools, reducing it by $25 million from the current level of $67.5 million.
Government Says Health Costs to Keep Growing Faster Than EconomyAssociated Press — U.S. health care spending will keep growing faster than the overall economy in the foreseeable future, squeezing public insurance programs and employers who provide coverage, the government said Wednesday. Annual projections from number crunchers at the Department of Health and Human Services cite an aging population and an uptick in prices for health care services and goods as factors behind the ongoing growth in costs. Spending is projected to rise by an average of 5.5 percent annually through 2026, or about 1 percentage point faster than economic growth. Prescription drugs account for the fastest increase, 6.3 percent a year on average, due to the high cost of advanced medications.
U.S. Spending on Drugs Will Grow Faster Than on Other Health Care Services Over the Next DecadeWashington Post by Carolyn Y. Johnson — Prescription drug spending will grow faster than any other major medical good or service over the next decade, according to a projection from the Centers for Medicare and Medicaid Services. The analysis, published in the journal Health Affairs, estimates that by 2026, national health spending will climb to $5.7 trillion, or nearly a fifth of the economy. Prescription drug spending is forecast to grow at 6.3 percent per year, on average, between 2017 to 2026. Drug spending skyrocketed in 2014 and 2015, driven largely by the use of a new generation of curative therapies for hepatitis C. When national health spending data was released in December showing a 1.3 percent increase in spending on prescription drugs in 2016 — a small fraction of the increases in previous years — a pharmaceutical lobby spokeswoman highlighted the trend as evidence of the "nation's competitive marketplace for medicines."
U.S. Opioid Crisis Has Cost $1 Trillion Since 2001, Economists SayNPR by Greg Allen — The opioid epidemic has cost the U.S. more than a trillion dollars since 2001, according to a new study, and may exceed another $500 billion over the next three years. The report by Altarum, a nonprofit group that studies the health economy, examined Centers for Disease Control and Prevention mortality data through June of last year. The greatest financial cost of the opioid epidemic, according to the report, is in lost earnings and productivity losses to employers. Early deaths and substance abuse disorders also take a toll on local, state and federal government through lost tax revenue. These costs are rising. One reason for the increase, says Corey Rhyan, a senior research analyst with Altarum's Center for Value and Health Care, is that more young people are being affected as the epidemic moves from prescription opioids to illicit drugs like heroin and fentanyl.
Ryan Calls For 'Incremental' Health Reforms After Failure of Obamacare RepealThe Hill by Peter Sullivan — Speaker Paul Ryan (R-Wis.) is calling for "incremental" health care reform after the Senate failed to pass an Obamacare replacement bill last year. Asked on Fox Business on Tuesday if lawmakers will try again to pass an Obamacare repeal legislation this year, Ryan pointed to incremental changes. "Well, I think there are a lot of things we can do kind of incrementally," Ryan said. The comments are an acknowledgement that there is no apparent path forward for a large-scale Obamacare replacement or entitlement reform bill this year in the Senate, where Republicans now have a one-seat majority.
New Health Secretary Faces First Test as Idaho Skirts Federal LawNew York Times by Robert Pear — Alex M. Azar II, the new secretary of health and human services, said Thursday that he would closely scrutinize a plan by Idaho to allow the sale of insurance that does not comply with the Affordable Care Act, an early test of how he will enforce a law he opposes. But he said it was too early to know what action he might take. "We'll be looking at that very carefully and measure it up against the standards of the law," Mr. Azar said at a hearing of the Senate Finance Committee. Democrats in Congress, as well as the American Cancer Society and other groups representing patients, say the Idaho plan would allow insurers to discriminate against people with preexisting medical conditions, in defiance of the federal law.
Center for Medicare and Medicaid Services Reports That Repeal of Mandate Penalty Will Lead to Spike in UninsuredModern Healthcare by Virgil Dickson — The Trump administration is projecting that nearly 8 million people will voluntarily lose insurance in the next eight years as a result of the repeal of the Affordable Care Act's financial penalty for not having health insurance. In all, 37.7 million people will be uninsured by 2026, up from the estimated 30 million in 2018, according to an analysis CMS actuaries released Wednesday. "These estimates assume that some younger and healthier people will choose to be uninsured, particularly those with comparatively higher incomes who would not qualify for premium subsidies in the marketplaces," Gigi Cuckler, senior economist in the office of the actuary at the CMS said at a news briefing. The findings appear in the agency's annual National Health Expenditure report.
Virginia's Republican-Controlled House Backs Medicaid ExpansionVox by Sarah Kliff — Over the weekend, a key committee in the Republican-controlled Virginia House of Delegates backed a budget that would have the state opt in to the Affordable Care Act program to cover low-income Americans. For years now, Virginia Republicans have opposed Medicaid expansion — so this new budget is a significant turnaround. But the Virginia Republicans' plan to expand Medicaid comes with a catch. State legislators say it would require enrollees to work in order to receive coverage, similar to new the new programs recently rolled out in Kentucky and Indiana. Advocates worry that these new rules could cause vulnerable Medicaid enrollees to lose coverage, unable to either comply with the new requirement or complete the necessary paperwork to prove employment.
Trump's Historic Medicaid Shift Goes Beyond Work RequirementsStateline by Michael Ollove — Requiring able-bodied adults to work for their Medicaid is just part of the Trump administration's drive to remake the decades-old health insurance program for the poor. The administration signaled late last year that it welcomes state-based ideas to retool Medicaid and "help individuals live up to their highest potential." At least 10 states have requested waivers that would allow them to impose work requirements and other obligations.
Google Paper Stirs Interest, but Not Seen as TransformativePolitico by Darius Tahir — By throwing some of its best engineering and medical minds at vast stores of clinical data with the help of powerful computers running for hundreds of thousands of hours, Google appears to have produced a model that accurately predicts patient deaths, hospital readmissions and other health-related events. The model won't transform medicine. But academics and other technology mavens think the methods described in the paper serve as a prototype for future work in predictive models, in areas like end-of-life care. The researchers analyzed seven years of de-identified clinical data from hundreds of thousands of hospital patients at the universities of Chicago and California. They discovered indicators of health events with a degree of accuracy that "outperformed state-of-the-art traditional predictive models," according to the paper. Still, as much as the Google work might improve the efficacy of prediction, it seems that prediction has limited value in our health system. A doctor can be told a patient will die tomorrow, but it doesn't mean the doctor can do anything about it.
