The annual open-enrollment period for people who buy their own insurance on the Affordable Care Act’s marketplaces ends Dec. 15 in most states. Enrollment in states that use the federal healthcare.gov platform has been sluggish this year compared to last. From Nov. 1 through Dec. 1, about 3.2 million people had chosen plans for 2019. Compared with the previous year, that’s about 400,000 fewer, or a drop of just over 11 percent. The wider availability of short-term plans is one big change that has set this year’s apart from past sign-up periods. Another is the elimination of the penalty for not having health insurance starting next year (Michelle Andrews, Kaiser Health News)
Headlines in Health Policy: December 10, 2018
Need Health Insurance? The Deadline Is Dec. 15
As The Cost of Health Care Keeps Rising, Here's How Much People Are Getting Squeezed in Every State
The cost of health care keeps on rising, and a new report shows just how much of a squeeze it's putting on family budgets. Researchers at The Commonwealth Fund added up the cost of health insurance with the size of deductibles, or how much people would have to spend if they got sick before their insurance kicks in. They then compared that dollar figure with median incomes in every state. (Zachary Tracer, Business Insider)
Growth of Health Care Spending Slowed Last Year
The growth of national health spending, which surged as millions of Americans gained coverage under the Affordable Care Act (ACA), slowed last year, the Trump administration said on Thursday. Health spending in the United States totaled $3.5 trillion last year, up 3.9 percent from 2016, or about $10,740 a person. It accounted for 17.9 percent of the economy, officials said. But the rate of increase for the major categories — drugs, doctors and hospitals — was more modest than in recent years. For the first time in several years, health spending grew at about the same rate as the economy as a whole in 2017.. (Robert Pear, New York Times)
Bipartisan Senators Introduce New Drug Pricing Bill
A bill introduced by Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.) will seek to crack down on the tactics used by drug companies to overcharge taxpayers for Medicaid rebates. The bipartisan bill from the incoming chairman and ranking member of the Senate Finance Committee could be a sign the two will seek common ground on drug prices. The bill would give the Department of Health and Human Services new authority to reclassify a drug and recoup rebates when a manufacturer deliberately misclassifies a drug in order to pay lower rebates. (Nathaniel Weixel, The Hill)
GOP Balks at Trump Drug Pricing Plan
Republican opposition is building to a proposal from President Trump to lower drug prices in Medicare. The rare break between Trump and Republican allies follows an aggressive step from the president in October that would tie certain Medicare drug prices to lower prices in other countries, a departure from the traditional GOP position. (Peter Sullivan, The Hill)
Democrats Are Suddenly Eyeing a Valuable Pharma Asset: Its Patents
Forget the push to bring more generics to market or to tweak Medicare’s arcane payment system. Democrats, newly empowered in D.C. and on the hunt for bigger and bolder ways to lower drug prices, are suddenly taking aim at a far more central part of pharma’s monopoly power: the patents the industry holds on its drugs. (Lev Facher, STAT)
The Medicaid Experiment: Treating Mind and Body
Many of the 67 million Americans on Medicaid—mostly old and poor—can least afford to ping pong from one hospital visit to another either physically or emotionally. Yet that’s exactly what often happens, due to their chronic conditions, sometimes combined with mental illness. This is why a novel Medicaid program in Tennessee and Iowa, which combines treatment from physicians and mental health specialists, is so fascinating. What’s even more appealing: the data show this person-centered care program from CareMore Health is improving health outcomes and saving patients money. (Forbes)
New Hampshire's New Medicaid Expansion Work Requirement Could Apply to As Many As 15,000 People
State officials say they are still working out how much it will cost to enforce a newly approved work requirement for some beneficiaries of New Hampshire's expanded Medicaid program. Last week the federal government approved a plan by the state to require some Medicaid-expansion recipients to complete at least 100 hours of so-called "community engagement" work each month, or lose their coverage. (Jason Moon, New Hampshire Public Radio)
Inside the Trump Administration’s Proposed Medicaid Managed Care Rule
On November 14, 2018, the Trump administration published its long-anticipated proposed modifications to Medicaid managed care regulations issued by the Obama Administration in 2016. The proposed rules revise, rather than replace, the existing regulatory framework. (Sara Rosenbaum, Health Affairs)
Fixing U.S. Health Care: Can States Step Up Where Washington Has Failed?
The midterm elections may have focused extensively on health care, but the results have done little to clarify where health care reform is headed. “The future of U.S. health care reform is muddier now than at any point in the past two decades,” write researchers from the Boston University School of Public Health, University College London, and the Milbank Memorial Fund in this week’s New England Journal of Medicine. That leaves states to fill the vacuum, they suggest — and so they surveyed state legislators serving on committees related to health, asking them to rank their policy priorities. (Yuval Rosenberg, Fiscal Times)
How Climate Change Is Challenging American Health Care
Experts say mounting environmental pressures will make people sicker, and that the health care system will play a major role in averting disaster. A major report published November 28 in the public-health journal The Lancet provides predictions of how climate change is degrading human health, and how it will alter health care systems in the future. The findings are reliably grim. (Vann R. Newkirk II, The Atlantic)
Hospital-Acquired Infections Are Declining
The risk of getting a hospital-acquired infection is decreasing. In a study published in the New England Journal of Medicine, researchers surveyed almost 200 hospitals caring for about 12,000 patients across the country in 2011 and again in 2015, reviewing medical records to find cases of health care-associated infection. They found that in 2015, hospital-acquired infections affected just 3.2 percent of patients, compared to 4 percent in 2011. They calculate that a patient’s risk of getting infected during a hospital stay was 16 percent lower in 2015 than in 2011. (Nicholas Bakalar, The New York Times)