— David Blumenthal, M.D., The Commonwealth Fund
March 26, 2018
Headlines in Health Policy
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http://www.commonwealthfund.org/publications/newsletters/headlines-in-health-policy/2018/mar/mar-26-2018
Quotable
"It’s Obamacare’s birthday. After eight years of relentless pounding, the Affordable Care Act (ACA) is still the law of the land. Its resilience reflects the fundamental decency of the American people who — when faced with the reality of taking coverage away from millions of their neighbors — refused to let that happen. They filled town hall meetings, they flooded the corridors of Congress, and support for the law surged to its current 54 percent. That is not to say that the law’s future is assured."
— David Blumenthal, M.D., The Commonwealth Fund
— David Blumenthal, M.D., The Commonwealth Fund
Affordable Care Act Stabilization / Spending Bill
- Medical Research, Drug Treatment and Mental Health Are Winners in New Budget Bill National Public Radio by Alison Kodjak — The big budget deal reached this week in the House doesn't include a long-sought-after provision to stabilize the Affordable Care Act marketplaces. But the $1.3 billion plan, set to fund the government through September, has lots of new money for medical research, addiction treatment and mental health care. Here's the rundown of what's included in the 2,232-page spending bill, now in the hands of a Senate vote, based on summaries released by the House and Senate appropriations committees.
- Who in Industry Wins/Loses in Omnibus Bill? Modern Healthcare by Susannah Luthi — Congressional leaders released the long-awaited $1.3 trillion, two-year spending omnibus after days of wrangling behind closed doors over contentious policies, including an embattled stabilization package for the individual market that would fund cost-sharing reduction payments and a $30 billion reinsurance pool. Here's what did and did not make it into the bill. Winners included: insurers that fought to keep a new policy that phases down their share of the cost of prescription drugs not covered by Medicare while raising it for drugmakers; the National Institutes of Health; and opioid addiction abatement efforts, which received $500 million to develop alternative pain medication. Losers included: Insurers that had been optimistic following the weekend's negotiations for CSRs and reinsurance; the Affordable Care Act, which now faces several attempts to limit data or grant opportunities related to the legislation; and drugmakers, who wanted to offload some of their newfound financial liability for the Medicare Part D donut hole back to insurers.
- Health Insurance Premiums Loom as Election Issue Wall Street Journal by Stephanie Armour — Health insurance premiums are likely to jump right before the November elections, a result of Congress’s omission of federal money to shore up insurance exchanges from its new spending package. Lawmakers from both parties had pushed to include the funding in the $1.3 trillion spending law signed Friday, but they couldn’t agree on details. A battle has already begun over how to cast the blame for the expected rate increases. The finger-pointing comes as health care is expected to be a top issue in this year’s midterm elections. Both parties face political risks, although polls have so far shown voters are more likely to hold Republicans responsible for high costs.
- With No Fix in Omnibus Budget Bill, Insurers Set To Hike Premiums, Rethink Selling Individual Plans Modern Healthcare by Shelby Livingston — In a blow to health insurers, the House on Thursday passed a $1.3 trillion, two-year omnibus spending bill that didn't include funding for cost-sharing reduction payments or a federal reinsurance program. Insurers had been lobbying hard to get something included in the massive spending bill. Absent that lifeline, insurers will likely be raising premiums and rethinking their participation in the individual market in 2019....The industry's dominant lobbying group, America's Health Insurance Plans, and the Alliance for Community Health Plans, which represents not-for-profit insurers, are regrouping after the loss.
Prescription Drugs
- Nonprofit Generic Drug Venture Could Include Third of Hospital Market Politico by Sarah Karlin-Smith — A nonprofit generic drug company led by some well-known U.S. hospital systems and the Department of Veterans Affairs is trying to expand the market for inexpensive medicines — fast. The nonprofit aims to fulfill two needs. It wants to produce generic drugs that are in short supply. And it's trying to create more competition for pricey, older off-patent drugs so that they become more affordable. The fast-rising company could soon count one-third of all U.S. hospital operators as its members. Seventy hospital systems have expressed interest in joining the venture since its launch about six weeks ago, said Dan Liljenquist, vice president at Intermountain Healthcare in Utah, one of the lead institutions behind the project, on Monday. The nonprofit — led by Intermountain with Ascension, SSM Health, Trinity Health and the Department of Veterans Affairs — plans to directly ship to hospitals, bypassing wholesalers and other middlemen to keep costs down. It will also publish product prices.
Opioid Epidemic
- Trump Offers Tough Talk but Few Details in Unveiling Plan to Combat Opioids New York Times by Maggie Haberman, Abby Goodnough, and Katharine Q. Seelye — President Trump made his first visit to New Hampshire since the 2016 campaign on Monday, unveiling a plan to combat the opioid epidemic that includes a push for the death penalty for drug dealers and a crackdown on illegal immigrants. Mr. Trump spoke in a state with the nation's third-highest rate of deaths from overdoses and where opioids are a potent political issue. In a speech at a community college here, he offered up more tough talk than he did specifics about his plan, or how he would pay for it. The plan says little about how addiction treatment would be expanded besides a vague goal of expanding access to "evidence-based addiction treatment" in every state, particularly for members of the military, for veterans and their families, and for people leaving jail or prison.
- States: Federal Money for Opioid Crisis a Small Step Forward Associated Press by Geoff Mulvihill — The federal government will spend a record $4.6 billion this year to fight the nation’s deepening opioid crisis, which killed 42,000 Americans in 2016. But some advocates say the funding included in the spending plan the president signed Friday is not nearly enough to establish the kind of treatment system needed to reverse the crisis. A White House report last fall put the cost to the country of the overdose epidemic at more than $500 billion a year. Former U.S. Rep. Patrick Kennedy, a Democrat who served on President Donald Trump’s opioid commission last year, said there are clear solutions but that Congress needs to devote more money to them. “We still have lacked the insight that this is a crisis, a cataclysmic crisis,” he said. By comparison, the Kaiser Family Foundation found the U.S. is spending more than $7 billion annually on discretionary domestic funding on AIDS, an epidemic with a death toll that peaked in 1995 at 43,000.
- Omissions on Death Certificates Lead to Undercounting of Opioid Overdoses National Public Radio by Jake Harper - Standards for how to investigate and report on overdoses vary widely across states and counties. As a result, opioid overdose deaths aren't always captured in the data reported to the federal government. The country is undercounting opioid-related overdoses by 20 to 35 percent, according to a study published in February in the journal Addiction. Data from death certificates move from coroners and medical examiners to states and eventually the Centers for Disease Control and Prevention (CDC), which publishes reports on overdose counts across the U.S. According to the CDC, more than 42,000 people died from opioid-related overdoses in 2016, a 30 percent increase from the year before. But that number is only as good as the data states submit to the CDC.
Editor
Editor: Peter Van Vranken