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Oct. 25: Trump Expected To Unveil Changes To Medicare Drug Program During Speech At HHS

Trump Expected To Unveil Changes To Medicare Drug Program During Speech At HHS.

Politico  (10/25, Karlin-Smith, Diamond) reports that on Thursday, President Trump is expected to “unveil a plan to overhaul how Medicare pays for certain drugs, attacking ‘foreign freeloaders’ that he says have driven up costs in the U.S.” This “bold move addresses a Trump campaign pledge to lower drug prices, just days before the tightly contested midterm elections in which health care is playing a pivotal role.” The article says Trump will discuss “the details in a speech at HHS at 2 p.m., his first address at the health department. The proposal, described to POLITICO by three individuals with knowledge, still needs to be refined and put through a federal rulemaking process.”

        The Hill  (10/24, Sullivan) reports that according to unnamed sources, President Trump “will speak at the headquarters of the Department of Health and Human Services on Thursday.” He “is expected to focus on drug pricing but it is possible other health care issues could come up as well.” The article adds, “There is expected to be an announcement of some kind, though it is not clear what it will be.”

        STAT  (10/24, Florko) reports that specific “details of his remarks are still unclear, but an array of lobbyists and experts told STAT the focus would be on high prescription drug costs.” The article says since the Administration unveiled its plan to lower drug prices, it has taken several steps, such as “speeding up the Food and Drug Administration’s approval process or giving private insurers more negotiating power in Medicare.”

Legislation and Policy

Trump Signs Opioid Bill Into Law.

Reuters  (10/24, Abutaleb) reports, “Medical treatment will be more widely available to opioid abusers while mailing illicit drugs will be more difficult under a measure to fight drug addiction” that President Trump signed into law on Wednesday. The Washington Examiner  (10/24, Leonard) reports, “The 650-page-plus bill signed Wednesday is meant to tackle the crisis, giving healthcare workers more latitude to respond, and allocates roughly $8.5 billion in funding authorized in appropriations bills passed earlier this year.” On NBC Nightly News (10/24, story 5, 2:00, Holt), Peter Alexander reported that Trump is “touting his Administration’s progress against the opioid epidemic. ... The raid of overdose deaths [is] beginning to slow down.”

        WCAU-TV Philadelphia (10/24, 4:12 p.m. EDT) reported, “President Trump has signed legislation that he says will end or put a big dent in the opioid crisis. It will add treatment and get the US Postal Service to screen overseas packages for fentanyl, which is a key cause of overdose deaths.”

Small Businesses Now Able To Form Association Health Plans If State Laws Allow Them.

The AP  (10/24, Rosenberg) reports, “As small business owners shop for 2019 health insurance, some will for the first time have the chance to join forces and buy cheaper insurance – depending on” their state. The article says new regulations which started “going into effect last month allow sole proprietors and other business owners without employees to form what are known as association health plans, or AHPs.” Although “the Trump administration has touted the rules as a breakthrough, many owners will be disappointed to learn their states’ insurance laws will limit their ability to join the plans.”

Most Young Americans Support Single-Payer Healthcare, Poll Indicates.

The Hill  (10/24, Burke) reports in its “Blog Briefing Room” that most “young Americans support single-payer health care and other expanded government services, according to a new” Associated Press-NORC Center for Public Affairs Research and MTV poll. Data show “69 percent of Americans between the ages of 15 and 34 are in favor of a single-payer health-care program.” In addition, 88 percent of young Democrats “said they support such a program, as did about two-thirds of young independents and 40 percent of young Republicans.”

North Carolina Gets Medicaid Approval For Managed Care System.

The AP  (10/24) reports the North Carolina Department of Health and Human Services “said it received Wednesday a waiver from the Centers for Medicare and Medicaid Services to move away from the traditional fee-for-service program used for decades,” and shift toward a managed-care system. DHHS wants to begin managed care late next year.

        Additional coverage by the Winston-Salem (NC) Journal  (10/24, Craver) and Modern Healthcare  (10/24, Subscription Publication).

Public Health and Private Healthcare Systems

Medicaid Signups Flat, Spending Increasing For Prescription Drugs And Addiction Treatment, Survey Finds.

USA Today  (10/25, Alltucker) reports that according to the Kaiser Family Foundation on Thursday, “a strong economy has slowed Medicaid signups nationwide, but state programs are spending more on prescription drugs and addiction treatment.” Kaiser “found that signups dipped less than 1 percent this year,” the first decrease “after a decade of swelling enrollment fueled by the Great Recession” and the Medicaid expansion under the Affordable Care Act. USA Today says that “despite the essentially flat enrollment, the average combined federal and state spending increased 4.2 percent during 2018,” and state Medicaid directors “project that average spending will increase 5.3 percent next year,” driven by the “rising costs of prescription drugs, addiction treatment and long-term care for seniors and the disabled also fueled higher spending.”

Oscar Health Revamps Website As Open Enrollment Approaches.

Fierce Healthcare  (10/24, Meltzer) reports that startup insurer Oscar Health “has invested in designing a consumer-friendly website for open enrollment this year. Consumers who sign up through their website can see a side-by-side comparison of covered services, cost-sharing and premiums.” The article says this is “part of the company’s broader strategic approach to attracting customers, said Sara Wajnberg, senior vice president of product at Oscar.” The piece adds that this year, Oscar “is entering three states – Arizona, Florida and Michigan – and it will expand in Ohio, Texas and Tennessee.”

Aetna, Coventry Poised To Split With Mount Sinai Medical Center Over Pricing Dispute.

The Miami Herald  (10/24, Chang) reports Aetna Health and Coventry Health Care of Florida are warning of a potential break up with Mount Sinai Medical Center “that could affect more than 100,000 Miami-Dade residents.” Aetna and Coventry “declined to specify the reason for the split,” but Mount Sinai CEO Steven Sonenreich has indicated “the disagreement is over reimbursement rates.” Sonenreich said Coventry and Aetna “have provided no rate increase to Mount Sinai in more than five years and we are compensated significantly less than other providers in Miami-Dade for the same services.”

Emergency Department Physicians Say Iowa’s Privatization Of Medicaid Hurts Hospitals, Patients.

The AP  (10/24) reports Iowa hospitals are warning Gov. Kim Reynolds (R) and the Iowa DHHS administrator that the privatization of Medicaid “will cost the state’s largest hospitals tens of millions of dollars in lost revenue a year and will lead to layoffs.” Dr. Hans House, an emergency department physician, spoke on behalf of the American College of Emergency Physicians saying, “The privatization of Medicaid has been a disaster for the health care industry in this state. We’re not getting paid for our work and our patients aren’t getting adequate coverage.” The article adds that the two insurers managing Medicaid, Amerigroup and UnitedHealthcare, said they will not fully reimburse emergency room visits for non-emergency symptoms. Physicians are concerned that this may discourage patients from seeking emergency care, even in cases where it is needed.

Consumer Directed Healthcare News

Some 100 Million Americans Have Pre-Existing Conditions Which Could Impact Coverage If ACA Is Repealed, Study Indicates.

The Houston Chronicle  (10/24, Deam) reports that about 100 million people in the US “have a pre-existing medical condition that could make finding health coverage difficult, if not impossible, should current protections be lifted,” according to a study conducted by Avalere. This “means more than half of Americans with insurance outside major public programs, such as Medicaid or Medicare, could potentially feel the brunt of a lawsuit seeking to declare the Affordable Care Act unconstitutional and dismantle the law’s consumer protections.” The article says a 2016 study conducted “by Kaiser Family Foundation estimated about 27 percent of adult Texans under the age of 65, or roughly 4.5 million, had a health issue that would have led them to be denied health coverage in the pre-Obamacare era.”

        Fortune  (10/24, Shoot) reports that data from Avalere’s study show “a total of 102 million individuals – not to mention their immediate families – could face higher health insurance premiums and significant out-of-pocket costs related to their medical care” if the ACA were repealed.

        Some 15 Million Consumers Could Lose Coverage, Face Higher Premiums If ACA Lawsuit Succeeds, Analysis Indicates. The Hill  (10/24, Weixel) reports that if a lawsuit challenging the ACA’s constitutionality “succeeds, more than 15 million people could either lose their health coverage or face premium increases as a result of their pre-existing conditions, gender or age,” according to a new analysis unveiled by congressional Democrats on Wednesday. The article says the analysis “serves as a counterpoint to claims” by Republicans “heading into the midterms that they will protect people with pre-existing conditions.” The piece adds that the Trump Administration supports the suit.

Consumers May Have More Difficulty Finding Help To Enroll In ACA Plans This Year.

The AP  (10/24, Murphy) reports that Americans dread open enrollment for healthcare coverage. Each year, the process “involves sifting through deductibles, provider networks and other arcane terms that can quickly scramble the brain.” The article says that while assistance is available, it “may be harder to find this fall” because of funding cuts. The piece adds that the ACA’s open enrollment period starts on November 1 and lasts through December 15. Consumers are urged not to waste time in selecting their options for next year.

Jeff Sopko