In This Edition:
From Kaiser Health News:
Researchers estimate thousands of children suffer two debilitating eye conditions because they don’t get proper exams while young. (Michelle Andrews, 8/19)
Putting sexual development on hold gives children a breather as they consider transitioning to the opposite gender. But when to begin? (Elaine Korry, 8/19)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Think Carefully'" by Dan Piraro.
Here's today's health policy haiku:
IN MIDST OF TROUBLING NEWS, A PRO-ACA TAKE
Best way to describe
Obamacare is — it has
Saved a lot of lives!
If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.
Summaries Of The News:
Aetna's departure from the health law marketplace in Arizona threatens to leave one county without any options for next year. Meanwhile, America’s Health Insurance Plans has issued a brief with ideas on how to help struggling insurers, and an analysis looks at the groups with the highest uninsured rates.
Politico Pro: The County Obamacare Forgot
An Arizona county is poised to become an Obamacare ghost town because no insurer wants to sell exchange plans. Aetna’s announcement that it would exit 11 of 15 states where it offers Obamacare plans leaves residents of Pinal County, Ariz., without options for next year, unless regulators scramble to find a carrier to fill the void. Yet they have limited options and little time before plan approval deadlines for 2017 open enrollment. About 9,700 people in Pinal signed up for Obamacare plans this year, according to HHS data. (Pradhan, 8/18)
The CT Mirror: As Some Quit Exchanges, Insurers Press For Changes In ACA
In an issues brief, the insurance industry association America’s Health Insurance Plans has recently proposed several changes aimed at helping insurers make more profit on the policies sold to individuals and small businesses through the exchanges. ... Insurer recommendations include scrapping a requirement that the oldest – and likely the sickest — customers pay no more than three times the amount in premiums that the youngest policy holders do. ... Another thing insurers would like to change is the ACA minimum medical loss ratio, which caps the revenues insurers can raise from selling policies after claims and certain other expenses are met. (Radelat, 8/19)
Morning Consult: The Poor, The Young And Latinos Most Likely To Be Uninsured, Analysis Finds
Adults who are poor, young, Latino or work at a small business are most likely to be uninsured, according to an analysis released today by the Commonwealth Fund. Groups that were at risk of not having health insurance before the Affordable Care Act was implemented continue to be at a higher risk of not having coverage under the law, the analysis says. (McIntire, 8/18)
Donald Trump and other Republicans have been calling into question the state of Hillary Clinton's health, but her campaign says the allegations are ludicrous.
Politico: Clinton Camp Rips 'Terribly Weak' Trump On Health Records
Hillary Clinton's campaign sees no reason to put out an update on her health, chief strategist Joel Benenson said Thursday, smacking down Donald Trump's insinuations and calling on the Republican nominee to release medical records comparable to those put out by the Democratic candidate's campaign in July. Trump knows that there is no issue with Clinton's health, Benenson told MSNBC's Andrea Mitchell, remarking that it "must be driving his ego crazy that she's outworking him, outthinking him, connecting better with the American voters about the issues that matter in their life." (Gass, 8/18)
Politico: Newt Rips 'Junk Medicine' Worries About Clinton Health
Newt Gingrich dismissed outright as "junk medicine" on Thursday theories about Hillary Clinton's state of health and treatment, after board-certified internist and media personality Drew Pinsky speculated that the Democratic nominee is not receiving a proper level of care. The former speaker of the House and Donald Trump ally responded on "Fox & Friends" after the show played a clip of Pinsky speaking Tuesday on KABC Radio's McIntyre in the Morning. In that segment, Pinsky said he was "gravely concerned" about Clinton's health, noting her doctor's 2015 assessment that showed a "1950 level sort of care" by the evaluation of himself and a colleague. (Gass, 8/18)
In other 2016 election news, it's unclear if Clinton's policies will affect insurer Obamacare participation, a look at where each candidate stands on Medicare and how Trump's trade stance concerns the pharmaceutical industry —
Morning Consult: Would Clinton’s Health Plans Help Struggling Insurers On Exchanges?
Hillary Clinton’s health care plan clearly intends to tackle affordability issues on Obamacare exchanges. Less clear is whether — or how — it deals with the increasingly prominent issue of insurer participation and financial viability in the marketplace. ... While some experts say addressing consumer affordability issues will, in turn, increase insurers’ profitability on exchanges, others say the Democratic nominee’s proposals fall short of addressing the issue. Some even say a public option, which she has proposed, would only make things worse for private plans by pushing premiums artificially lower. (Owens, 8/18)
CBS News: How Clinton And Trump View Medicare And Retiree Health Plans
So far in the 2016 presidential campaign, Medicare and retiree health plans haven’t been near the top of the burning issues’ list. But these important programs still deserve your careful attention when making your choice this fall. ... your options will be significantly influenced by the next president’s intentions for Medicare benefits and its financing, as well as health care plans for retirees under age 65. Let’s look at the positions Hillary Clinton and Donald Trump have staked out, in alphabetical order. (Vernon, 8/18)
Stat: Donald Trump's Trade Talk Is Making The Drug Industry Uneasy
The drug industry is quietly troubled over Donald Trump’s tough talk on trade.The Republican presidential nominee has promised to aggressively renegotiate America’s trade deals — and to tear them up if need be. Those pledges are now rankling a biopharmaceutical sector that depends heavily on the deals to protect their intellectual property and, by extension, their entire business model. Provisions in the deals typically require participating nations to adhere to patent protections similar to those in the United States, to give companies relief if there is a delay in granting a patent, and to keep their clinical data confidential. (Scott, 8/18)
The investigation will look at whether the providers, such as dialysis centers, encouraged people eligible for Medicare and Medicaid to buy private plans instead so that the providers could get higher reimbursements.
The Wall Street Journal: U.S. Opens Probe Into Concerns Over Health-Provider Payments
The Obama administration has launched a probe into whether health-care providers such as dialysis centers are steering patients eligible for Medicare and Medicaid benefits into insurance plans offered on the health law’s exchanges. The Centers for Medicare and Medicaid Services on Thursday said it sent warning letters to all dialysis centers that participate in the federal Medicare program. The agency also said it is weighing financial penalties on providers who are found to have directed people eligible for Medicare into Affordable Care Act plans instead. “We are concerned about reports that some organizations may be engaging in enrollment activities that put their profit margins ahead of their patients’ needs,” said CMS Acting Administrator Andy Slavitt in a news release. (Armour and Wilde Mathews, 8/18)
Morning Consult: CMS Investigating If Providers Steered Patients Away From Public Insurance Programs
The Centers for Medicare and Medicaid Services said on Thursday it is investigating whether some providers or affiliated groups have improperly steered people who would be eligible for Medicare or Medicaid toward individual market plans. The agency has concerns that such actions are resulting on issues on the federal exchanges. Providers would steer patients toward individual marketplaces, either on or off the exchanges, to obtain higher reimbursement rates, the CMS release suggests. (McIntire, 8/18)
Reuters: U.S. Health Agency Weighs Rules On Outside Payments For Obamacare
A U.S. government health agency on Thursday said that it was considering new rules to prevent healthcare providers or related groups from steering patients into Obamacare individual insurance plans instead of Medicare or Medicaid in order to receive higher payments for medical services. The Centers for Medicare & Medicaid Services on Thursday said it is seeking public comment and considering rules including prohibiting or limiting premium payments or cost-sharing for the individual marketplace plans, monetary penalties and limits on such payments. (Humer, 8/18)
The data, looking at prescriptions purchased under the Medicare Part D program, shows that medications for heart problems were among the most prescribed. Sovaldi, a drug to treat hepatitis C, was the highest cost drug at more than $3.1 billion spent by the program. Following that were Nexium, for reflux disease, and Crestor, to treat high cholesterol.
Modern Healthcare: Medicare Part D Spending Rose 17% In 2014 Because Of High-Cost Drugs
Medicare spending on prescriptions increased more than 17% in 2014, despite a claims increase of only about 3%, according to data released Thursday. The second annual set of data shows prescription drugs paid for under the Medicare Part D Prescription Drug Program, which has 38 million beneficiaries. (Muchmore, 8/18)
Politico Pro: Medicare Part D Data Shows Rise In Costs Per Prescription For Many Drugs
Hundreds of drugs administered in Medicare Part D increased their cost per prescription by 10 percent or more in 2014, with more than 20 drugs jumping by 100 percent or more, according to a POLITICO analysis of data released Thursday by CMS. The drugs which saw big spikes in prescription costs ranged from newer brand medications to old generic drugs. The brand drug Vimovo, which combines an acid reflux medication with a pain reliever, topped the list rising by nearly 543 percent per claim in 2014. The generic steroid fluorometholone, used for eye conditions, was second, rising by nearly 341 percent per claim. (Karlin-Smith, Norman and Doherty 8/18)