“Prehabilitation” may help patients recover more quickly, early research suggests, but insurance coverage can be tricky. (Michelle Andrews, 7/28)
Premiums for the state’s 1.3 million people in the state's Obamacare marketplace will rise an average 4 percent, with average increases as low as 1.8 percent in Los Angeles and as high as 13 percent in Santa Cruz. (April Dembosky, KQED and Lisa Aliferis, KQED, 7/28)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Weak At The Sees?'" by Dave Coverly, Speed Bump.
Here's today's health policy haiku:
DON'T MESS WITH MITCH McCONNELL
Some rogue amendments
And a real Senate smackdown…
Tough days on the Hill.
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.
News outlets report that the increase in health care premium costs for Obamacare plans will be felt the most by residents of the Bay Area and other northern parts of the state. Other states will experience rate boosts between 10 percent and 40 percent.
The New York Times: Average Rise On Insurance Seen At 4% In California
Health insurance rates will rise next year by an average of just 4 percent in California, one of the few states that actively negotiate prices, state officials said Monday. In other states, insurers, including Blue Cross and Blue Shield, have requested rate increases of 10 percent to 40 percent or more. New customers under the Affordable Care Act turned out to be sicker than expected, many insurers have said. Some insurers reported financial losses on their exchange business, saying they paid out more in claims than they collected in premiums. (Pear, 7/27)
Los Angeles Times: Obamacare Rates To Rise 4% In California For 2016
The modest price increases for 2016 may be welcome news for many of the 1.3 million Californians who buy individual policies through the state marketplace, known as Covered California. California's rates are a key barometer of how the Affordable Care Act is working nationwide, and the results indicate that industry giants Anthem and Kaiser Permanente are eager to compete for customers in the nation's biggest Obamacare market. (Terhune, 7/27)
Kaiser Health News: Covered California Reports Modest Rate Increases, Regional Variation
This increase is slightly less than last year’s increase of 4.2 percent. ... Consumers who live in different parts of the state will see varying rates. ... On the flip side, some consumers could see their premiums go down, if they choose to shop around. (Aliferis and Dembosky, 7/27)
The Associated Press: Covered California: Cost Of Coverage Increasing
The average increase in Southern California is 1.8 percent, for a total of $296 a month, compared to 7 percent, or a total of $384 a month, in Northern California. Southern Californians can get better rates because the region has more provider competition. The exchange also added two new participants for the first time — UnitedHealthcare, the nation's largest health insurer, and a New York startup called Oscar. Lee said California's 2016 rates are proof that the Affordable Care Act is working in the state. He credited California's aggressive approach on haggling with insurers. (Lin, 7/27)
The Sacramento Bee: Covered California Sets 4 Percent Hike In 2016 Healthcare Premiums; Northern Californians To Pay More
Northern Californians will pay $88 more in average monthly healthcare premiums than Southern California consumers, under new 2016 rates announced Monday by Covered California, the state’s official healthcare marketplace under the Affordable Care Act. (Buck, 7/27)
The San Jose Mercury News: Obamacare: Bay Area Residents Will See Higher Covered California Premiums In 2016
Covered California, the state's health insurance exchange, on Monday boasted a second straight year of modest rate hikes next year for the majority of its customers, but one region of the state won't have it so easy: the Bay Area. While average premiums will rise only 4 percent statewide, rates will climb as high as 12.8 percent in Santa Cruz County, 7 percent in Santa Clara County and more than 6 percent in Alameda and San Mateo counties, exchange officials revealed. (Seipel, 7/27)
The drug, Praluent, has demonstrated the power to drive down levels of LDL cholesterol to numbers almost never seen in adults. Its cost is $14,600 a year.
USA Today: FDA Approves New Cholesterol Drug - At $14,600 A Year
Up to 10 million Americans will soon have a new option for lowering their cholesterol – at a price of $14,600 a year. The Food and Drug Administration surprised much of the medical community Friday by broadly approving a new cholesterol drug for a vast potential patient population. The agency approved Praluent for people with an inherited condition that causes very high levels of LDL, or bad cholesterol, as well as for the millions of Americans who have had heart attacks, strokes or other types of heart disease and whose LDL is higher than it should be. (Szabo, 7/27)
The New York Times: Praluent Looks Cheap To Those With Extreme Cholesterol
The newly approved cholesterol-lowering drug, Praluent, is powerful almost beyond belief. It can drive levels of LDL cholesterol, the dangerous kind, into the 20s or even the teens, numbers almost never before seen in adults. In general, it lowers cholesterol by 50 percent to 70 percent, compared with 25 percent to 55 percent with statins. The $14,600 yearly price of the drug, which is injected under the skin once every two weeks, is a stunner. Yet for some patients, that might actually be a bargain. (Kolata, 7/27)
The Wall Street Journal: Patients Seeking Alternatives To Statins May Undergo Rigorous Vetting
The new drugs are expensive. And unlike a much cheaper class of pills called statins—which are proven to reduce cardiovascular risk—the jury is still out on whether the new drugs reduce serious events like heart attacks. For these reasons, many insurers plan to require rigorous evaluations before authorizing prescriptions, to make sure patients can’t get their cholesterol down with statins. An estimated 10% to 25% of people who have tried statins report having muscle pain, which limits the dose they can tolerate or precludes them from taking a statin at all. Doctors who specialize in the condition, known as statin intolerance, say by changing statins or trying other strategies, many patients initially considered intolerant can end up taking a statin after all—which is the aim of payers who plan to aggressively challenge claims of statin intolerance. (Winslow, 7/27)
The Connecticut Mirror: Insurer: Cost Of Cholesterol Meds, Other Drugs Driving Rate Hikes
High-cost specialty drugs, including a new class of cholesterol medications expected to come to market later this year, are key drivers of the need to raise health insurance premiums by nearly 10 percent, ConnectiCare’s chief actuary told state regulators during a public hearing Monday. (Levin Becker, 7/27)
The Israeli company will acquire Allergan's generic drug business and, if approved, the deal will place Teva among the largest drug companies in the world.
Marketplace: Teva Agrees To Buy Allergan For $40 Billion
The world’s largest manufacturer of generic drugs, Teva, has bagged some big game. Monday morning, the company announced that it has agreed to buy Allergan’s generic business for a little more than $40 billion. If approved, the deal places Teva amongst the largest drug companies on the planet. (Gorenstein, 7/27)
Reuters: Teva To Buy Allergan Generic Business For $40.5B, Drops Mylan Bid
Israel's Teva Pharmaceutical Industries will pay $40.5 billion in cash and stock for Allergan's generic drugs business, solidifying Teva's position as the world's No. 1 maker of generics while freeing Allergan to focus on branded drugs, paying down debt and potential "transformational" acquisitions. The deal, the largest in Israel's corporate history, allows Teva stronger economies of scale, crucial in the low-margin generic drugs business. Teva , which dropped its hostile pursuit of Mylan, will likely have to sell off some drugs to allay antitrust concerns. (Cohen and Scheer, 7/27)
Meanwhile, the big picture -
The Associated Press: Analysts Expect More Tie-Ups In Generic Drug Business
Analysts say they expect more tie-ups are coming in the generic drug industry in the wake of Teva’s mammoth deal for the generic drug business of Allergan. The Dutch drugmaker Mylan, which had resisted Teva’s advances for three months, is pressing ahead with its offer for Irish drug and ingredients maker Perrigo. Teva withdrew its offer for Mylan on Monday as it announced its alternative deal. (7/27)
The House Judiciary Committee is planning two hearings in September to discuss these worries. Meanwhile, another House panel contemplates an overhaul of how Medicare pays hospitals for short-term stays. And a Kansas congressman throws his support behind the so-called "health care compact."
Reuters: U.S. House Panel To Hold Hearings On Competition In Health Care
The U.S. House of Representatives Judiciary Committee is planning two hearings for September to discuss concerns about reduced competition in the healthcare industry, lawmakers from both parties said. In July, insurer Aetna said it would buy rival Humana for $33 billion, while Anthem said it would buy Cigna for $54.2 billion. The dual deals would effectively lower the number of major U.S. health insurers from five to three. (Bartz, 7/27)
Politico Pro: Ways And Means Plans Hospital Payment Overhaul
Republican lawmakers on a powerful House committee are planning a comprehensive overhaul clearing up how Medicare pays hospitals for short-term patient stays, but hospitals opposing the effort say a recent proposal from the Obama administration offers a much better solution. (Mershon, 7/27)
The Kansas Health Institute News Service: Pompeo Agrees To Co-Sponsor Health Care Compact Resolution
Kansas 4th District Congressman Mike Pompeo has agreed to co-sponsor a joint resolution that would allow states to form a health care compact and, potentially, circumvent parts of the Affordable Care Act. “Mike has agreed to be a part of the health care compact because he views it as one of the last remaining opportunities to protect Kansans from the disaster that is the Affordable Care Act,” Heather Denker, a spokesperson for Pompeo’s office, said in an email. Pompeo, she said, believes the Affordable Care Act, also known as Obamacare, will “drive up costs for the poorest people in Kansas and diminish access, especially in the rural areas of Kansas.” (Ranney, 7/27)