THIS WEEK IN REVIEW: Monday, Oct. 28th – Friday, Nov. 1st

November 1, 2019 by B. Cameron Webb, MD, JD

THIS WEEK IN REVIEW: Monday, October 28th – Friday, November 1st

Grab your pile of Reese’s, take a seat, and enjoy some health policy news updates!

Now that Halloween has passed, we can start off the holiday season with what some might see as a healthcare holiday: Happy Affordable Care Act (ACA) enrollment day! If you’ve wondered whether we’d continue to have this day each year, there are some signs that this years’ might not be the last. One analysis by the organization Get America Covered found that two-thirds of healthcare.gov shoppers will be able to find a subsidized plan costing $10 or less. Premiums in general are expected to be lower, and more insurers are offering plans than years prior. Regardless of these positives however, 2019 was the fourth consecutive year of drops in enrollment numbers. Democrats blame actions by the Trump Administration, which continues to loosen regulations on plans that don’t fit ACA requirements and cut funding for marketing and outreach.

For those of you that will enroll in the marketplace, you may find a use for its new-ish five-star rating system that is supposed to help inform consumers. However, if you do, you’d be one of the lucky few — a third of all plans on the federal exchange do not have these ratings, as plans that have existed for less than three years are not eligible. Additionally, a quarter of all U.S. counties only have one insurer in their exchange, so the rating system currently does little in terms of facilitating residents’ choice.

In the Senate this past Wednesday, Democrats failed to pass a resolution against a recent Trump administration rule that gives states more leeway in their insurance markets. The rule allows states, through waivers, more freedom in the makeup of their markets, notably through the promotion of more short-term limited duration plans. Democrats, who commonly refer to these types of plans as “junk plans” because insurers do not have to provide coverage for pre-existing conditions, pushed a vote under the Congressional Review Act. A Republican majority blocked the resolution with a vote of D-43, R-52, with Sen. Majority Leader Mitch McConnell (R-KY) citing that it was “another political messaging exercise with no path to making an impact.”

Stephen Hahn, Chief Medical Executive at MD Anderson Cancer Center in Houston, is likely to be President Trump’s nominee for commissioner of the Food and Drug Administration (FDA). The FDA is in need of a full staff with a full plate of vaping-illnesses, e-cigarette bans, and drug shortages. On Wednesday, The FDA released a report outlining the sources of drug shortages, noting that two-thirds of 163 drugs in recent short supply are available as generics. The report cites 3 core causes: a lack of incentives for manufacturers to produce less profitable drugs, quality control issues, and problems associated with market disruptions, specifically for companies that are sole suppliers of a drug. Controversially, one of the report’s suggested solutions was that buyers like hospitals consider paying higher prices for older generic drugs.

Speaker Nancy Pelosi’s (D-Calif.) drug pricing bill is facing criticism from moderate and progressive Democrats, particularly about the Jayapal amendment. The Jayapal amendment would extend protections against drug price increases to private employer-sponsored insurance plans, not just Medicare. Progressives see this as necessary, but moderates note the solely partisan-support and suggest seeking a bipartisan middle-ground. White House attentions have turned to a more modest, Medicare-centric bill in the Senate from Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.). The Grassley-Wyden bill does not include negotiations but would require drug companies to pay money back to Medicare if their prices rise faster than inflation. This bill has some bipartisan support, but has faced criticism from Republicans. What does the public think? The winner of Kaiser Health News Halloween Haiku competition puts it best:

“Drug prices rise up
Like a witch on a broomstick
Cannot pay? So die.”
-Sarah Collins

In line with the Trump Administration’s move to allow states to opt-out of ACA coverage requirements, Republican Governor Brian Kemp of Georgia has proposed a plan that would enable the use of ACA subsidies to purchase short term and association health plans. Proponents claim that the proposal will increase access to more insurance options. However, opponents warn that, although cheaper, these plans provide less coverage and may lead to higher out of pocket costs for consumers.

Lawmakers in Indiana announced a temporary suspension of its Medicaid work requirements due to a pending lawsuit on Thursday. This lawsuit follows previous challenges to a Trump Administration policy that approved Medicaid work requirements on the grounds that they help “lift people out of poverty by making sure they are working.”

In contrast to the Trump Administration’s push to require Medicaid recipients to work, Pennsylvania has opted for a gentler approach. Starting next year, the Pennsylvania Medicaid Agency will offer job training assistance for new enrollees. Teresa Miller, Pennsylvania’s human services secretary, predicts that this strategy will be more effective than work requirements.

Looking at Alabama, a restrictive abortion law that was set to kick in this month has been temporarily blocked by a federal judge. Similar bans have been blocked in Georgia, Kentucky, Mississippi, Missouri, and Ohio. Speaking of Missouri, a legal dispute in the “Show-Me” state between Planned Parenthood and Governor Mike Parson could lead to it becoming the first state in the nation without a clinic that performs abortions. Back in July, the state refused to renew the clinic’s license on the grounds that it was violating state health regulations. A suit was filed which allowed for the clinic to stay open and the hearing has now concluded (there was some weird stuff going on there). A final decision is not expected for several weeks or even months. 

And finally, some uplifting news: a new study from the journal Circulation: Cardiovascular Quality and Outcomes suggests that dogs can help you live longer. From a reduction in cardiovascular risk to depression, these four-legged friends are certainly a paw-sitive influence in our lives. Check out these very good pups working hard this week in the State Attorney’s office as a support for children who are victims of assault and this military working dog who was injured during a recent mission

Enjoy your extra hour of sleep (or of reading health policy news??) this weekend!

 


This Week’s Viewpoints Writing Team:
Avery Bullock, Carina Clawson, Jo McClain, Steven Moore and Nana Owusu