DCMedical News: Thursday, June 13, 2019
DCMedical News-DCMN
Washington, D.C.
Thursday, June 13, 2019
DCMedical News is published every day both the House and the Senate are in session. Subscription information below.
THE BIG STORY IN HEALTH CARE
State Scorecard Turning Negative, Public Concerns with Health Costs Up
Commonwealth Fund researchers find (here) that the “scorecard” for health status and health care is turning negative, in some states more than others. “Most states are losing ground on key measures related to life expectancy as premature deaths from suicide, alcohol, and drug overdose continue to increase. Several states that most recently expanded eligibility for their Medicaid programs saw meaningful gains in access to health care; in other states prior gains eroded between 2016 and 2017. Finally, the Scorecard found that health care costs are placing an increasing financial burden on families across the nation.”
The report notes that the rise in deaths from suicide, alcohol and drug overdose is a “national crisis,” but that individual states are affected in different ways. Also, per capita spending growth in employee plans is greater than that in Medicare. Hawaii, Massachusetts, Minnesota, Washington, Connecticut and Vermont are the top states, using 47 measures of access, quality, and outcomes. In 11 states--generally in the south and southwest--average employee health insurance contributions were 8 percent or more of median income in 2017. A useful bibliography and comprehensive appendices on state rankings constitute half of the report. Louisiana (here) moved from 49th to 45th based on Medicaid expansion.
Kaiser Family Foundation weighs in (here) with a summary of current polling and surveys on America’s health concerns. “Health care costs dominate public and personal discussions on health care. Americans consistently put health care costs at the top of their list when it comes to health care issues they want the government to address and for political candidates to talk about and recent KFF polling indicates health care costs now occupy a tier of their own on the public’s list of pressing health care issues. Health care costs also top the list of household expenses the public worries about affording.”
White House Announcement on Provider Price Transparency
Not yet. Lead up in Wall Street Journal coverage, here and here.
MEDICARE, MEDICAID, COMMERCIAL HEALTH INSURANCE
Ways and Means Hears About Medicare for More
Testimony at the House Ways and Means Committee on public options included a powerful summary of “Inslee-Care,” the collective accomplishments of the State of Washington (Jay Inslee, Governor, and Presidential candidate) in bolstering the success of the Patient Protection and Affordable Care Act, and in preparing for Cascade Care, the nation’s first state-sponsored public option.
The Chief Executive of the Washington Health Benefit Exchange listed (here) accomplishments to date: “Extending the open enrollment period and securing state funding for marketing and outreach in Washington’s Exchange, when the sign-up period and marketing and outreach at the federal level was restricted; Permitting insurance carriers to modify their silver plan premiums (a practice known as ‘silver loading’) when federal funding for cost-sharing reductions was terminated; Protecting consumers from short term limited duration insurance plans by establishing minimum standards and limiting short-term policies to three months, through rule-making by the state insurance commissioner, when federal rules were issued that permitted the expansion of short-term limited duration insurance policies that are largely unregulated and threaten the stability of the individual market; Codifying consumer protections in state law in response to ongoing federal threats to the ACA, including protections for pre-existing conditions, essential health benefits, non-discrimination protections, caps on out-of-pocket costs, open enrollment periods, and prohibitions on annual and lifetime caps on care; Ending the practice of surprise medical billing with a new law that protects consumers and establishes a process for carriers and providers to address billing disputes; Actively responding to consumer confusion and complaints, such as recent actions taken by our insurance commissioner to prevent organizations falsely claiming to be health sharing ministries from engaging in deceptive business practices.” On cost, “Our Exchange recently released a joint analysis with Covered California and the Massachusetts Health Connector, which highlights the stark difference between the experiences of consumers who live in states that have been committed to using the tools of the ACA and those who are now relying on the federal marketplace. Since 2014, the cumulative premium increase that consumers in states served by the federal marketplace have risen by 85 percent, while in our three states the increase has been less than half of that.” Rep. Pramila Jayapal, lead sponsor of the H.R. 1384 the Medicare-for-All bill (here) is also from Washington.
The hearing, which The Hill characterized as taking place before a “lively audience” of Medicare-for-All supporters, also heard from an advocate for less government involvement in health insurance (here), who noted “While the promises of Medicare for All sound utopian, what if 173 million people don’t want to give up their job-based insurance? What if 60 million seniors like their current Medicare and Medicare Advantage plans and don’t want the program abolished? And what about union members who have made significant sacrifices in wages to earn their rich health benefit packages? Will they and others who like the coverage they have now be forced to pay significant new taxes to finance a government program that is inferior to the one they have now?” Also of note, Kaiser Family Foundation testimony, here.
READINGS AND REFERENCES
John Early on benefit design changes to preserve Medicare’s financial viability, in the Wall Street Journal, here, and in his Cato Institute study, here.
U.S. House of Representatives:
Members at https://www.house.gov/representatives.
Committees and Members at https://www.house.gov/committees.
U. S. Senate:
Members at https://www.senate.gov/general/contact_information/senators_cfm.cfm.
Committees and Members at https://www.senate.gov/committees/membership_assignments.htm.
House and Senate 2019 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
June publication dates: 18, 19, 20, 21, 24, 25, 26, 27
July publication dates: 9, 10, 11, 12, 15, 16, 17, 18, 23, 24, 25, 26
August publications dates: None
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.