Six months ago, the Department of Health and Human Services said it would delay, yet again, an Affordable Care Act regulation that would fine drug companies for "knowingly and intentionally" overcharging hospitals in the federal 340B program. But now HHS "no longer believes a delay" is necessary, the agency said in a rule Wednesday.
The bottom line: The penalties will now go into effect Jan. 1, 2019, instead of July 1, 2019 — putting drug manufacturers on the hook sooner than they thought, but still considerably later than when the ACA expected the rule would go into effect.
The Democratic super PAC Forward Majority is releasing a seven-figure ad campaign targeting GOP state legislators over their opposition to pre-existing conditions coverage under the Affordable Care Act as part of the group's $8 million investment in over 100 state legislative districts in the 2018 midterm election cycle.
Why it matters: This health care topic has shown up in gubernatorial, House and Senate races, where more GOP candidates are campaigning on protecting people with pre-existing conditions, even after their party attempted to repeal and replace the ACA. Now, Forward Majority is trying to help Democrats running for state legislatures in key battlegrounds capitalize on this issue — especially after the Trump administration gave states more leeway last week to waive some of the ACA's rules.
Voters like some form of “Medicare for All” but are divided over what it should look like, according to our latest Axios/SurveyMonkey poll — which is about the same situation Democratic candidates are in.
The big picture: Many of Democrats’ leading 2020 prospects, and a host of candidates in the midterms, have embraced “Medicare for All,” but there’s a big variation in the policies they propose under that banner.
Pfizer CEO Ian Read told Wall Street today the company's drug pricing strategy will be "business as normal" next year, just months after Read spoke with President Trump and agreed to temporary delays of recent drug price hikes. Pfizer reported a $4.1 billion profit in the third quarter, a 45% increase from the same time last year.
Reality check: The Trump administration hailed Pfizer's move this summer as a "major win for American patients." But the company's decision to return to the status quo shows both sides were looking to score political points, and patients won't see meaningful changes to their drug prices in the near term.
Idaho Gov. Butch Otter, a Republican, says his state should join the Affordable Care Act's Medicaid expansion. Otter appears in a new ad encouraging voters to support a ballot initiative next week that would adopt the expansion — a tool advocates turned to after elected officials resisted the expansion for years.
Why it matters: Medicaid expansion could be one of the biggest winners of the midterm elections. Three states — Idaho, Nebraska and Utah — will vote on ballot initiatives about whether to expand. If those measures pass, and Democrats win close gubernatorial races in large non-expansion states like Florida and Georgia, millions of uninsured people could end up getting Medicaid coverage.
How much more expensive are prescription drugs in the U.S.? Enough that one Utah insurer can fly its customers to San Diego, give them a ride across the Mexican border, pay them $500 cash for their trouble, and still save over $13,000 per person.
This is bananas. PEHP, which covers state employees and their families, recently added the cash bonus to an existing "pharma tourism" package, and is hoping participation will rise, the Salt Lake Tribune reports.
A lot has been written about how much the cost of health care varies from one region to another — say, the difference between urban and rural hospitals. But prices also vary within one region, and even within the same hospital, based on the rates each patient’s insurance plan has negotiated.
The details: A new working paper, published yesterday in the National Bureau of Economic Research, aims to shed some light on the differences in what various insurers pay for the same services, using data from Massachusetts’ claims database.
States are increasingly using their Medicaid programs to focus on addressing social determinants of health, like access to housing and food, as a way to make health care more comprehensive and cost-effective.
The big picture: These state Medicaid efforts are part of a growing recognition that improving overall population health — and health equity — will have to include interventions beyond the traditional health care system.
