Texas has a way to help patients appeal their surprise medical bills. It's not open to everyone. But it's still overwhelmed and unable to keep up with demand.
How it works: Texas operates a mediation program for patients hit with a surprise out-of-network bill, and it has expanded access to the program twice over the past 4 years.
Prescription drugs may be the latest snag for President Trump’s proposed NAFTA replacement.
The big picture: Trump's deal, known as USMCA, already faces an uncertain fate in the Democratic-controlled House, as my colleague Jonathan Swan reported earlier this week. And now Democrats are homing in on the deal's protections for biologic drugs, according to the Associated Press.
Almost 70% of Congress signed onto new letters backing Medicare Advantage, the growing alternative to traditional Medicare that collects $250 billion of taxpayer funding.
The bottom line: In what has become an annual tradition, members of Congress praised Medicare Advantage plans' out-of-pocket caps and vision benefits — but did not mention the program's tradeoffs and concerns, like narrower networks of doctors and the controversial billing practices that have led to inflated payments.
The FDA has sent a warning letter to McKesson, alleging the drug distributor broke federal law by not responding to notifications from pharmacies that drugs were tampered with while in McKesson's possession — including instances where oxycodone pills were stolen and replaced with "illegitimate" medications. FDA commissioner Scott Gottlieb said the alleged violations were "simply unacceptable."
Why it matters: Drug wholesalers like McKesson face a lot of legal liability for their role in the opioid epidemic, and now the FDA is threatening legal action if the companies don't prove they are rectifying their oversight of painkiller shipments. McKesson said it has been in touch with the FDA and is "in the process of providing additional procedural detail and documentation."
Workers who get health care coverage through their jobs are bearing the brunt of rising health care costs. And that’s mainly because health care prices keep going up, not because we’re using more health care services.
The big picture: Per-person spending is growing faster for private insurance than it is for Medicare or Medicaid, according to a new analysis from the Robert Wood Johnson Foundation and the Urban Institute.
Democrats' shift to the left with big ideas like Medicare for All, along with the rise of progressives like Rep. Alexandria Ocasio-Cortez (D-N.Y.), is changing the balance of power in the party’s unofficial policy establishment.
Why it matters: Think tanks, policy analysts and advocacy groups are vitally important — they help shape the party’s policy platforms and channel the base's enthusiasm. And a new set of players are gaining power in that world just as Democrats seize the reins in the House and wade into a policy-heavy primary for 2020.
Utah Republican Gov. Gary Herbert on Monday signed legislation into law to limit the expansion of the state’s Medicaid program, after voters in the deep-red state approved a ballot measure in November to extend coverage under the Affordable Care Act to about 150,000 additional low-income people starting April 1.
Why it matter: Under the GOP-controlled legislature’s plan, Utah would only provide coverage to about 80,000 people and ask the Trump administration for a waiver to permit the "partial expansion" of Medicaid. But the White House, which has repeatedly voiced opposition against efforts to expand Medicaid, had signaled its opposition to Republicans' scale-down version last year. The government has never approved a partial expansion before, and if it does not grant Utah the waiver, the new law would automatically repeal the entire expansion voters approved.
