Aug 15, 2019

Hospitals winning big state battles

Illustration: Aïda Amer/Axios

Several states have made ambitious attempts to address health care costs, only to be thwarted by the hospital industry.

Why it matters: States' failures provide a warning to Washington: Even policies with bipartisan support — like ending surprise medical bills — could die at the hand of the all-powerful hospital lobby.

The big picture: Hospitals are the biggest contributor to rising health care spending, and states are on the leading edge of trying to curtail those costs.

Driving the news: Hospitals' most recent political victory came in North Carolina, where large systems were able to remain in state employees' health plan without agreeing to the state's proposed payment rates, according to the Charlotte Observer.

  • Last month, hospitals killed a California proposal to curb surprise medical bills. It would have limited how much hospitals could charge insurers for out-of-network emergency care, according to California Healthline, and hospitals said it would have given insurers too much incentive to exclude hospitals from their networks.
  • And in June, Washington state passed a law to create a public insurance option — but only after hospitals secured higher payment rates than the proposal had initially called for. The public plan's low costs wouldn't be worth much if too few providers agreed to accept it.

What we're watching: Congress and the Trump administration are trying to pull off several reforms that hospitals oppose — including price transparency measures and a federal prohibition on surprise billing that would be similar to California's.

  • And new public insurance plans are central to Democratic presidential candidates' health care plans.

The bottom line: If the state battles are any indication, all of those political battles will be difficult, if not impossible, to win.

Go deeper

Hospital lawsuits unearth "cracks in our system"

Data: Peterson-Kaiser Health System Tracker; Chart: Axios Visuals

Low-income patients often face steeper out-of-pocket health care costs — and that means they're also more likely to be sued by hospitals when they can't pay their bills.

Driving the news: The New York Times yesterday reported on Carlsbad Medical Center's prolific use of lawsuits to collect its patients' medical debts, which often leads to wage garnishment or property liens.

Go deeperArrowSep 4, 2019

The plight of America's rural health care

Illustration: Sarah Grillo/Axios

Rural America is stuck in a cycle of increasingly vulnerable patients with declining access to health care.

Why it matters: Rural patients often can't afford care, are being hounded by hospitals and collection agencies over their unpaid bills, and are facing the reality of life in communities where the last hospital has closed.

Go deeperArrowAug 21, 2019 - Health

Health care dominates 2019 ad spending

Data: Advertising Analytics; Chart: Axios Visuals

More than half of all issue advertising this year has been on health care, and that spending will only increase as the 2020 campaign gets closer.

Between the lines: Most of the top health care spenders are focused on issues like surprise medical bills and drug prices — many of which would cut into the health care industry's profits.

Go deeperArrowSep 11, 2019