Good morning ... Could Tennessee be among the next red states in line to expand Medicaid?
"At some point in time, I think those states that haven't (expanded) will look around and say, we're all 50 states paying for it and 40 states are getting the benefit," outgoing Gov. Bill Haslam said in an interview with The Tennesseean.
Several pharmaceutical companies have said they'll delay some of their price increases, under pressure from the Trump administration. But hospitals have made no such concessions, even though they make up a much larger share of health care spending.
The big picture: Axios' Bob Herman reached out to 27 (!) hospital systems, many of which have some of the highest prices in the country. None said they would voluntarily freeze or lower their prices.
Between the lines: Most of pharma's voluntary steps aren't very consequential. Some have merely delayed price increases; others have lowered prices for drugs that were already facing competition from generics.
Yes, but: Although drug pricing is the political controversy of the moment, hospitals cost the health care system far more.
What they're saying: Not much.
The Centers for Medicare & Medicaid Services is trying to reinstate the Affordable Care Act’s risk adjustment program, which it recently froze in the wake of a court ruling.
Risk adjustment transfers money among insurance companies — the government doesn’t pay. The dispute is over the way CMS calculates insurers’ obligations under the program.
Driving the news: Late yesterday, CMS reissued its formula for 2017, along with new supporting arguments for that methodology.
Clinical trials for Alzheimer's drugs are having a hard time recruiting participants — yet another setback for a field of research that's already enormously difficult.
Where it stands: There are more than 200 trials in search of roughly 100,000 participants, Medscape reports, citing federal officials. The New York Times cites experts who put the shortfall closer to 25,000, but that's still a daunting gap to close.
Recruitment is especially difficult for Alzheimer's trials because it can be hard to reach people who have the disease, especially in its early stages, and also because Alzheimer's is often misdiagnosed.
“The irony is that the science has never been more promising,” John Dwyer, president of the Global Alzheimer’s Platform Foundation, told the Times. “How many promising drugs will be abandoned or their evaluation seriously delayed? Some good science is going to be left on cutting-room floor.”
Remember HMOs? The health plans everyone hated in the 90s? Well, they're back, Bloomberg reports.
How it works: HMOs tried to control health care spending by requiring customers to get a referral from their primary care physician to see a specialist, and using that leverage to push patients toward cheaper treatments.
New HMOs are trying to differentiate themselves with simpler pricing structures — replacing deductibles with fixed co-pays for office visits, emergency-room admissions and hospital stays. One company, Bind, is also trying out "on-demand insurance."
“It’s deja vu all over again,” University of Pennsylvania researcher Lawton Burns said. “It’s not clear to me, this is just me talking, that people have learned the lessons of the 1990s.”
1. The Senate HELP Committee today will consider a bill to ban pharmacy "gag clauses." Those policies, imposed by pharmacy benefit managers, prohibit pharmacists from telling patients when paying cash for a drug would be cheaper than using their insurance.
2. The House voted 283–132 yesterday to fully repeal the ACA's tax on medical devices. Previous, non-binding votes to repeal the tax have garnered significant bipartisan support in the Senate, but putting together 60 votes for anything ACA-related remains a hard job, to say the least.
Americans see e-cigarettes as better than cigarettes, but still harmful overall, according to a new Gallup survey.
By the numbers: Almost everyone — 96% of those surveyed — said cigarettes are at least somewhat harmful to the people who use them, including 82% who said they’re “very harmful.”
Why it matters: The Food and Drug Administration, kind of like the public overall, is still sorting out exactly how it feels about vaping.
What we're watching today: Earnings reports from Anthem this morning and Gilead Sciences this afternoon.
What we're watching this week: Energy and Commerce subcommittee hearing Thursday on Medicare's payment systems.
More Q2 earnings — follow along with our earnings spreadsheet.
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