Good morning ... A big thanks to Caitlin Owens and Bob Herman for picking up the slack on today's Vitals, while I covered the Kavanaugh hearings yesterday. I'm still wrapping my mind around it all, but I can confidently say we're going to be talking about yesterday for decades to come.
Alex Azar. Photo: Chip Somodevilla/Getty Images
Premiums for benchmark Affordable Care Act plans are projected to drop in 2019, the first time that has happened since the law has been implemented, HHS Secretary Alex Azar announced yesterday.
Between the lines: The drop in premiums is primarily because insurers raised them too much last year. They did so after President Trump ended the ACA's cost-sharing reduction payments.
State reinsurance programs, which the administration has been actively supportive of, have also played a roll in premium stabilization.
Every 15 minutes, a baby is born addicted to opioids.
Axios' video team dug deeper in Baltimore, where doctors at Mt. Washington Pediatric Hospital say babies born with Neonatal Abstinence Syndrome — a set of conditions caused by withdrawal from exposure to drugs — now account for 25% of the hospital’s admissions.
Why it matters: Nationally, the number of babies born with the syndrome has increased by over 400% since 2004.
The Congressional Budget Office score of the House opioids bill is in, and billions of dollars are shuffling around in the health care industry, Bob reports.
Winners: Inpatient behavioral hospitals, which would receive more than $1 billion in increased federal Medicaid payments from 2020–2023 for patients addicted to opioids.
Losers: Medicaid insurers.
Many states already follow a so-called medical loss ratio, and the Obama administration established federal Medicaid MLR guidelines in a giant regulation in 2016. The Obama-era rule did not require states to collect excess Medicaid profits, but this bill would.
Aetna is selling its entire Medicare prescription drug business, which includes prescriptions for more than 2.2 million people, to WellCare.
By the numbers: WellCare would have 3.3 million Medicare Part D members if this divestiture occurred, or 13% of the market. WellCare essentially would have the same market share as the combined membership of the soon-to-be-merged Cigna-Express Scripts.
The bottom line: This divestiture wouldn’t materially change the high concentration in Medicare’s standalone drug plan market. Five companies (CVS, UnitedHealth, Humana, WellCare and Cigna-Express Scripts) would control 90% of that market.
1 financing thing: Terms of the deal weren’t disclosed, but the companies said it would be an all-cash transaction. WellCare had $515 million of “unregulated” cash on hand as of June 30.