Sep 30, 2019

Axios Vitals

By Caitlin Owens
Caitlin Owens

Good morning. Careful with those vapes, everyone.

Today's word count is 785 words, or ~3 minutes.

1 big thing: Ads for nonexistent "Trumpcare" are everywhere

Illustration: Sarah Grillo/Axios

Do a quick search for health insurance, and you'll find plenty of ads for "Trumpcare" plans that cost $59 or less per month. But there's a catch: Trumpcare doesn't exist, and many of these advertised plans offer bare-bones coverage, Axios' Bob Herman reports.

Why it matters: For people who buy health insurance on their own instead of receiving it through an employer, searching for a plan is already challenging. And deceptive marketing only makes it harder, especially when these plans will leave consumers on the hook for potentially ruinous medical bills.

Reality check: The primary way the Trump administration has altered the insurance market is by expanding niche products — including short-term plans, association plans and health reimbursement arrangements.

After seeing Trumpcare ads in search engines, Bob submitted contact information to get quotes about coverage options. Over the the next week, he was bombarded with 70 phone calls and 12 texts from insurance brokers.

  • Every broker he spoke to admitted there is no such thing as Trumpcare, and that it is a marketing ploy from the lead generator site.
  • When he asked how he could get the plan that was advertised for $59 or less per month, brokers said the ads were in reference to short-term plans or fixed indemnity plans that offer little to no coverage for serious illness or injury.

What they're saying: "These websites that are selling 'Trumpcare' are capitalizing on the fact that very few people know what's going on," said Louise Norris, an independent insurance broker in Colorado.

Go deeper.

2. Industry pushes back on transparency rule

Comments on the administration's proposed rule requiring the disclosure of negotiated hospital prices reveal the ongoing battle between the hospital industry and patient advocates, the Wall Street Journal reports.

Between the lines: The industry is fiercely protective of negotiated rates and adamantly opposes the administration's proposal.

  • Hospitals say it creates an unrealistic burden and unfairly leaves insurers alone, per WSJ.
  • Patient advocates say price transparency gives patients more power when selecting care and would counteract industry price gouging.
  • Some experts and advocates for the proposal say hospitals' opposition alone suggests that the measure would successfully drive down prices for patients — which would cut into providers' profits.

Hospitals also argued in their comments that the rule would allow insurers to extract the same discounts obtained by their competitors, while giving less expensive hospitals leverage to demand higher rates.

  • Some critics asked that the rule be delayed for rural hospitals, as they don't have the resources to comply.
  • Others argued that patients care more about what they'll pay out of pocket than the negotiated price of care.

My thought bubble: These comments were predictable, but where the administration lands with the rule isn't. It's difficult to begin with to take on the hospital industry, but that's compounded by all the uncertainly regarding the proposal's effect.

Go deeper: Washington's favorite health policy isn't a silver bullet

3. Fertility startup files to go public

Progyny is ready to go public, and unlike a lot of other health care startups that have slid into the public markets, the fertility benefits company is already profitable, Bob reports.

The big picture: Employers rarely covered in vitro fertilization, egg freezing and other fertility care in the past, and those services are expensive when paying out of pocket — in vitro could cost $25,000 per try.

  • Progyny is capitalizing on companies increasingly offering fertility benefits as a way to attract and keep employees.

By the numbers: Progyny's revenue in the first half of this year was $103 million, and it turned a $4 million profit, according to its IPO documents

  • Progyny's largest customers, Google and Microsoft, together account for 28% of its revenue.

Worth noting: 2 of Progyny's largest investors are big pharmaceutical companies — GlaxoSmithKline and Merck KGaA.

4. Rural America's doctor crisis

Illustration: Sarah Grillo/Axios

The Washington Post's Eli Saslow profiles the life of Ed Garner, the only doctor serving 11,000 square miles in West Texas.

The big picture: This isn't unusual. As I've written before in this newsletter, rural America often has high health care needs but is increasingly faced with limited health care services.

  • That's often portrayed through the struggles and closures of rural hospitals, but recruiting and keeping doctors is just as significant as the challenge of keeping hospitals from going too far into the red.

By the numbers: The federal government has designated almost 80% of rural America as "medically underserved," per the Post. While 20% of Americans live in these areas, less than 10% of U.S. doctors practice in them.

  • Rural doctors tend to be older than urban ones, and the number of rural doctors is expected to only decrease over the next decade.
  • In Texas, 159 of the state's 254 counties have no general surgeons, 35 counties have no doctors at all, and 30 counties have only one doctor.

Go deeper: The plight of America's rural health care

5. While you were weekending...
  • A dispute over a Russian biochemist's quest to use CRISPR to produce genetically modified children could end up being decided by Vladimir Putin, Bloomberg reports.
  • While the U.S. cracks down on vaping amid a growing number of cases of mysterious lung illnesses, the U.K. has increasingly welcomed and promoted e-cigarettes as an alternative to traditional smoking, AP reports.
  • CVS has stopped selling Zantac at its stores following a recent FDA alert that the heartburn drug could contain a likely carcinogen, WSJ reports.
Caitlin Owens