The year-end spending bill in Congress epitomizes the power of health care interests, Axios' Bob Herman writes.
The big picture: There are lots of goodies for the industry, while patients will get the worst kind of holiday surprise — more medical bills.
The bill includes some of the usual health care "extenders" — keeping money flowing to rural hospitals and community health centers, and again delaying cuts to hospitals that treat the poorest patients.
- But in the weeds of the negotiations, the industry came out even better than you may have realized.
- This was the bill that, once upon a time, might have been the vehicle for deals to reduce drug prices and crack down on unscrupulous billing practices. Instead, it became an industry giveaway.
The bill repeals several Affordable Care Act taxes — a particularly big win for health insurers that sell Medicare Advantage plans.
- The bill also gives more drugs — for example, some that treat diabetes or osteoporosis — 12 years of market exclusivity instead of the five years they would have gotten.
- Hospitals that perform certain stem cell transplants will now get paid by Medicare for the costs associated with acquiring those stem cells, a policy that will add an average of $50,000 to $65,000 in extra pay for each procedure.
- Companies that make some radioactive substances for PET scans will get an extra nine months of higher pay from Medicare.
- Clinical labs got a one-year delay on price-reporting requirements. This will give them more time to collect data from higher-priced labs, which will be used to drive up their pay in the face of recent Medicare cuts.
The big picture: All of these policies will materially benefit pretty much every sector within an industry that already wields more financial power than ever.