Rising health costs are squeezing states' budgets to the point where some are considering raising premiums for hundreds of thousands of teachers and public employees for the first time in more than a decade.

Why it matters: The potential hikes show that even state workers with generous benefits aren't immune from the cost growth that's been facing commercial insurers and federal health programs.

• Better benefits have often made up for lower salaries in public sector jobs — and kept some workers from moving to the private sector.
• But those benefits rely on state dollars, making them an attractive place to cut when states have to balance their budgets.

Driving the news: North Carolina State Treasurer Brad Briner said he'll have no choice but to raise premiums for the nearly 750,000 people insured by the state health plan, which faces a deficit of more than $500 million, Axios Raleigh's Zachery Eanes reported last week.

• South Carolina legislators are also discussing a state budget that would hike premiums for teachers and state employees by about $441 a year. The state hasn't raised premiums for its state health plan in 12 years.
• Other states have already increased premiums for this year: Delaware's 27% increase in premiums for state health plan enrollees kicked in last July.

Zoom out: States are also looking at ways to control costs for their employee health plans.

• Washington is considering legislation that would set a maximum price for hospital services for state employee plan enrollees at a percentage of Medicare's rate. Oregon previously implemented hospital price caps for its state employee plan.

Read more

As hundreds of researchers, patient advocates and policymakers gather in Washington, D.C., this week for an advocacy fly-in on rare diseases, a notable gap has appeared on their schedule: an annual gathering hosted by the FDA and NIH.

Why it matters: The annual two-day gathering known as Rare Disease Day is among the agencies' largest public engagements, and its postponement is raising questions about the agency's priorities.

The big picture: Individual rare diseases are, by definition, uncommon. But there are thousands of them, and they affect a large group of patients — more than 30 million in the U.S.

• Just 5% of rare diseases have FDA-approved treatments, and research assessing new drugs' effectiveness faces unique challenges in gaining approval under FDA trial guidelines due to the small number of people impacted by a particular disease.

More than 800 rare disease advocates will already be in D.C. for Rare Diseases Week, and many were planning to attend the FDA-NIH event, said Will Nolan, a spokesperson for EveryLife Foundation for Rare Diseases.

• "The cancelation of this important event for our community underscores the consequences of removing key experts at Health and Human Services Agencies including NIH and FDA," he told Axios in an email.

HHS, FDA and NIH officials did not respond to requests for comment.

• "Rare Disease Day is important to all of us, and we want to make sure we can fully focus on the event to make it the best that it can be," officials said in a statement posted on the event's website.

Share this

The FDA on Monday granted its first approval for an adaptive pacemaker-like device for the brain to ease symptoms of Parkinson's disease, which affects nearly 1 million people in the United States.

Why it matters: Medtronic, the device's manufacturer, said this will be the largest-ever commercial rollout of brain-computer interface technology.

State of play: The implant uses more than 30-year-old brain pacemaker technology and adjusts treatment to patient needs in the moment.

• Algorithms sense motor symptoms of Parkinson's and produce a level of brain stimulation to prevent them that can be adjusted to what the patient needs at a given moment.
• That's viewed as preferable to the constant electric currents used in traditional deep brain stimulation devices that can produce unpleasant side effects.
• Clinical trial results published in August showed that the device reduced involuntary movements and other symptoms by 50% in four patients who had Parkinson's for at least 10 years.
• Adaptive deep brain stimulation has also shown promise in treating conditions like depression and chronic pain.

Go deeper

Medicare spending on 10 diabetes drugs, including popular GLP-1s, more than quadrupled over a five-year period and could reach $102 billion next year, an analysis by HHS' inspector general found.

Why it matters: Medicare doesn't cover the drugs for weight loss, but the watchdog report noted a surge in utilization raises questions about whether the program paid drug claims for unauthorized uses.

• The findings also come as the Trump administration weighs the fate of a Biden administration proposal that would require Medicare and Medicaid to cover GLP-1s for weight loss.

By the numbers: Medicare Part D spending on the 10 drugs studied rose from $7.7 billion in 2019 to $35.8 billion in 2023, for an overall increase of 364%.

• The biggest spikes in usage were for Rybelsus, Novo Nordisk's once-daily GLP-1 tablet, and for the company's weekly injectable Ozempic, whose spending about doubled every year under review.
• While Eli Lilly's Mounjaro wasn't covered by Medicare Part D until mid-2022, program spending on it increased 1,541% the following year.

Read more

📩 HHS told employees not to respond to the DOGE-led email asking them for a list of completed work tasks, after initially directing them to answer the request. (Fierce Healthcare)

🩸 A U.S. appeals court upheld the fraud conviction for Elizabeth Holmes, the founder of failed blood-testing startup Theranos. (Axios)

🚒 Firefighters worry the Trump administration could strip their recently won coverage for breast and cervical cancer developed because of hazardous exposure on the job. (The 19th)

🏥 A small but growing group of unrepresented patients are facing inappropriate care and limbo in hospitals. (WHYY)