Good morning ... Hope you're excited for the big game this weekend, by which of course I mean Kentucky men's basketball vs. Florida (4 pm ET Saturday, on ESPN). The Super Bowl, meh.
Health and Human Services Secretary Alex Azar. Photo: Chip Somodevilla/Getty Images
The Trump administration is rolling out the policy specifics for a central promise in its plan to lower drug prices — taking on the system's middlemen.
The big picture: Health and Human Services Secretary Alex Azar has long had his eye on pharmacy benefit managers and the rebates that are their bread and butter.
How it works: Today, drug companies set a price for their products and then PBMs negotiate a discount in the form of a rebate, on behalf of insurance plans. PBMs keep some of that money for themselves and the insurers use some of it to help lower premiums across the board.
Winners: In the short term, this would largely move money around. Patients would pay less at the pharmacy — which is good news for seniors who take a lot of expensive drugs.
In the long term, HHS is hoping this will change the pharmaceutical industry's pricing practices.
The bottom line: This is a major shakeup in the way we pay for drugs. It's in the weeds, and it’s not a cure-all (nothing is), but it's big.
Medicaid politics are a pretty good snapshot of health care politics overall right now.
Driving the news: Voters in three blood-red states — Idaho, Nebraska and Utah — said overwhelmingly last year that they wanted to adopt the Affordable Care Act’s Medicaid expansion.
On the other end of the Medicaid spectrum, New Mexico is moving forward with its plan to let some residents buy into the state’s Medicaid program.
Take a step back, and the trend line is clear. Democrats are winning, and they're the ones pushing further ahead.
Go deeper: Medicaid is the ACA's workhorse
The company that manufactures EpiPens ignored or downplayed technical defects in the product for years, even in the face of repeated warnings from the Food and Drug Administration, Business Insider reports.
The big picture: This gives us two big issues for the life-saving drug: How much people have to pay for it, and how well it works when they need it.
"Your own data show that you received hundreds of complaints that your EpiPen products failed to operate during life-threatening emergencies, including some situations in which patients subsequently died," the FDA said in its September 2017 letter.
People Googling for ACA coverage often found results that were actually trying to sell them skimpier short-term health plans, according to a report from Robert Wood Johnson Foundation and the Urban Institute.
Why it matters: Consumer confusion is one of the things regulators worried about most when the Trump administration expanded access to “short-term” coverage.
Details: Researchers Googled terms including "cheap health insurance" and "Obamacare plans" and looked at the first 4 results — which are usually ads.
A rapidly consolidating industry. One that generally delivers on very difficult work, but with such a horrible customer-service reputation that people hate dealing with it. Known for wringing every last dollar out of its customers. You and the person next to you may be paying wildly different prices.
Health care, or an airline?
It’s a common comparison, and not without merit.
The bottom line: In all seriousness, this analogy does get at an underlying problem with health care: As much as providers love to talk about new payment models, volume is still king — it's simply too lucrative to give up.