Today's Vitals is 923 words, or a <4-minute read. It does not cry like a man.
President Trump and CMS administrator Seema Verma. Photo: Mark Wilson/Getty Images
The Trump administration made a very big decision over the weekend: It won't approve full federal funding for a partial Medicaid expansion.
Why it matters: The partial expansion had looked like a key weapon in red states' continued resistance to the ACA. Without it, Medicaid enrollment likely will keep growing.
Between the lines: Although the reasoning is different, the Trump administration is now adopting the same policy as the Obama administration — a decision many experts believe the law compels.
Details: Utah voters approved the full ACA expansion last year, but the state legislature overruled them to pass a more limited version.
The intrigue: While the Obama administration rejected these requests on the grounds that federal law dictates the terms of a Medicaid expansion, the Trump administration went a different route, per the Washington Post.
The bottom line: Utah has a backup plan in place — the full Medicaid expansion that Utah residents voted for in the first place.
Health care's administrative back end — services like verifying patients' insurance, putting patients on payment plans and collecting patient debt — is bigger than ever, Axios' Bob Herman reports.
The big picture: The U.S.' fractured insurance system leads hospitals and doctors to spend tens of billions of dollars annually on billing software and services — none of which are tied to actual health care.
Driving the news: For-profit hospital system Tenet Healthcare decided to spin off its billing services unit, Conifer, into its own publicly traded entity in 2021.
Between the lines: Many hospital systems that send out bills have ownership stakes in these companies.
Researchers have cited administrative costs as a sizable source of health care waste. Some startups are trying to address this issue, but traditional billing and service firms are only getting larger and have providers as investors.
Photo: Justin Sullivan/Getty Images
After changing course a couple of times on Sen. Bernie Sanders' "Medicare for All" plan, Sen. Kamala Harris is out with a version of her own this morning.
How it works: Harris' proposal differs from Sanders' in a couple of key ways.
My thought bubble: Harris has gone back and forth on the elimination of private insurance, a centerpiece of Sanders' plan. Today's proposal gives her a firm answer to point to.
Illustration: Rebecca Zisser/Axios
A very small group of patients with major illnesses is responsible for an outsized share of health care spending. And in his latest Axios column, Kaiser Family Foundation president Drew Altman breaks down new data showing that prescription drugs are a big part of the reason their bills are so high.
“Persistently high spenders” are people who have accumulated big health care bills for at least 3 consecutive years.
Why it matters: These are exactly the people our insurance system is failing. They have insurance and a major illness, but still struggle with their medical bills as deductibles, and other out-of-pocket costs keep rising faster than wages.
Go deeper: Read the column