Good morning ... There's a lot to break down in the Senate's new budget deal, so let's get right to it.
Everybody wants to control health care costs — until it’s time to actually control health care costs.
Driving the news: The bipartisan budget deal unveiled yesterday in the Senate would repeal the Affordable Care Act’s Independent Payment Advisory Board. It’s merely the most recent time Congress has voted, with bipartisan support, to chip away at efforts to slow the growth in health care spending, or at least to help balance the federal checkbook.
Ask not for whom the cost curve bends:
It’s not just the IPAB. The budget deal would "slow down federal efforts to hold providers accountable for reducing Medicare costs," Modern Healthcare reports.
The bottom line: One person’s cost control is another person’s pay cut — and that fact will always complicate the execution of these ostensibly shared goals.
The budget deal would provide billions of dollars in new health care spending, including:
The proposal also would beef up the discounts pharmaceutical companies are required to provide to seniors in Medicare's "donut hole" — a coverage gap in its drug benefit that the ACA attempted to close. The budget deal would accelerate that process.
Consumers could soon face surprising increases in how much they have to pay for their prescription drugs, thanks to changes in the way health insurers and pharmacy benefit managers process coupons from drug manufacturers.
The details, per my colleague Bob Herman:
Go deeper: Read Bob's full story on axios.com.
Total enrollment in the ACA’s insurance exchanges ended up at roughly 11.8 million — a 3.7% drop from the year before, according to math from the National Association of State Health Policy.
Why it matters: Enrollment is supposed to go up every year, not down, but this is a much smaller drop than almost anyone anticipated based on the changes the Trump administration made to the signup process.
The new Amazon-Berkshire Hathaway-JPMorgan Chase health care venture may lower the companies’ health care costs, but that doesn’t mean it can do the same for anyone else, the Kaiser Family Foundation’s Drew Altman writes in today’s column.
The bottom line: “They could be successful and still have almost no impact on national health spending, federal spending, or consumer out of pocket costs,” Altman writes.
What we're watching this week: Negotiations over the spending deal — and separate talks about how best to stabilize the ACA.
What's on your mind grapes? Let me know: firstname.lastname@example.org.