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Premiums for health insurance sold through the Affordable Care Act simply aren't rising next year by quite the dramatic margins many experts had anticipated.
Why it matters: These numbers are a sign that insurers basically accounted for a lot of their political problems — especially the nullification of the ACA's individual mandate — when they set their rates for this year.
The big question: Democrats are trying to make the 2018 elections all about health care. Does that strategy get harder, and should Republicans breathe easier, if premium spikes before the midterms aren't that bad?
What they're saying: Probably not. Both a Republican lobbyist and a Democratic operative told me they think health care prices — including drug prices — are a bigger issue than premiums for voters this year.
Ohio Attorney General Mike DeWine says he's hiring lawyers in preparation to sue the pharmacy benefit managers that help administer the state's Medicaid program, saying they profited excessively from those contracts.
“It is clear that the conduct by PBMs in these areas remains a major concern, and we anticipate that our investigation will result in major litigation against PBMs," DeWine said yesterday, according to the Columbus Dispatch.
By the numbers: The PBMs that handle Ohio's Medicaid managed care plans — CVS Caremark and OptumRx — billed the state for roughly $224 million more than what they paid out to pharmacies, according to the Dispatch.
A new HHS analysis finds that Medicare’s prescription drug program could have saved almost $3 billion in 2016 if pharmacies dispensed generic drugs instead of their more expensive brand-name counterparts, Axios’ Bob Herman reports.
It’s a worthwhile report to scan. There’s almost no reason, for example, Medicare should have paid more than $1 billion in 2016 for Nexium when the cheaper generic, esomeprazole, is readily available.
Doctors probably do practice "defensive medicine" — for example, ordering tests they don't think are necessary just to avoid a malpractice suit down the road — according to a new paper from Duke University law professor Michael Frakes and MIT's Jonathan Gruber.
The intrigue: Defensive medicine has been hard to quantify in the past because everyone in the health care system can sue for malpractice — so there was no good control group to measure against.
The big picture: Frakes and Gruber compared the services performed in the commercial health care market to the military health care system, where malpractice suits aren't allowed.
If a Justice Kavanaugh did ultimately lead the Supreme Court to overturn Roe v. Wade, abortion access would be governed by a patchwork of state laws. Axios' Kerrie Vila breaks down the lay of the land:
Fears of an HIV resurgence are dominating an international AIDS conference that kicked off yesterday in Amsterdam. The rate of new HIV infections is falling worldwide, but is nevertheless rising in 50 countries “as global attention has waned and funding leveled off,” AFP reports.
The details, via AFP:
What we're watching today: The House is scheduled to vote to repeal the ACA's medical device tax. Ways and Means subcommittee hearing on the implementation of a bill designed to combat the opioid crisis (10am; details).
What we're watching this week: More health care votes in the House.
The Senate health committee considers four health care bills on Wednesday.
Energy and Commerce health subcommittee hearing Wednesday on implementation of the 21st Century Cures Act. The same Energy and Commerce subcommittee also holds a hearing Thursday on Medicare's payment systems.
What's on your radar? Let me know: firstname.lastname@example.org.