Good morning ... Situational awareness: Two big health care mergers hit potential stumbling blocks yesterday: California's insurance commissioner is formally urging the Justice Department to block the proposed merger between CVS and Aetna, while activist investor Carl Icahn is trying to stop the merger of Anthem and Express Scripts.
Illustration: Lazaro Gamio/Axios
If you thought yesterday’s expansion of “short-term” health plans seemed especially controversial, even within the bounds of a debate we’re all very used to, you were right.
The big picture: These new rules challenge two fundamental parts of the Affordable Care Act: its minimum standards for what insurance has to cover; and its goal of making those guarantees work by pulling in a mix of healthy people.
What they're saying: Democrats accused the Trump administration of “sabotaging” the ACA.
HHS Secretary Alex Azar said he had no desire to undermine the ACA, only to provide an affordable option for healthy people already driven out of the exchanges by rising premiums.
"The Affordable Care Act is sabotaging itself."— HHS Secretary Alex Azar
Either way, you end up at the same place: The Trump administration, unlike its predecessor, is not trying to find or create a better mix of healthy and sick people within the exchanges.
Winners: UnitedHealthcare, which is the biggest provider of short-term plans in the country, and brokers like eHealth, whose stock was up more than 9% yesterday.
Losers: People in the individual market who have pre-existing conditions or who need coverage for services like prescription drugs, but who make too much money to qualify for financial assistance under the ACA.
What’s next: States can still impose additional regulations on short-term plans, and some of them surely will. That could include tighter limits on how long the policies can last, or benefit requirements.
ACA premiums would probably be going down next year if the Trump administration and congressional Republicans had simply left it alone, Brookings' Matt Fiedler says in a new analysis this morning.
Insurers are raking in money this year, largely thanks to the very large premium hikes they enacted. They'll likely see a profit margin north of 10% on their ACA business this year, up from just 1.2% last year and losses in the years before.
Premiums are actually falling in a few markets.
The country's highest-grossing drugs are protected by thickets of patents that will shield them from generic competition for years, sometimes decades, according to a new paper from I-MAK, a nonprofit organization that advocates for changes to the patent system for prescription drugs.
By the numbers: On average, the 12 highest-grossing drugs in the U.S. are protected by 71 patents, blocking competition for 38 years. And they've seen an average price hike of 68% since 2012.
Some caveats: These totals include all of the patents for each drug — not just the ones drugmakers have obtained after their products were already on the market.
Why it matters: Drugmakers' patent practices are facing tougher scrutiny amid the political push for lower drug prices.
Wall Street had a field day with Molina Healthcare’s big earnings surprise, driving the insurer’s stock up 17% yesterday. But the profit bonanza may not be as clean as the investor community thinks, Axios’ Bob Herman reports.
The intrigue: A few one-time moves, particularly to Molina's ACA business, tipped the scales.
Sad news from Reuters: Just days after an Ebola outbreak was declared over in the Democratic Republic of the Congo, there’s a new one. Four people tested positive for the disease, more than 1,500 miles away from the location of the last outbreak.
The details, per Reuters:
Want a silver lining? This is the best we can do: Science magazine notes that the health ministry said the detection of the new outbreak “is an indicator of the proper functioning of the surveillance system.”
Rant: Calling them “short-term limited duration” plans was bad enough. Those terms are synonyms, and there is no need to use both of them. (HHS' justification for this redundancy is Washington word salad of the highest order.)
But also, a thing that lasts three years is not “short-term.” The Korean War lasted three years. It’s been three years (and change) since Donald Trump announced he was running for president. It’s not a short amount of time.
We need a new name for these insurance plans. Send your best suggestions to firstname.lastname@example.org.