February 8, 2019
Issue 28
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Preview of the Coming Medicare For All Debate
By Grace-Marie Turner
Forbes, Feb. 7, 2019
The pre-existing condition scare tactics continue. Grace-Marie testified Wednesday before a House Education and Labor Committee hearing on “Examining Threats to Workers with Preexisting Conditions.” She continually stressed the guarantees that already exist to protect people with pre-existing conditions, and members on the Republican side underscored their commitment to making sure these protections remain. The hearing was a preview of the coming debate over Medicare for All, including unfounded scare tactics and the belief by many members that neither the private sector nor the states can be trusted to provide protections.
Medicare-For-All Means Long Waits for Poor Care, and Americans Won’t Go for It Once They Learn These Facts
By Sally Pipes
Fox News, Feb. 3, 2019
Medicare for All proposes reimbursing doctors and hospitals at Medicare's current rates, which are 40% below what private insurance pays. Health care providers are unlikely to just absorb those cuts. Those with narrow margins may be forced to close, unable to cover their costs. Some doctors may respond to lower payments by seeing fewer patients, retiring early, or leaving the practice of medicine altogether. Bright young people may decide not to pursue careers in medicine, given that Medicare for All will limit their earning power. Regardless, ratcheting down the price of care by force is going to cause health care providers to supply less of it. And that will lead to longer waits for patients.
Top Pelosi Aide Privately Tells Insurance Executives Not to Worry About Democrats Pushing Medicare for All
By Ryan Grim
The Intercept, Feb. 5, 2019
After Democrats won control of the House of Representatives in November, the top health policy aide to then-prospective House Speaker Nancy Pelosi met with insurance company executives and assured them that party leadership had strong reservations about single-payer health care and was more focused on lowering drug prices, according to sources familiar with the meeting. Pelosi adviser Wendell Primus detailed five objections to Medicare for All—which is strongly supported by most of the party’s prospective presidential candidates— and said that Democrats would be allies to the insurance industry in the fight against single-payer health care.
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Trump Administration Initiatives
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Trump Places Health Care at Center Stage in State of Union Address
By Paige Winfield Cunningham
The Washington Post, Feb. 6, 2019
President Trump sought to place the health care of Americans on center stage during his State of the Union address this week. The president applauded the rollback of a key portion of the ACA, which he has called a disaster. He also called for protecting people with preexisting conditions. He pledged to bring down the price of prescription drugs and called for childhood cancer funding, earning some applause from Democrats, and called for halting the spread of HIV transmission before 2030.
Deregulating Health Insurance Markets: Value to Market Participants
Council of Economic Advisers, February 2019
The White House this morning released a report showing that the economic benefits of recent administration and congressional actions on health coverage will total $450 billion over ten years. The report analyzes the economic effects of the administration's rules on association health plans, short term limited duration plans, and repeal of the mandate. This is the first comprehensive analysis of these important regulatory changes. It finds that, contrary to those who argue that these actions would harm consumers, Americans will benefit significantly from these consumer-friendly policies.
How Team Trump Is Bringing Drug Prices Down
By HHS Secretary Alex Azar
New York Post, Feb. 7, 2019
Each year, more than $150 billion in rebates are passed around the drug-pricing system—and patients are entirely in the dark about it. In 2017, there were more than $29 billion in rebates in the Medicare Part D program alone, which pays for medication for elderly Americans. Under the president’s proposal, kickbacks in Medicare Part D would be eliminated and replaced with direct discounts that are passed on to seniors at the pharmacy counter.
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New Research Suggests
Preventive Care May Lower Costs
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Explaining the Slowdown in Medical Spending Growth Among the Elderly, 1999–2012
By Cutler, Ghosh, et al.
Health Affairs, Feb. 2019
This paper examines trends in per capita spending for Medicare beneficiaries ages 65 and older in the period 1999–2012 to determine why spending growth has been declining since around 2005. It shows that half of the spending slowdown was attributable to slower growth in spending for cardiovascular diseases. Spending growth also slowed for dementia, renal and genitourinary diseases, and aftercare for people with acute illnesses. Roughly half of the reduction in major cardiovascular events was attributable to medications controlling cardiovascular risk factors.
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Utah Senate OKs Replacement for Medicaid Expansion
By Lisa Riley Roche
Deseret News, Feb. 4, 2019
The Utah Senate gave final approval Monday to a replacement plan for a voter-initiative passed in November calling for full Medicaid expansion. A fiscal note in the bill spells out the cost to taxpayers. The legislature is concerned about the cost of full expansion, and the bill now includes a provision that would wipe out Medicaid expansion if the federal government doesn't come through with needed waiver approvals. The bill passed the Senate 22-7, with all six Democrats and Republican Sen. Todd Weiler voting in opposition.
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Did This Health Care Policy Do Harm?
By Wadhera, Maddox, and Yeh
The New York Times, Dec. 21, 2018
In 2010, CMS established the Hospital Readmissions Reduction Program under the ACA. Two years later, the government began fining hospitals with high rates of readmission within 30 days of a hospitalization for pneumonia, heart attack, or heart failure. But a study finds the program may have led to more patient deaths. “Why are policies that profoundly influence patient care not rigorously studied before widespread rollout?” the researchers ask. “[W]e remain uncertain about whether it has had unintentionally deadly consequences. That should be a bracing reminder that before we are seduced by promising but untried ideas, we need to first demand robust evidence that they will not harm patients.”
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