Health Care Policy

Health Affairs is a peer-reviewed healthcare journal established in 1981 by John K. Iglehart; since 2014, the editor-in-chief is Alan Weil. It was described by The Washington Post as "the bible of health policy".
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  • Reid to host Medicare for All program Saturday
    The Pueblo Chieftain

    Reid to host Medicare for All program Saturday

    Former Washington Post reporter T.R. Reid will moderate a free program about single-payer health care systems starting at 10 a.m. Saturday in the Ryals Room at the Robert Hoag Rawlings Public Library. During his newspaper career, Reid traveled the world reporting on health care systems in various countries for the Post. He is also the author of "The Healing of America." Reid has written 10 books, also three in Japanese. The PBS "Frontline" program made two documentaries about Reid's investigation into national health systems around the world. Saturday's program will explore how a Medicare for all health care system in the U.S. would work. Reid is currently chairman of the Colorado Coalition for

  • The Economic Times

    Kansas to let Farm Bureau health coverage avoid ACA rules

    TOPEKA, Kan. (AP) — Kansas will allow its state Farm Bureau to offer health care coverage that doesn't satisfy the Affordable Care Act after Democratic Gov. Laura Kelly on Friday declined to block a Republican-backed effort to circumvent former President Barack Obama's signature health care law. Kelly allowed an insurance bill to become law without her signature, and it includes provisions that will exempt the bureau from state insurance regulations in the health care coverage it offers to its members. Kelly, in a statement, said that while she has "serious reservations" about the measure, she will allow it to become law "as a demonstration of my genuine commitment to compromise." Kansas Senate

  • Long-Term Care and Retirement Home Workers Launch Campaign with Direct Message: Tell Them to Care
    www.newswire.ca

    Long-Term Care and Retirement Home Workers Launch Campaign with Direct Message: Tell Them to Care

    RICHMOND HILL, ON, April 19, 2019 /CNW/ - SEIU Healthcare, a union that represents over 60,000 frontline healthcare workers in Ontario, has launched a public advocacy campaign calling on Ontario's major long-term care and retirement home corporations to invest more profits in care. The campaign titled "Tell Them To Care," is appealing to families in Ontario to join with the frontline workers who are calling on large for-profit healthcare corporations including Chartwell, Extendicare, Sienna and Revera to fix the systemic problems that arise as a result of chronic understaffing. The first television advertisement is set to air Friday, April 19, 2019 during the Toronto Maple Leafs playoff hockey

  • Not So Fast on Ending Rebates for Prescription Drugs
    www.realclearhealth.com

    Not So Fast on Ending Rebates for Prescription Drugs

    Give President Trump credit for acting on his promise to bring down prices for prescription drugs. But one policy idea his administration has proposed needs a second look. The Department of Health and Human Services has proposed a rule that would end rebates that drug companies pay to Part D and Medicaid-managed organizations for the prescription drug equivalent of preferential shelf placement and instead require savings from any such rebates be passed along to consumers. It's as if Congress passed a law that required baseball teams to stop selling beer but allow beer companies to sell their beer directly to customers at the stadium. If there are enough beers at the stadium for competition, prices

  • Commerce department expected to slash march-in rights for drugs
    POLITICO

    Commerce department expected to slash march-in rights for drugs

    With help from Allie Bice — March-in rights aren't a drug price control tool, a final Department of Commerce Report is expected to declare this week. Many patient advocacy groups aren't happy. Story Continued Below — CMS takes aim at copay coupons in final Obamacare rule. The changes should discourage use of manufacturer coupons. — Judge rejects Justice Department attempt to dismiss lawsuit charging drug company use of nurse educators. It's one of several similar suits that DOJ wants to shoo away. Happy Friday and welcome back to Prescription PULSE where we were intrigued to learn that Columbia University researcher have already created embryos with genetic material from three people, even though

  • Health Insurers' Stocks Have Been Battered. Now They Look Like A Buy.
    www.barrons.com

    Health Insurers' Stocks Have Been Battered. Now They Look Like A Buy.

    Investing in health insurers today amounts to a bet against the Medicare for All proposal championed by Sen. Bernie Sanders and other Democrats running for president, which could eliminate a role for private insurers in the medical-care system. Newsletter Sign-up Yes, the stocks have been battered. But given the long odds of an industry-killing plan becoming law, shares of the leading insurers— UnitedHealth Group (ticker: UNH), Anthem (ANTM), Cigna (CI), Humana (HUM), and CVS Health (CVS)—look appealing. The stocks trade for an average of just 12 times projected 2019 earnings. And UnitedHealth, Anthem, and Humana already are generating double-digit growth in earnings per share. “Anyone who has

  • Wall Street, K Street step up criticism of 'Medicare for All'
    POLITICO

    Wall Street, K Street step up criticism of 'Medicare for All'

    Editor's Note: This edition of Pulse is published weekdays at 10 a.m. POLITICO Pro Health Care subscribers hold exclusive early access to the newsletter each morning at 6 a.m. To learn more about POLITICO Pro's comprehensive policy intelligence coverage, policy tools and services, click here. — Wall Street firms are trying to calm investors' fears after a new 'Medicare for All' proposal helped strip tens of billions of dollars of value from private health insurers' stock prices. — CMS issued a final rule for the Obamacare marketplace that trims subsidies for some customers and reduces the use of drug industry coupons. — CBO unveiled more details about its new health insurance model, which is poised to play a key role in how Congress' next health legislative proposals are received.

  • CBO: over 1 million Americans have become uninsured since 2016
    Vox

    CBO: over 1 million Americans have become uninsured since 2016

    More than 1 million Americans have lost health coverage since 2016, a new report from the Congressional Budget Office finds. The report — which came out within hours of the Mueller report on Thursday and so didn't get much attention — follows other studies, all suggesting that America's uninsured rate is rising under President Trump, whose administration has passed new rules that make it more difficult to enroll in coverage. The CBO estimates that the number of Americans without insurance has risen from 27.5 million in 2016 to 28.9 million in 2018, an increase of 1.4 million Americans going uninsured. Much of that increase is concentrated in the Medicaid program, where the Trump administration has approved new rules like work requirements that can make it more difficult for low-income Americans to enroll in the program.

  • Study Reveals Staff Physicians Prescribe Fewer Medications for Long-term Care Facility Residents
    seattlepi.com

    Study Reveals Staff Physicians Prescribe Fewer Medications for Long-term Care Facility Residents

    New research indicates significant increases in the number of prescriptions prescribed by outside physicians when compared to staff physicians. The findings are published in Senior Care Pharmacist. This is according to a study of U.S. men and women led by the staff at the Los Angeles Jewish Home (LAJH) under the auspices of the Brandman Research Institute (BRI). Residents in long-term-care nursing facilities were prescribed fewer medications when treated by staff physicians than those treated by outside physicians. This is according to a study of U.S. men and women led by the staff at the Los Angeles Jewish Home (LAJH) under the auspices of the Brandman Research Institute (BRI). The quality assurance

  • Legislature considers bill that gives a reason to smile
    David Farmer

    Legislature considers bill that gives a reason to smile

    For some people, it's the menacing whir of a drill, maybe coming from the other room. For others, it's anxiety about not taking care of themselves before the visit or fear of a painful experience. For about 12 percent of the population, going to the dentist causes severe anxiety, so much so that they will put off a visit until they have a serious problem. At least one dental website suggests maybe thinking about a joke and sharing it with the dentist when you sit down in the chair might help. Let's see: What are the seven scariest words in the English language? The dentist is ready to see you. But for thousands of Maine people, it's not fear that keeps them away from the dentist or getting the

  • Washington set to be 1st state with long-term care benefit
    The MetroWest Daily News

    Washington set to be 1st state with long-term care benefit

    OLYMPIA, Wash. (AP) " Washington is poised to become the first state to establish an employee-paid program creating an insurance benefit to help offset the costs of long-term care, a step advocates say will help an aging population that is likely not prepared for the increasing costs needed for daily assistance. The measure creates a benefit for those who pay into the program, with a lifetime maximum of $36,500 per person, indexed to inflation, paid for by an employee payroll premium. It has cleared both the House and the Senate, but because the Senate made several changes before passing it earlier this week, the measure now heads back to the House for a final vote. According to AARP of Washington, 70% of residents 65 and older will require some type of assistance to live independently.

  • Fox Never Expected This — The Medicare for All Moment
    Medium

    Fox Never Expected This — The Medicare for All Moment

    It was an unexpected teaching moment for Fox News — a lesson that all the fear-mongering outlined in your playbook doesn't carry you very far when you confront a mass movement for transformative change that will dramatically improve people's lives. In a town hall April 15 with Sen. Bernie Sanders, Fox host Bret Baier threw out an anticipated gotcha question for the audience that Fox likely presumed were Fox viewers.    How many people “get their insurance from work, private insurance?” he asked. Most hands went up. How many, Baier then asked, “are willing to transition to what the Senator says a government-run system?”    To no doubt his shock, nearly all the hands stayed up, accompanied by wild

  • Miami Herald

    Lethal plans: When seniors turn to suicide in long-term care

    Lethal plans: When seniors turn to suicide in long-term care When Larry Anders moved into the Bay at Burlington nursing home in late 2017, he wasn't supposed to be there long. At 77, the stoic Wisconsin machinist had just endured the death of his wife of 51 years and a grim new diagnosis: throat cancer, stage 4. His son and daughter expected him to stay two weeks, tops, before going home to begin chemotherapy. From the start, they were alarmed by the lack of care at the center, where, they said, staff seemed indifferent, if not incompetent – failing to check on him promptly, handing pills to a man who couldn't swallow. Anders never mentioned suicide to his children, who camped out day and night

  • EurekAlert!

    Commentary: Modifications to Medicare rules could support care innovation for dialysis

    Considering QOL for end-stage kidney disease patients Emory Health Sciences ATLANTA --In a commentary published in the American Journal of Kidney Diseases, public health researchers suggest adjustments to recently proposed rule changes on how Medicare pays for dialysis services. Medicare spends approximately $35 billion annually on care for beneficiaries with end-stage renal disease (kidney failure), more than 7 percent of Medicare's total paid claims. Over half a million people receive regular dialysis treatments to manage this condition, with treatment costs averaging about $85,000 a year, according to the study. "A year ago, rule changes were proposed that would limit how many dialysis treatments

  • Eighth Circuit Rules Against Third Party Administrator in Cross-Plan Offsetting in Group Health Plans
    The National Law Review

    Eighth Circuit Rules Against Third Party Administrator in Cross-Plan Offsetting in Group Health Plans

     On January 15, 2019, the federal Eighth Circuit Court of Appeals issued its decision in Peterson v. UnitedHealth Group, Inc., 913 F.3d, 769 (8th Cir. 2019), in which the Court upheld the federal district court's holding that UnitedHealth Group, Inc. (“United”) was not authorized to reduce (or “offset”) payments to medical providers under ERISA group health plans for which United was the third-party administrator (or “TPA”) by the amounts United determined had been previously overpaid to the same providers under completely different  group health plans also administered by United.  This practice is known as “cross-plan offsetting.”  It arose in the last 20 years as a unilateral, informal overpayment