November 23, 2023 Rice University's Baker Institute for Public Policy reports that more Texans have health insurance coverage now thanks to the Affordable Care Act. According to the Institute's November 14 issue brief, entitled Looking at the Numbers: 10 Years of Data on the Affordable Care Act Reveal Benefits for Texans:"When the ACA was enacted in 2010, Texas had the highest uninsured rate (23.7%) in the country — 5.6 million people. The Texas Health and Human Services Commission estimated that full implementation of the ACA could cut the uninsured rate in half, with 36% or 2 million people gaining subsidized…
Update: Medicare Drug Price Negotiations Moving Forward
Negotiations between the federal government and the manufacturers of ten prescription drugs over prices for the Medicare program are moving forward. The American Hospital Association reported on Oct. 3, 2023 ("CMS: Makers of selected drugs agree to participate in Medicare price negotiation"):"The companies that make the first 10 Medicare Part D drugs selected to participate in the Medicare Drug Price Negotiation Program have agreed to participate in the program’s price negotiations, the Centers for Medicare & Medicaid Services announced. CMS in August selected 10 high-cost drugs for the first negotiation cycle, which will run until next August for prices effective in…
Medicare and Medicare Advantage
Medicare is a complicated system that mixes public and private insurance providers. As reported by the Scripps News Service on Oct. 21, 2022 ("Why Is Medicare So Complicated?"):"By the government's last count in 2021, 64 million adults were enrolled in Medicare. But that doesn't mean it's simple to navigate. The Medicare maze is growing more entangled over the years, as Congress adds new benefits, exceptions, and penalties."As KFF explains in its Sept. 18, 2023 issue brief, What to Know about the Medicare Open Enrollment Period and Medicare Coverage Options:"People with Medicare may choose to receive their Medicare benefits through traditional…
Medicare Open Enrollment Season Runs October 15 – December 7
Open enrollment season for Medicare is October 15 through December 7. According to the federal Centers for Medicare and Medicaid Services (last accessed Oct. 15, 2023):"Medicare health and drug plans can make changes each year—things like cost, coverage, and what providers and pharmacies are in their networks. October 15 to December 7 is when all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs."As KFF explains in its brief on Medicare open enrollment and plan options including Medicare Advantage plans, What to Know about the Medicare Open…
List of Drugs For Which Medicare Will Negotiate Prices Announced
September 1, 2023 On August 30, 2023, Kaiser Health News reported ("5 Things to Know About the New Drug Pricing Negotiations"):"The Biden administration has picked the first 10 high-priced prescription drugs subject to federal price negotiations, taking a swipe at the powerful pharmaceutical industry. It marks a major turning point in a long-fought battle to control ever-rising drug prices for seniors and, eventually, other Americans."Under the 2022 Inflation Reduction Act, Congress gave the federal government the power to negotiate prices for certain high-cost drugs under Medicare. The list of drugs selected by the Centers for Medicare & Medicaid Services will…
Learning From Others
June 14, 2023 Professor Aaron E. Carroll, MD, MS, is the Chief Health Officer of Indiana University. In a guest essay comparing the US health care system with the systems of five other nations that was published June 13, 2023 in the New York Times ("I Studied Five Countries’ Health Care Systems. We Need to Get More Creative With Ours."), he writes:"America could learn a thing or two from these other countries. We could take inspiration from them and potentially improve access, quality and cost."Though the Canadian system may be more familiar with people in the US due to simple…
Practice Consolidation and Access to Quality Care
May 14, 2023 The New York Times reports on a growing trend among healthcare organizations in the US, the impact of which may be of concern for patients and taxpayers. The Times reported on May 8, 2023 ("Corporate Giants Buy Up Primary Care Practices at Rapid Pace") that:"CVS Health, with its sprawling pharmacy business and ownership of the major insurer Aetna, paid roughly $11 billion to buy Oak Street Health, a fast-growing chain of primary care centers that employs doctors in 21 states. And Amazon’s bold purchase of One Medical, another large doctors’ group, for nearly $4 billion, is another…
Medicaid Re-Enrollment Begins Again
US states are restarting yearly Medicaid and Children’s Health Insurance Program (CHIP) eligibility reviews. The Kaiser Family Foundation reported on February 22, 2023 ("10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision"): "Primarily due to the continuous enrollment provision, Medicaid enrollment has grown substantially compared to before the pandemic and the uninsured rate has dropped. But, when the continuous enrollment provision ends, millions of people could lose coverage that could reverse recent gains in coverage. As part of the Consolidated Appropriations Act, 2023, signed into law on December 29, 2022, Congress set an end of March 31, 2023 for the…
The Existential Threat of Greed in US Health Care
February 7, 2023 The journal JAMA published a Viewpoint on Jan. 30, 2023 by Donald Berwick, MD, MPP, entitled Salve Lucrum: The Existential Threat of Greed in US Health Care.In it, Dr. Berwick contends:"Profit may have its place in motivating innovation and higher quality in health care, as in any industry. But kleptocapitalist behaviors that raise prices, salaries, market power, and government payment to extreme levels hurt patients and families, vulnerable institutions, governmental programs, small and large businesses, and workforce morale. Those behaviors, mostly legal but nonetheless wrong, have now accumulated to a level that poses an existential threat to…
Oregon Becomes First US State To Guarantee Its Residents Access To Affordable Healthcare
January 20, 2023 In the November 2022 general election, Oregon voters narrowly approved Oregon Measure 111, the Right to Healthcare Amendment. The measure amended the state constitution, adding a guarantee of access to affordable healthcare for all Oregon residents. According to Ballotpedia, last accessed Jan. 20, 2023:"Ballot title"The ballot title was as follows:[7]"Amends Constitution: State must ensure affordable healthcare access, balanced against requirement to fund schools, other essential services"Result of 'Yes' Vote: 'Yes' vote requires state to ensure affordable healthcare access. State must balance healthcare funding against funding for schools, other essential services; courts must respect balance."Result of 'No' Vote:…
