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2018年7月9日 星期一

Overnight Health Care: ObamaCare insurers sound alarm after payments suspended | Trump calls out Pfizer on drug prices | Maine House fails to fund Medicaid expansion

 
 
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Welcome to Overnight Health Care, Monday edition. We hope you had a relaxing holiday week while Congress was in recess. The summer's Supreme Court battle will officially begin tonight, with abortion rights and ObamaCare at the center, when President Trump announces his pick to replace Justice Anthony Kennedy in a primetime address. Check out TheHill.com this evening for Trump's decision and the reaction.

Also today: insurers are raising a ruckus over the suspension of ObamaCare's risk adjustment payments, and President Trump took Pfizer to task for a price hike.

 

First up... Suspension of ObamaCare funds sets off a scramble

The health-care world is in a flurry of activity after the Trump administration's abrupt suspension of billions of dollars in payments to ObamaCare insurers.

From insurers, warnings of premium hikes: "This action will significantly increase 2019 premiums for millions of individuals and small business owners and could result in far fewer health plan choices," Scott Serota, the CEO of the Blue Cross Blue Shield Association, said in a statement. "It will undermine Americans' access to affordable coverage, particularly those who need medical care the most."

For Democrats, it's more fodder for their claims that Republicans are sabotaging the law: "Republicans are doing a bang up job ensuring they are properly blamed for health care rate hikes this fall," said Matt House, a spokesman for Senate Democratic Leader Chuck Schumer (N.Y.).

The details: The program is called risk adjustment. No taxpayer money is involved. Instead, money is collected from insurers who have healthier enrollees and given to insurers with sicker enrollees to help them cover those costs.

What to watch: How long will a resolution take? No one seems to know. Insurers are hoping it's fast.  

More on the decision here.

 

Trump hits Pfizer for price hikes.

Drug prices are still going up despite the administration's efforts to stop them, and President Trump took to Twitter on Monday to call out one company in particular.
 


The administration in May introduced a blueprint aimed at reducing drug prices. Trump promised companies would be announcing "massive, voluntary" price drops within two weeks. But that was five weeks ago. It clearly hasn't happened yet.

More on Trump's tweet here.

HHS Secretary Alex Azar has hinted that Trump may use his bully pulpit to call out individual companies, and that seems to be what happened on Monday.
 


Azar also rebuked drug companies for their prices Monday.

Key quote: "Change is coming to prescription drug pricing, whether it's painful or not for pharmaceutical companies," Azar said in a speech Monday at a health policy conference. ""The drug companies that recently increased prices will be remembered for creating a tipping point in U.S. drug pricing policy," he added.

Pfizer's response: "The list price remains unchanged for the majority of our medicines. Our portfolio includes more than 400 medicines and vaccines; we are modifying prices for approximately 10% of these, including some instances where we're decreasing the price. Importantly, list prices do not reflect what most patients or insurance companies pay."

The background: Pfizer, one of the world's largest drugmakers by sales, raised the list prices for more than 100 of its prescription drugs on July 1, according to the Financial Times, marking the second time in a year the company has done so.

Mid-year drug price increases are a common industry practice that has not abated, despite the Trump administration's efforts.

For more on the company's price hikes, click here.

 

Maine House fails to override LePage veto of Medicaid expansion funding.

Lawmakers in Maine's state House failed to override the governor's veto of a bill that would fund the first year of Medicaid expansion.

The lawmakers voted 85-58 to uphold Republican Gov. Paul LePage's veto of the $60 million bill, falling short of the two-thirds majority needed to pass the bill.

LePage, and conservative Republicans who voted against the override, said the expansion should have a long-term funding plan, not a one-time funding source.

Maine voters approved Medicaid expansion at the ballot box last year, but LePage has blocked its implementation.

Read more on Maine here.

 

What we're reading

The Trump administration freeze on Obamacare's risk adjustment payments, explained (Vox.com)

CMS risk-adjustment payment freeze to hit high-cost insurers hardest (Modern Healthcare)

Supreme Court shortlister Kavanaugh's role in ObamaCare's survival fiercely debated by conservatives (Fox News)

 

State by state

Top Louisiana auditor digs into Medicaid spending (Associated Press)

Not everyone agrees abortion is a Connecticut governor's race issue (Associated Press)

 
 
 
 
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