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Media Attacking Trump Healthcare Picks As Contrarians

The mainstream media are busy attacking Donald Trump’s healthcare picks as public health and healthcare contrarians. They worry the administration could aim to set vaccine policy that is outside of the so-called mainstream.

So far, Trump has named the following to lead key agencies:

• Robert F. Kennedy Jr. to lead the Department of Health and Human Services
• Mehmet Oz to lead the Centers for Medicare and Medicaid Services
• Dr. Mary Makary to lead the Food and Drug Administration
• Dr. Dave Weldon to lead the Centers for Disease Control and Prevention
• Janette Nesheiwat to be Surgeon General

The media are less concerned about Oz and Makary and most concerned with Kennedy and Weldon. Some of the criticism is unfair, especially toward Makary. During the COVID years, Makary stood out as a man of science and great educator, calling out the need for COVID vaccines for those most vulnerable to the virus but reasonably pushing back on COVID vaccine hysteria and other excesses.

Additional article: https://www.managedhealthcareexecutive.com/view/trump-names-picks-for-top-jobs-at-fda-and-cdc-and-also-surgeon-general

 (Article may require a subscription.)

#healthcare #trump #election2024 #hhs #cms #fda

https://www.modernhealthcare.com/politics-policy/donald-trump-health-nominees-vaccines-fda-marty-makary-cdc-dave-weldon

CMS Loses Again In Court On Stars

A just released court decision gives the Centers for Medicare and Medicaid Services (CMS) yet another defeat on how the agency runs the Stars program.

Judge Jeremy Kernodle, of the U.S. District Court for the Eastern District of Texas, ruled CMS violated the Administrative Procedures Act of 1946 by improperly reviewing UnitedHealth Group’s health plan call center ratings.

The judge was rather biting in his assessment. He said that CMS creates the guidelines, identifies the phases, and specifies the criteria for the call center metrics. He concluded that the responsibility for any unreasonable or absurd outcomes therefore lies with the agency not plaintiffs. Other lawsuits have been filed by Humana, Centene and Elevance Health.

This could likely lead to recalculations for many plans, although it will not rise to the mass recalculation we saw in 2024.

CMS says it is looking to deprioritize the measures anyway. The lawsuit likely expedites such a sunset.

#cms #stars #medicareadvantage

https://www.fiercehealthcare.com/payers/trump-could-boost-medicare-advantage-cracks-suggest-reform-may-be-coming

Commonwealth Study Covers The Underinsured

A very important study from The Commonwealth Fund found that close to a quarter of people who have health coverage are underinsured. This is consistent with other findings that put the number of uninsured and underinsured at about 85 million Americans. In essence, the underinsured are Americans that have coverage but, in many ways, have a hard time accessing the benefits due to high out-of-pocket costs. In my book, The Healthcare Labyrinth (available at this site), I discuss that affordable universal access is needed to address both the uninsured and underinsured crisis.

The Commonwealth Fund polled a national sample of adults aged 18 to 64 and found that 23% are underinsured. Most (about 66%) are in employer-sponsored health plans. About 14% were in individual or Exchange plans and 11% were in Medicaid. About 57% who were underinsured said they skipped care because of the cost. About 44% said they have medical debt.

With regard to Exchange coverage, if premium subsidy enhancements are not renewed as of 2026 annual premium costs for consumers will increase by an average of $705 a year and an estimated 4 million people could lose their coverage. A Kaiser Family Foundation (KFF) study confirms the premium change.

The Commonwealth study recommends a series of policies that could address healthcare affordability, including:

• Fully expand Medicaid. There are 10 states that have yet to expand. In the interim, allow citizens access to the Exchanges.
• Make the enhanced premium tax credits for the Exchanges permanent.
• Bar medical debt from credit reports and reform hospital billing.
• Lower deductibles and out-of-pocket expenses for Exchange plans.
• Further expand continuous Medicaid coverage for 12 months.

Additional articles: https://www.modernhealthcare.com/insurance/aca-subsidies-extension-commonwealth-fund and https://www.kff.org/interactive/how-much-more-would-people-pay-in-premiums-if-the-acas-enhanced-subsidies-expired/

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#uninsured #underinsured #coverage #healthcare #healthinsurance #exchanges #aca #obamacare #employercoverage

https://www.fiercehealthcare.com/regulatory/commonwealth-fund-many-enrolled-employer-plans-are-underinsured

More on Mehmet Oz’s Healthcare Positions

President-elect Donald Trump’s nominee for the Centers for Medicare and Medicaid Services administrator, Mehmet Oz, has raised concerns with high insulin prices and the role of pharmacy benefit managers (PBMs). At the same time, he has not taken a position on Medicare drug price negotiations. He favors permanent telehealth expansions and has invested in numerous digital health companies over the years. This means he may support artificial intelligence, remote monitoring, wearables, and digital therapeutics.

Oz has long been a supporter of Medicare Advantage (MA) and even pushed for the concept of Medicare Advantage for All, which would have eliminated employer coverage and put everyone in private plans outside of Medicaid.

Additional articles: https://insidehealthpolicy.com/daily-news/oz-raised-concerns-pbms-insulin-costs-his-ira-views-unclear and https://insidehealthpolicy.com/daily-news/oz-would-bring-support-permanent-telehealth-ai-wearables-dtx-cms and https://thehill.com/policy/healthcare/5000821-trump-oz-cms-medicare-medicaid/

(Some articles may require a subscription.)

#oz #cms #trump #medicareadvantage

https://www.beckerspayer.com/payer/dr-oz-on-medicare-advantage-5-things-to-know.html