While we have already covered the proposed 2025 Exchange rule, this article from Kaiser Health News discusses the rule as well as some of the history of the Affordable Care Act under Trump and later Biden.
#aca #obamacare #exchanges #medicaid
The Kaiser Family Foundation (KFF) poll says that the ACA and generally healthcare are fading as issues in the 2024 campaign. The poll was done before Donald Trump’s remarks on the Affordable Care Act (ACA).
But let me take a slightly contrarian view here. As the poll notes, about half of the 1,401 people surveyed said the future of the ACA is a key topic. About 70% of Democrats thought so and 32% of Republicans thought so. To me, in a close election, 32% of Republicans thinking the ACA is significant is, well, significant. In a close election, how do you win if one-third of Republicans and a greater percentage of independents care about an issue?
#aca #obamacare #exchanges #medicaid #healthcare #healthinsurance #healthcarereform
An article in The Economist discusses the United Kingdom’s new drug pricing deal. As we know, all other developed nations negotiate and set prices globally, as Great Britain does. The Inflation Reduction Act’s Medicare drug price negotiation will slowly bring some of what other developed nations have. In fact, we have some in force now.
Key points from the article:
Still, the U.K. says it is getting hurt by high-cost cancer and other drugs.
The U.K. and other systems work and should be fully in place in America.
(Article may require a subscription.)
#drugpricing #medicare #partd #uk #nhs
While federal and state regulators will look closely and potentially oppose a combination, experts seem to think that the Cigna-Humana merger could eventually go through. As I have indicated as well, the company profiles are quite different than earlier deals that fell through.
#cigna #humana #mergers #acquisitions
Similar to others, Walgreen’s has launched a drug price transparency and saver tool for its customers. No monthly fee applies.
#drugpricing #walgreens
Stunning news on the health plan front with speculation that Cigna and Humana are entertaining a merger. This explains reports not too long ago that Cigna was thinking about giving up its Medicare Advantage (MA) line of business. The merger seems like a match made in heaven. Cigna is a commercial powerhouse, but its MA line is much smaller than Humana’s. Its MA line is struggling from a Star perspective. It sold its only Medicaid assets a few years ago. Humana is second only to United in MA and has a growing Medicaid line. Both plans have some provider assets as well. And Express Scripts, Cigna’s PBM and one of the nation’s big three, would be a huge asset for Humana. Humana has a subscale PBM asset.
Earlier mega mergers (Aetna-Humana and Cigna-Anthem) fell apart due to federal and state pushback and footprint overlaps. Cigna would have to sell its MA line in some states, but otherwise this merger is much cleaner than the earlier ones. The feds may still attempt to stop it given the political climate on Capitol Hill.
One story at the Article link and two more here. (Some may require a subscription.):
https://www.fiercehealthcare.com/payers/wsj-cigna-humana-exploring-insurance-mega-merger
https://www.modernhealthcare.com/insurance/cigna-medicare-advantage-sale-humana
#medicare advantage #commercial #medicaid #managedcare #mergers #healthplans
Interesting article on policy brief from the Commonwealth Fund on various innovations occurring in the state-based and federal Exchange programs. As of 2023, 20 states operate a state-based marketplace and 30 rely on Healthcare.gov for sign-ups. Some state-based exchanges use the federal website for enrollment.
States are experimenting with enrollment campaigns, simplified enrollment, auto-enrollment programs, health-equity requirements, and more.
Article at link. The actual study is here: https://www.commonwealthfund.org/publications/issue-briefs/2023/nov/policy-innovations-affordable-care-act-marketplaces
#aca #obamacare #exchanges #commonwealthfund
Pro Publica article recounts where health plans have not covered mandated services in state laws. It is easy to sensationalize mistakes, but health plans every day are approving treatments timely. (May require subscription.)
#plandenials #healthplans
The Healthcare Labyrinth Newsfeed will be off on November 23 and 24 for the Thanksgiving holiday. We will be back on November 27. Happy Thanksgiving to all! Stay safe!
— Marc S. Ryan
The new CMS 2024 Medicare Advantage (MA) rule prohibiting the use of most evidence-based criteria by MA plans is already being debated. Hospital lobbies are saying plans are out of compliance and January 1 has not even hit yet. Read my new companion blog at the blog tab on this site. I tell you why this rule is a terrible idea. Additional article here: https://www.modernhealthcare.com/politics-policy/health-plans-2024-medicare-advantage-rule-aha-cms-unitedhealthcare
#hospitals #medicareadvantage #medicare #ncd #lcd #priorauthorization
