Good News, Bad News On Drug Tariffs
President Trump said Tuesday that he could levy up to 200 percent tariffs on pharmaceutical products imported into the U.S. soon. “If they have to bring the pharmaceuticals into the country, the drugs and other things into the country, they’re going to be tariffed at a very, very high rate, like 200 percent,” Trump said during a Cabinet meeting. That is the bad news.
In good news, Trump said any tariffs would not take effect immediately. “We’re going to give people about a year, year and a half, to come in, and after that, they’re going to be tariffed,” Trump said.
America imports the majority of its generic drugs from abroad and Trump wants this production onshored for national security reasons. Many brand drugs are also imported. Levies on drugs would increase already steep spending trends in healthcare.
#tariffs #drugpricing
https://thehill.com/homenews/administration/5390505-trump-200-percent-tariffs-pharma-imports
Employer Coverage Changes Not In Final Bill
While some Health Savings Account (HSA) and other changes impacting commercial and employer coverage were in the final reconciliation bill, several employer individual coverage or ICHRA provisions were not. These include the rebranding of ICHRA to CHOICE Arrangements and a national employer tax credit to offer such individual coverage subsidies.
ICHRA arrangements for employer coverage are exploding, especially at the smaller employers. The tax credit provision would have further helped. As it is, the sunset of the enhanced premium subsidies is slated to reduce enrollment, send some plans to reduce their footprints or exit the Exchanges, and increase risk. This will make ICHRA less attractive.
As well, states are bracing for major changes from the budget bill and a separate rule regarding Exchange enrollment. There will be shorter enrollment periods, more eligibility checks, and a ban on automatic reenrollment. The last item has helped drive growth in the program, but the GOP believes it also means improper enrollment. Reenrollment is popular in states with their own Exchanges.
All told, the changes and expiration of the enhanced premium subsidies could reduce enrollment from 24 million nationally to 16 million – or about one third.
In other news, Democrats are ramping up their election efforts against the budget bill. On Monday, the House Democrats’ campaign launched its first national digital ad campaign of the year targeting 35 battleground Republicans who voted for Trump’s bill. The ads call out Medicaid cuts. An outside group launched similar ads.
Many reductions are not slated to take effective until after the election, which could complicate Democrats’ efforts to brand the GOP anti-working class.
Additional articles: https://www.beckerspayer.com/policy-updates/the-one-big-beautiful-bill-and-employee-benefits-6-notes/ and https://thehill.com/homenews/house/5390753-democrats-trump-big-beautiful-bill/
#aca #obamacare #exchanges #ichra
Alignment Wins Part Of Star Lawsuit
A federal court gave Alignment Healthcare a partial victory in its Star rating lawsuit against the Centers for Medicare and Medicaid Services (CMS). Alignment will now have its Arizona HMO Star rating raised from 3.5 to 4 stars getting all its members in 4 Star or greater plans.
The insurer argued that CMS’ methodology, particularly its use of the Tukey Outlier Rule, was flawed and led to arbitrary results. It also said CMS uses low-reliability survey data and questioned the handling of Spanish-language surveys. The court rejected most claims except that it agreed with Alignment that CMS wrongly included two appeals in Star ratings’ calculations.
Other insurers also sued. Florida Blue lost its challenge, while UnitedHealthcare and Centene won their challenges. Blue Cross and Blue Shield of Minnesota dropped its case. Humana said it expect to lose its pending case. Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Massachusetts and Elevance Health have cases pending.
Additional article: https://www.beckerspayer.com/legal/alignment-healthcare-wins-star-ratings-lawsuit-against-cms/
(Some articles may require a subscription.)
#cms #medicareadvantage #star #quality
https://www.modernhealthcare.com/insurance/mh-alignment-health-medicare-star-ratings-recalculated
HCSC To Rebrand Cigna Medicare Products
Health Care Service Corporation (HCSC) will rebrand the Medicare Advantage (MA) products it acquired from Cigna. It will use the name HealthSpring. That company was acquired by Cigna in 2012.
Additional article: https://www.beckerspayer.com/m-and-a/health-care-service-corp-launches-medicare-brand/
(Some articles may require a subscription.)
#medicareadvantage #hcsc #cigna
https://www.modernhealthcare.com/insurance/mh-hcsc-medicare-healthsprings-cigna
Exchange Risk Adjustment Winners and Losers
Health insurance companies will shuttle $10.4 billion in Exchange risk-adjustment payments between them for the 2024-year settlement. Centene, CVS Health’s Aetna and UnitedHealthcare will receive the biggest payments, while Cigna, Elevance Health, Molina Healthcare and Oscar Health will remit the most. Despite the cash influx, Centene reported bad financial news.
(Article may require a subscription.)
#riskadjustment #exchanges
https://www.modernhealthcare.com/insurance/mh-aetna-centene-aca-risk-adjustment-payments
— Marc S. Ryan
