March 8, 2024

Biden SOTU Address Fiery And With Major Expansion Requests

President Joe Biden gave a fiery campaign speech at the State of the Union Thursday.  He touched on policy changes he wants to see across government and society.  In the healthcare world, he asked for significant additions to what he thinks is his successful record:

  • Major expansion of Medicare drug price negotiations.  As opposed to the maximum of 60 drugs in the current law, Biden wants the ability to negotiate the prices of 500 drugs over the next decade.
  • Permanent expansion of enhanced premium subsidies in the Exchanges.
  • A special healthcare program for those in the coverage gap in the ten states that have not expanded Medicaid.
  • A $2,000 annual cap on drug cost-sharing in commercial products.
  • A $35 per month insulin cap in commercial products.
  • Extension of inflation-cap drug rebates to commercial products. 

Additional articles: https://www.fiercehealthcare.com/payers/biden-call-drug-negotiation-expansions-stronger-reproductive-care-access-sotu and https://insidehealthpolicy.com/daily-news/biden-advocates-expansion-drug-price-controls-aca-state-union and https://www.modernhealthcare.com/politics-policy/joe-biden-state-union-sotu-2024

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#biden #sotu #healthcare #healthcarereform #aca #obamacare #exchanges #drugpricing #ira #coveragegap #insulin

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Change Healthcare May Need Until Mid-March To Fully Restore All Services

While some services have been restored, Change Healthcare says all services may not be restored until mid-March.  Meanwhile, class-action lawsuits are beginning to be contemplated.  Major parts of health plan and provider services have been impacted.

Additional articles: https://www.fiercehealthcare.com/payers/optums-change-healthcare-responding-cybersecurity-issue and https://www.modernhealthcare.com/cybersecurity/change-healthcare-update-systems-online-march15

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#changehealthcare #cybertattacks

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Sanders Asks Other Drug Makers To Reduce Inhaler Costs

Senate HELP Committee Chair Bernie Sanders, I-VT, called on other brand drug makers to reduce asthma inhaler costs to $35 a month as well.  Boehringer Ingelheim made the decision to do so yesterday.

(Article may require a subscription.)

#drugpricing #sanders

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Cigna And Evernorth Find Innovative Way To Cap GLP-1 Drug Cost Increases

Bucking the trend of employers and insurers limiting access to GLP-1 drugs, Cigna and its service subsidiary Evernorth (home to PBM ESI Express Scripts) will cap employers’ annual increases for the drugs as long as employers and plans offer Evernorth’s weight-loss programs. Cigna will cap annual price increases for the drugs at 15%. Some argue 15% is little comfort, but it represents a reasonable cap vs. the cost trends generally seen with these drugs (40% to 50%). ESI is using its leverage with two brand drug makers to cap inflationary costs — Novo Nordisk and Eli Lilly.

#weightlossdrugs #cigna #evernorth

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Study Says 8 In 10 Calls To Florida Medicaid Center Disconnected

Showing that the Centers for Medicare and Medicaid Services (CMS) need to hold states accountable for their eligibility and redetermination processes in Medicaid, a report from an Hispanic civil rights group, UnidosUS, says eight in ten calls to the Medicaid call center get disconnected.  In addition, wait times have been 50 to 90 minutes.

The vast majority of people nationwide lost coverage due to procedural reasons.  Part of that is the inability to ask questions and get through to the Medicaid agency.  UnidosUS notes that about 1 million Florida residents have lost coverage since redeterminations returned in April 2023. Florida has had the second largest drop in rolls.

Report: https://unidosus.org/publications/follow-up-long-and-discriminatory-delays-at-floridas-call-center/

#medicaid #redterminations #fl

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— Marc S. Ryan

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