Medicaid Cuts Advance In House
After a marathon overnight hearing where lawmakers literally fell asleep in their chairs, the House Energy & Commerce Committee advanced on a party-line vote deep Medicaid spending reductions in the budget reconciliation process. The cuts amount to $624 billion in Medicaid over 10 years. New provider tax bans, cost-sharing for certain populations, and work requirements are some of the largest reductions. Democrats proposed to tackle Medicare Advantage (MA) overpayments instead. They, too, wanted to use savings from President Trump’s recent executive order to reduce drug pricing.
While the reductions advanced, a deep divide is quickly emerging. Moderates and conservatives are still at odds in the House. Conservatives claimed that the reductions are not deep enough, while many moderates could be off the bill due to the existing Medicaid cuts. Some moderates and pragmatic conservatives in the Senate are also concerned about the Medicaid cuts. In the House, enough conservatives and/or moderates exist to tank the bill. The same could be true in the Senate as well. The Senate GOP generally also has taken issue with the broad scope of the entire reconciliation process and could craft its own bill.
In other news, healthcare policy group KFF discusses the impediments to passing deep Medicaid cuts and how that task has only gotten harder with a major expansion of Medicaid, the popularity of the program, and the more-easily-definable fallout on coverage.
As well, the Senate Judiciary Committee appears poised to back major pharmacy benefits manager (PBM) reform after a hearing where major issues were discussed, including the role of the Big 3 PBMs.
Additional articles: https://kffhealthnews.org/news/article/house-budget-bill-medicaid-deja-vu-2017-republican-cuts/ and https://www.healthcaredive.com/news/senate-judiciary-backs-pbm-reform-hearing/747989/ and https://www.modernhealthcare.com/politics-policy/reconciliation-bill-medicaid-cuts-energy-commerce and https://thehill.com/policy/healthcare/5299154-republicans-advance-medicaid-bill-trump-agenda/ and https://thehill.com/homenews/senate/5298819-senate-gop-house-trump-package-medicaid/
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#medicaid #coverage #budgetreconciliation #medicareadvantage #drugpricing #trump #congress
https://thehill.com/homenews/house/5300149-trump-meditaid-reforms-gop-fight
Hemsley’s Costly Return Applauded By Investors
Many are looking forward to UnitedHealth Group’s Stephen Hemsley’s return as CEO after Adrew Witty left in an unexpected move. UnitedHealth Group recently has suffered financially, but previously has always been regarded as a successful money machine for investors. It looks to have missed warning signs of major problems in its Medicare Advantage (MA) line and perhaps elsewhere. Indeed, the United CEO indicated higher medical costs are beginning to crop up in other lines of business. United is also being investigated for Medicare fraud.
To attract Hemsley back to his previous role as CEO, the United board had to come up with a one-time $60 million equity award to turn around the beleaguered company. The move is being supported because Hemsley’s was responsible for having built the business out over time to what it is today – the largest insurer in UnitedHealthcare and the largest service entity in Optum.
Additional articles: https://www.modernhealthcare.com/insurance/unitedhealth-group-stephen-hemsley-award and https://www.beckerspayer.com/payer/costs-set-to-rise-outside-of-medicare-advantage-unitedhealth/
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#unitedhealthcare #healthplans #medicareadvantage #margins
https://www.modernhealthcare.com/insurance/unitedhealth-stephen-hemsley-andrew-witty-optum
Retail Meets Healthcare Is Struggling
A good article reviewing the current state of retail meets healthcare. There are many high-profile failures, while some continue to plod through rough times.
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#retailmeetshealthcare #coverage #primarycare
https://www.modernhealthcare.com/providers/amazon-cvs-health-best-buy-healthcare-disruption
— Marc S. Ryan
