insurers

Politico Raises Issue Of CMS Premium Stabilization Demonstration For Medicare Part D PDPs The mainstream media is finally covering the potential October Surprise for Democrats. There are possible huge increases in standalone Medicare Part D (PDP) premiums due to the transfer of costs to plans from the government and member out-of-pocket cost reductions in the Inflation Reduction Act (IRA). The Politico article lays it out well. The Centers for Medicare and Medicaid Servies (CMS) created a last-minute demonstration to blunt the impacts and the GOP is accusing Democrats of using the U.S. Treasury for political purposes. I continue to doubt that CMS has the authority to do this.  It usurps Congress’ control. I raised this issue in two blogs several weeks ago (July 24 and July 25) here: https://www.healthcarelabyrinth.com/will-democrats-be-victim-of-an-october-surprise-of-their-own-making/ and https://www.healthcarelabyrinth.com/part-d-premium-woes-due-to-the-inflation-reduction-act/ . In addition to the PDP premium hikes, Medicare Advantage (MA) plans are expected to have benefit cuts for

AHIP To Go On Offensive On Medicare Advantage With Medicare Advantage (MA) facing huge financial difficulties due to lower rates and crippling government regulatory changes, AHIP, the health plan lobby, is underwriting a seven-figure lobbying and advertising campaign to call attention to the challenges, obtain higher rates, and explain the major benefits for Medicare enrollees. Additional article: https://subscriber.politicopro.com/article/2024/08/top-health-insurance-group-outlines-plans-to-protect-medicare-advantage-00173713 (Some articles may require a subscription.) #medicareadvantage https://www.beckerspayer.com/payer/payers-plan-medicare-advantage-lobbying-blitz.html Kaiser Reports Good Financial Results Kaiser Permanente wrapped reported $908 million of operating income (3.1% operating margin) and more than $2.1 billion of net income in Q2 2024. It had $29.1 billion in revenue in the quarter. The numbers were up from a year ago. It had a good 1H 2024 and is overcoming its earlier troubles. Additional article: https://www.fiercehealthcare.com/providers/kaiser-permanente-posts-31-operating-margin-21b-net-income-q2-2024 #kaiserpermanente https://www.healthcaredive.com/news/kaiser-second-quarter-financial-results-operating-margin-geisinger-risant/724065 Mark Cuban Tells Daily Show He Wants To Shake Up Healthcare Mark Cuban appeared on The Daily Show to declare that he

PhRMA Attacks FDA Licensing Affordability Proposal PhRMA, the brand drug manufacturer lobby, is attacking the National Institutes of Health’s (NIH) proposal to tie its licensing process to drug affordability in the United States once products hit the market. The proposal would tie U.S. prices to those in other developed countries. PhRMA argues that it would discourage collaboration by the private sector with NIH. “History demonstrates that placing unreasonable terms on licensing agreements diminishes willingness to engage in public-private partnership,” PhRMA said. But there is nothing wrong with the government tying affordability to any collaboration with the government. So much of what the drug industry eventually markets is tied to government innovation and funding.  The proposal is not unlike march-in rights on patents, which is something to consider as well. It also ties to Medicare drug price negotiations. Let’s remember: the drug market is not a free market and needs reform.