Health Care Delivery

The public, including most Republicans, wants protections for people with pre-existing conditions preserved, finds the latest Kaiser Family Foundation health tracking poll. The poll was released as a federal court case regarding the constitutionality of the Affordable Care Act got underway in Texas and as Brett Kavanaugh began his second day of questioning from senators regarding his nomination to the Supreme Court.

Consolidation in California’s healthcare system has had a noticeable impact on measures of vertical integration and premiums for insurance bought through the exchanges established under the Affordable Care Act, according to a study published Tuesday in Health Affairs.

Senate Democrats plan to use the confirmation battle for Brett Kavanaugh's to the Supreme Court of the United States to mobilize their base around threats to the Affordable Care Act (ACA), the social safety net, and reproductive rights; a Texas courtroom will be the setting for another critical chapter in the fate of the ACA; consumers who buy insurance through ACA markets will find premiums have stabilized in 2019.

Over 200 patient and provider groups have written to CMS, saying that proposed consolidation of evaluation and management billing codes will adversely affect the sickest Medicare patients and the physicians that treat them.

GOP senators have introduced legislation they say would protect provisions for preexisting conditions under the Affordable Care Act; Cigna shareholders have voted in favor of the acquisition of pharmacy benefit manager Express Scripts; and study results show that aspirin does not lower cardiovascular (CV) risk in the long-term.

CMS is giving $8.6 million to 30 states and the District of Columbia to help insurance departments stabilize their health insurance markets and implement and plan for consumer protections and market reforms called for under the Affordable Care Act (ACA).

Allowing a partial expansion of Medicaid to some low-income adults may help some people in nonexpansion states, but it would cause a significant loss of health coverage if approved in expansion states, according to a recent analysis by the Center on Budget and Policy Priorities.

Public health advocates are alarmed by a possible shift in long-standing policy about penalizing legal immigrants for accepting healthcare services, food stamps, heating assistance, and other noncash assistance as their applications to become permanent residents are pending.

Following a peak of 17.4 million people enrolled in the individual insurance market in 2015, enrollment has continuously declined. With the elimination of the individual mandate and the expansion of short-term health plans, enrollment will likely continue to drop in 2019.

Major insurers are now seeking smaller, single-digit premium increases for Affordable Care Act (ACA) plans; drug makers and distributors of painkillers being sued for their alleged role in the opioid crisis are trying to build goodwill by giving grants and donations to hard-hit counties, cities, and states that are filing the lawsuits; hundreds of people have sued Bristol-Myers Squibb and Otsuka, alleging that the drug Abilify caused compulsive behavior.

Medicare has lowered its star ratings for staffing levels in 1 out of 11 nursing homes; the Pharmaceutical Research and Manufacturers of America has donated to a lobbying group running a "dark money" campaign in favor of repealing and replacing the Affordable Care Act; a libertarian policy center funded by the conservative Koch brothers found that Senator Bernie Sanders's Medicare for All plan would cost $32.6 trillion over 10 years.

Eleven states and the District of Columbia are suing the Trump administration, alleging it violated the Administrative Procedures Act when it promulgated the rule expanding association health plans.

The FDA is cracking down on a loophold drug companies use to avoid the requirement that they study products in children; a new study finds nearly 6 in 10 Hispanic adults cite a language or cultural barrier that makes it difficult for them to communicate with healthcare providers; a judge has ordered Wisconsin to pay for gender reassignment surgery for 2 Medicaid recipients.

Close to 200 organizations wrote to CMS and HHS this week to express concerns with the Trump administration’s plans to cut millions of dollars from the Affordable Care Act’s marketing and outreach budget, saying that they are “frustrated by CMS’ assertions that the need for these services has decreased as the number of uninsured or underinsured Americans continues to grow.”

Findings from the Foundation for Government Accountability did not net out those who would be eligible for exemptions under CMS rules.

If all states passed their own health insurance mandates similar to ones in New Jersey and Massachusetts, close to 4 million more Americans would have health insurance, and premium costs would drop an average of nearly 12%, according to a recent report from The Commonwealth Fund and the Urban Institute.

Senate Democrats are urging Republicans to agree to a resolution that would allow the Senate to intervene in a lawsuit challenging the legality of the Affordable Care Act; the after effects of Hurricane Maria are helping to fuel an exodus of physicians from Puerto Rico; a new congressional report suggests Anthem has effectively reversed a policy denying emergency department claims after the fact.

FDA Commissioner Scott Gottlieb, MD, announced the release of the agency’s Biosimilar Action Plan; Philadelphia’s tax on soda and other sweetened beverages has been upheld by the Pennsylvania Supreme Court; a federal judge dismissed a lawsuit by 19 states against the Trump administration over the decision to end cost-sharing subsidies under the Affordable Care Act.

Residents of the 20 Republican-led states that are challenging the Affordable Care Act (ACA)'s protections for people with preexisting medical conditions have the most to lose; House Ways and Means Committee Chairman Kevin Brady, R-Texas, is in talks with HHS about ways to restart ACA payments; Judge Brett M. Kavanaugh ruled in a case that paved the way for hospitals to seek more money from Medicare.

Here are 5 of Supreme Court nominee Judge Brett Kavanaugh’s opinions on heavily debated healthcare topics.

The FDA is planning a task force to find ways to combat drug shortages; a new Gallup poll finds nearly two-thirds of Americans support Roe v Wade 64% to 28%; the agency overseeing Oregon's legal medical marijuana industry conceded in a report it has not provided effective oversight of growers and others in the industry.

CMS cut the amount of money it is awarding to organizations that help individuals enroll in insurance for 2019 plans under the Affordable Care Act (ACA) by $26 million, and, for the first time, is encouraging the so-called “navigators” to also sign people up for health insurance that provides a narrower level of coverage than the plans under the ACA.

Blaming a recent decision by the US District Court for the District of New Mexico, CMS has announced that it has halted collections or payments under the risk adjustment program, including amounts for the 2017 benefit year, established by the Affordable Care Act for the 2014-2018 benefit period.

HHS Secretary Alex Azar appeared before the Senate Committee on Finance today to discuss the Trump administration’s efforts to drive drug innovation and affordability, answering a slew of questions revolving around the "American Patients First" blueprint, increasing generic and biosimilar competition, and value-based pricing.

How many uninsured people in the United States are eligible for coverage under the Affordable Care Act (ACA)? A new analysis from the Kaiser Family Foundation (KFF) found that 14.8 million people could gain coverage, either through Medicaid or by enrolling in a marketplace plan.

A conservative coalition is pushing a plan to repeal the Affordable Care Act (ACA), but centrist Republicans getting ready for the midterm elections have no interest in it; the World Health Organization has unveiled the 11th version of its International Classification of Diseases (ICD-11); doctors in Puerto Rico are seeing a stunning rise in the number and severity of asthma cases that they attribute to destruction caused by Hurricane Maria last September.

A look at telepsychiatry’s rapid expansion into nontraditional settings.

What seems like a straightforward idea—screen current and former heavy smokers for lung cancer—proves more challenging in practice, according to findings from a demonstration project at the Minneapolis Veterans Affairs Health Care System.

The Department of Justice (DOJ)’s legal brief in the Texas case against the Affordable Care Act (ACA) could have far-reaching ramifications besides ending protections for people with pre-existing conditions; 1 in 5 Medicare patients sent from the hospital to a nursing home boomerang back within 30 days, often for potentially preventable conditions; Anthem, Blue Cross Blue Shield of Texas, and UnitedHealth Group are among insurers scrutinizing the cost of emergency department (ED) visits.

Using data from 8 states, the Kaiser Family Foundation is tracking preliminary 2019 insurance premiums in the Affordable Care Act’s marketplaces as rate information is filed with state regulators. The 8 states are Maine, Maryland, New York, Oregon, Rhode Island, Vermont, Virginia, and Washington, plus the District of Columbia.