Bipartisan ‘Break Up Big Medicine’ Bill Aims To End Health Care Consolidation
The measure would force the separation of insurers, PBMs, and providers. “There’s no question that massive health care companies have created layers of complexity to jack up the price of everything," said Sen. Elizabeth Warren, D-Mass., one of the bill's sponsors. "This bipartisan legislation is a massive step towards making health care affordable for every American,” added Sen. Josh Hawley, R-Mo., the other sponsor.
The Hill:
Warren, Hawley Introducing Legislation To Break Up ‘Big Medicine’
Sens. Elizabeth Warren (D-Mass.) and Josh Hawley (R-Mo.) are teaming up to “break up big medicine.” The lawmakers introduced legislation to crack down on health care conglomerates that own multiple parts of the industry — including pharmacy benefit managers (PBMs), which act as a conduit between insurers and drug manufacturers, and pharmacies themselves. Warren and Hawley’s “Break Up Big Medicine Act” proposes prohibiting parent companies from owning a medical provider or management services organization and a PBM or insurer. (Rego, 2/10)
Modern Healthcare:
The Medicare Physician Payment Reforms Doctors Want From Congress
Doctors want more money from Medicare and more ways to get it, medical societies told House members developing plans to overhaul the payment system. In December, Reps. Dr. John Joyce (R-Pa.), Dr. Greg Murphy (R-N.C.) and Dr. Kim Schrier (D-Wash.) invited organizations representing physicians to weigh in on a potential successor to the Merit-based Incentive Payment System, or MIPS. Groups including the American Academy of Family Physicians, the Medical Group Management Association and the National Association of Accountable Care Organizations answered the call with policy recommendations. (Early, 2/10)
The New York Times:
Congress Quietly Used Funding Law To Try To Rein In Trump On Spending
Top Republicans and Democrats quietly tucked new requirements into the government funding package Congress passed last week to make it more difficult for the Trump administration to defy lawmakers and refuse to allocate federal dollars in the way they intend. Many of the measures fall far short of what Democrats wanted, including provisions restricting departments from canceling federal contracts and barring the White House from unilaterally rescinding funds Congress already approved. In some instances, House Republicans rejected stronger language written by appropriators in the Senate. (Edmondson, 2/10)
More on health care affordability and the end of ACA subsidies —
NBC News:
Hospitals And Insurers Are Fighting Over Money, Leaving Patients In The Lurch
Natalie Reichel is due for her next cancer therapy in March. But a contract fight between Mount Sinai Health System in New York City, where she gets care, and Anthem Blue Cross Blue Shield, whose network her insurance uses, has cast doubt on whether she’ll be able to get it on time. “I am feeling dubious,” said Reichel, 40. The dispute is about money: Mount Sinai says Anthem owes it more than $450 million in unpaid claims, while Anthem says Mount Sinai is demanding a 50% rate increase. (Lovelace Jr., 2/10)
Axios:
Charted: Where Health Coverage Breaks The Bank
Health insurance costs ate up 10% or more of median family income in 19 states, according to a new analysis. The findings show how tough it can be to afford health care, even with insurance, for many of the estimated 167 million Americans who get coverage through an employer. (Bettelheim, 2/11)
KFF Health News:
End Of Enhanced Obamacare Subsidies Puts Tribal Health Lifeline At Risk
Leonard Bighorn said his mother tried for two years to get help for severe stomach pain through the limited health services available near her home on the Fort Peck Reservation in northeastern Montana. After his mom finally saw a specialist in Glasgow, about an hour away, she was diagnosed with stage 4 colon cancer, Bighorn said. Now, 16 years after his mother’s death, Bighorn has access to regular screenings for cancer and other specialty care that she didn’t have, through a health insurance program the Fort Peck Tribes created in 2016. (Houghton and Orozco Rodriguez, 2/11)
KFF Health News:
Listen To The Latest 'KFF Health News Minute'
Katheryn Houghton reads the week’s news: American farmers are being hit hard by the end of extra Obamacare subsidies, and hospitals are starting their own Medicare Advantage plans. (2/10)
