1 In 7 Who Enrolled In An ACA Plan This Year Didn’t Pay First Premium Bill
An analysis found that nationally, 14% of enrollees missed January premium payments as federal Affordable Care Act subsidies expired. In some states, though, the share of missed payments was 25% or more, The Wall Street Journal reported.
The Wall Street Journal:
Around 14% Of Enrollees In ACA Plans Failed To Make Payments, Data Shows
One in seven people who signed up for Affordable Care Act plans this year failed to pay after premium costs rose sharply, according to an analysis that provides the first comprehensive look at the impact of expiring federal subsidies. Nationally, around 14% of those who enrolled in ACA plans this year didn’t pay their first monthly bill for January coverage. In some states, the share was a quarter or more, according to a new analysis from the actuarial firm Wakely Consulting Group, provided exclusively to The Wall Street Journal. (Wilde Mathews, 4/15)
The latest on prescription drug costs —
Fierce Healthcare:
Bill Would Force Payers To Apply DTC Drug Purchases To Patient Deductibles
A prominent physician voice in the House of Representatives has introduced a new bill that would compel insurers to apply the cost for drugs purchased from direct-to-consumer platforms to deductibles and out-of-pocket maximums. North Carolina Republican Greg Murphy, M.D., on Tuesday unveiled the Every Dollar Counts Act, a bill that aims to lower patients' out-of-pocket costs for pharmaceuticals. Murphy, a consistent critic of insurers and pharmacy benefit managers, notes in an announcement that consumers have increasingly embraced DTC offerings as costs rise. (Minemyer, 4/14)
Axios:
States' Efforts To Rein In PBMs Hit A Legal Roadblock
State efforts to regulate pharmacy benefit managers are colliding with federal law, reviving a power struggle over who can police the companies that manage drug benefits for most Americans. (Reed, 4/15)
More news about health care costs and coverage —
MedPage Today:
Brokers Get Paid More To Enroll Seniors In Medicare Advantage. Is That A Problem?
The system of paying Medicare agents and brokers more money if they enroll someone in a Medicare Advantage plan rather than traditional Medicare with a supplement plan needs to be changed, according to several members of the Medicare Payment Advisory Commission (MedPAC). (Frieden, 4/14)
KFF Health News:
Medi-Cal Immigrant Enrollment Is Dropping. Researchers Point To Trump’s Policies
For months, a cloud of fear has hovered over the immigrant community in San Bernardino, California, making it hard for María González to do her job as a community health worker in this city where almost a quarter of residents are foreign-born. It started building over the summer, fed by news of immigration raids across Southern California, Trump administration plans to share Medicaid data with Immigration and Customs Enforcement, and the passage of state and federal restrictions on immigrant Medicaid eligibility. Then in November, the federal government released a new “public charge” proposal that, if enacted, could block certain immigrants from obtaining permanent legal residency if they or family members have used public benefits, including Medicaid. (Boyd-Barrett, 4/15)
Military.com:
Disabled Veterans Charged Up To $20K To File VA Benefits Claims: Lawsuit
A new federal class-action lawsuit accuses a company of taking advantage of disabled veterans and their spouses, charging upwards of $20,000 for Veterans Affairs (VA) claims as part of alleged deceptive practices. (Mordowanec, 4/14)
Modern Healthcare:
Health Systems Invest In Concierge Medicine As Demand Grows
Health systems are increasing their investments in concierge medicine to meet patient demand and keep burned-out doctors practicing. Though typically a small percentage of a health system’s operations, concierge medicine — where patients pay thousands of dollars in membership fees for increased access to primary care physicians — helps diversify revenue and creates growth opportunities in new and existing markets. (Hudson, 4/14)
Modern Healthcare:
Hospital Price Transparency Gains Steam As Employers Seek Savings
Policymakers and advocates for decades have touted greater transparency in the healthcare system as a key to unlock major cost savings, with little to show for it. That seems to be changing, employer groups and others say. The trend toward greater price disclosure is accelerating and experts see significant impacts on providers, health insurance companies and government health programs. (McAuliff, 4/14)
KFF Health News:
Listen To The Latest 'KFF Health News Minute'
Zach Dyer reads the week’s news: Rising health costs have some middle-aged adults skipping the doctor until Medicare will pick up the tab. Plus, there’s little evidence that immigrants without legal status are using Medicaid, despite White House claims. (4/14)