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Morning Briefing

Summaries of health policy coverage from major news organizations

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Friday, Aug 9 2024

Full Issue

15 GOP-Led States Sue Biden Admin Over Health Coverage For 'Dreamers'

Effective Nov. 1, DACA immigrants will have access to insurance and related assistance such as lower out-of-pocket costs. The lawsuit filed Thursday says the rule violates federal law. Plus: In a loss for the pharmaceutical industry, an Ohio judge has tossed out a Medicare drug negotiation lawsuit.

Reuters: US States Sue Over Biden Rule Extending Health Insurance To DACA Immigrants

A group of Republican-led states filed a lawsuit on Thursday seeking to block the Biden administration from allowing up to 200,000 immigrants brought to the U.S. illegally as children to access federally-run health insurance. The 15 states led by the office of Republican Kansas Attorney General Kris Kobach say a rule adopted by the U.S. Department of Health and Human Services in May violates a federal law that prohibits giving public benefits to people who lack legal immigration status. (Wiessner, 8/8)

The Hill: Texas Gov. Abbott Orders Hospitals To Collect And Send State Data On Patients’ Immigration Status

Texas Gov. Greg Abbott (R) signed an executive order Thursday requiring hospitals to ask patients about their immigration status to help the state determine the cost of providing healthcare to noncitizens. Beginning Nov. 1, Abbott is directing hospitals in Texas to gather data on “patients who are not lawfully present in the United States,” as well as the number of inpatient discharges and emergency visits and the costs of care. (Irwin, 8/8)

More on coverage and access —

Modern Healthcare: Inpatient Claim Denials Grew In 2023: Kodiak Solutions

Insurance claim denials continue to be a vexing problem for healthcare providers, forcing them to expend more resources to reverse payers' decisions in an already-inflated cost environment. One common approach among insurers is denying payment until the provider submits additional information. Payers say it's a way to ensure their dollars are being spent appropriately, but many providers argue it's a stalling tactic. (Hudson, 8/8)

The CT Mirror: CT's Stricter Medicaid Limits Could Reduce Coverage, Advocates Say

Beginning in October, Connecticut will enact a stricter income threshold for HUSKY A, the Medicaid coverage for parents and caretaker relatives of eligible children. Currently, parents and caretaker relatives who earn up to 160% of the federal poverty level, or FPL, qualify for HUSKY A. But a measure passed last session, which was introduced and backed by Gov. Ned Lamont, will reduce the eligibility threshold to 138% of the federal poverty level beginning Oct. 1, 2024. (Golvala, 8/8)

North Carolina Health News: How Many Hospitals Will Join Cooper's Medical Debt Initiative? 

At least 37 of the state’s 99 hospitals have so far signed up for a new state program that promises them extra federal money if they agree to wipe out low-income patients’ old medical debt and to take steps to help those patients avoid debt in the future, state health officials said. (Crouch, 8/9)

On the high cost of prescription drugs —

Stat: Medicare Drug Negotiation Lawsuit Tossed Out In Loss For Pharma

A federal judge on Thursday tossed out a U.S. Chamber of Commerce lawsuit challenging Democrats’ drug pricing law. The decision is yet another loss for the pharmaceutical industry and its allies, which have filed lawsuits across the country arguing that the Inflation Reduction Act, which created a drug price negotiation program in Medicare, is unconstitutional. So far, they have lost every one. (Zhang, 8/8)

Stateline: States Want To Lower Drug Prices. A Federal Law Stands In Their Way

Oliver Lackey opened a pharmacy in his hometown of Fairview, Oklahoma, so he could “provide the best patient care.” He set up shop a decade ago in the local grocery store with “zero prescriptions.” Before long, business took off — yet he was still struggling. “I was getting more patients and was filling more prescriptions,” Lackey told Stateline. “But as I grew in revenues, my reimbursement from the insurance companies and PBMs every year was getting worse.” (Chatlani, 8/8)

Stat: Medicare Paid More For J&J's Stelara When It Was Covered Under Part D

A popular biologic medicine used to combat autoimmune diseases cost Medicare and its beneficiaries considerably more when the injectable treatment was obtained at pharmacies rather than injected in physician offices due to different methods for determining payment, a new analysis found. (Silverman, 8/9)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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