Morning Briefing
Summaries of health policy coverage from major news organizations
Health Care Industry Maneuvers Ahead Of Trump's Planned Tariffs On Supplies
Stat: The Health Care Industry Is Girding For Trump’s Tariffs —And Pushing Hard For Carveouts
President-elect Trump campaigned on imposing broad, steep tariffs to create more jobs in the U.S. and combat China. If enacted, these taxes would send the U.S. health care industry scrambling and could eventually force patients and insurers to shell out more for medical care. But no one in the industry is in a tizzy just yet, at least not publicly. There are two reasons for that. One: No one knows what Trump is actually going to do. Two: They’re pushing hard for carve-outs behind the scenes. (Bannow and Silverman, 11/21)
Modern Healthcare: Underinsured Patients At Risk If ACA Subsidies Lapse
More people may face gaps in insurance coverage, have trouble affording medical care or not be able to pay for coverage if certain Affordable Care Act subsidies aren't renewed next year, the Commonwealth Fund said Thursday. The independent healthcare research organization's 2024 report on health insurance found 44% of Americans are underinsured, face coverage gaps or are uninsured, despite improvements in lowering the number of uninsured citizens. In its 2022 report, the group pegged the percentage at 43%. (DeSilva, 11/20)
KFF Health News: Washington Power Has Shifted. Here’s How The ACA May Shift, Too
President-elect Donald Trump’s return to the White House could embolden Republicans who want to weaken or repeal the Affordable Care Act, but implementing such sweeping changes would still require overcoming procedural and political hurdles. Trump, long an ACA opponent, expressed interest during the campaign in retooling the health law. In addition, some high-ranking Republican lawmakers — who will now have control over both the House and the Senate — have said revamping the landmark 2010 legislation known as Obamacare would be a priority. They say the law is too expensive and represents government overreach. (Armour, Whitehead and Rovner, 11/21)
Modern Healthcare: Prior Authorization Policies Need More Changes, Providers Say
The Biden administration sought to tackle one of the most contentious policies in healthcare: prior authorization. Providers and insurers say there’s still room for improvement. Provider groups have complained misuse of prior authorizations is responsible for care delays, increased hospitalizations and a reduced likelihood that patients follow their care plans, along with the administrative burden providers face in trying to secure coverage for patients. (Early, 11/20)
AP: Open Enrollment: How To Shop For Health Insurance
Everyone likes a good deal, and health insurance bargains abound this time of year. But buyers should look beyond price when searching for a plan. Shoppers also should consider doctor networks and coverage limits to avoid getting stuck with big bills after care. Millions of Americans are looking for 2025 coverage now during annual enrollment windows for Medicare Advantage plans and individual insurance. Plus, many employers are telling their workers about their coverage plans for next year too. (Murphy, 11/20)
More on the high cost of health care —
MedPage Today: Health Prices Are Getting More Transparent, But It's Still Not Enough, Experts Say
Health transparency rules have helped researchers gain more insight into hospital pricing practices, Ge Bai, PhD, CPA, said here Wednesday at an event sponsored by Georgetown University's Center on Health Insurance Reforms. The price transparency regulations that were part of the Affordable Care Act (ACA) "gave us unprecedented insight into what's really going on in the commercial market," said Bai, who is professor of health policy and management at Johns Hopkins Bloomberg School of Public Health in Baltimore. (Frieden, 11/20)
North Carolina Health News and Charlotte Ledger: Trapped In The Medical Billing Maze
When Mary Katherine Snow of Cornelius was diagnosed with leukemia in 2017, she was prepared to fight for her life. But she didn’t expect that in addition to fighting cancer, she would also have to fight a cascade of medical billing errors that tanked her credit score, required hours of back-and-forth with her hospital and her health insurer, and piled on stress at a time when she could least afford it. (Crouch, 11/21)
Bloomberg: New York Aims To Lower Drug Prices With PBM Rules For CVS, Cigna, UnitedHealth
New York state regulators are setting new rules to rein in the behavior of prescription drug middlemen — including units of CVS Health Corp., Cigna Group and UnitedHealth Group Inc. — in a step the state’s top financial regulator said will boost competition and transparency. Regulations taking effect this month will make pharmacy benefit managers, or PBMs, publish their lists of covered drugs and directories of pharmacies in their networks. The state will also bar PBMs from steering patients to their affiliated pharmacies and allow local pharmacies to offer mail-order and home delivery. (Tozzi, 11/20)
