Viewpoints: New Debate On Shrinkage In Health Enrollments; ‘Mad Medicine’ On Generics

Bloomberg: More Bad News For Obamacare
Last Monday, Jed Graham of Investor's Business Daily reported that insurers say Affordable Care Act enrollment is shrinking, and it is expected to shrink further. Some of those who signed up for insurance on the exchanges never paid; others paid, then stopped paying. Insurers are undoubtedly picking up some new customers who lost jobs or had another "qualifying life event" since open enrollment closed. But on net, they expect enrollment to shrink from their March numbers by a substantial amount -- as much as 30 percent at Aetna Inc., for example (Megan McArdle, 8/18).

The Washington Post: The Volokh Conspiracy: Law By Other Means -- A Response To Rob Weiner On Halbig
Rob Weiner is at it again over at Balkinization. This time alleging he's found some smoking gun to prove that the Halbig litigation is "anti-democratic" and rests on a flawed legal theory. As with his posts on the D.C. Circuit's en banc procedures, Weiner's diatribe is long on bluster, but short on meaningful claims. And, as before, he says some things that are false, irrelevant, or both (Jonathan H. Adler, 8/18).

Balkinization: Politics By Other Means
[Opponents of the federal health law subsidies] claimed, in order to coerce states to establish insurance Exchanges, Congress had intended all along to deny insurance subsidies to low income families in states that did not cooperate. The language buried in the formula for calculating subsidies, they asserted, implemented this intent. The argument brings to mind the scene in the classic Woody Allen movie, Take the Money and Run, where a would-be bank robber ends up arguing with the teller as to whether his note says he has a "gun" or a "gub." The ACA opponents argue, in effect, not only that the note said "gub," but that it did so by design. This position is an after-the-fact rationalization (and not a very good one, at that). At the time the statute was enacted, no one – not legislators, not the press, not academics, and not even plaintiffs themselves – suggested that this provision implemented any such design (Rob Weiner, 8/16). 

Tampa Bay Times: Medicaid Expansion Creates Jobs, Saves Money, But Florida Still Doesn't Care
For a state that boasts about giving tax breaks (i.e. corporate welfare) to businesses on the vague promise of job creation, it is almost inconceivable to think we wouldn't invest in proven job creation through health coverage. And yet Florida lawmakers have not only rebuffed Medicaid expansion, they don't even talk about it any longer. Ignoring fact-based studies is not simply partisan politics. When the stakes are this high, it is deplorable politics (John Romano, 8/18).

Bloomberg: The FDA's Mad Medicine
[G]eneric manufacturers are not allowed to put warning labels on drugs unless those warnings are also in the warning label for the original brand-name drug. That's when I realized that this was a classic case of outrageous regulatory incompetence. Oblivious bureaucrats at the Food and Drug Administration created a ridiculous situation in which Pfizer can be sued for a product it didn’t make. Then I read further. And it turns out that the FDA has proposed a new rule that would allow generic-drug manufacturers to add labeling to their products independently. And guess who’s blocking it? The generic drug manufacturers, of course (Megan McArdle, 8/18).

The New York Times: Is Gov. Rick Perry's Bad Judgment Really A Crime?
Gov. Rick Perry of Texas is one of the least thoughtful and most damaging state leaders in America, having done great harm to immigrants, abortion clinics and people without health insurance during his 14 years in office. But bad political judgment is not necessarily a felony, and the indictment handed up against him on Friday -- given the facts so far -- appears to be the product of an overzealous prosecution (8/18).

Journal of the American Medical Association: Optimizing Health for Persons With Multiple Chronic Conditions
Although HHS and its partners have made incremental progress in addressing chronic conditions through use of a multiple chronic conditions lens, there is an imperative to accelerate efforts across all of the goals. First, more delivery and payment models will need to focus specifically on subsets of the multiple chronic conditions population that are at highest risk for poor outcomes and high costs. ... Second, evidence-based community prevention and wellness programs currently reaching hundreds of thousands of individuals should be expanded further through partnerships with health care entities to reach tens of millions of individuals with multiple chronic conditions. Third, the multiple chronic conditions population needs to be an area of focus for research on patient-centered outcomes to inform the development of future clinical practice guidelines, best practices, and quality measures (Anand K. Parekh, Richard Kronick and Marilyn Tavenner, 8/18).