Morning Briefing
Summaries of health policy coverage from major news organizations
Research Roundup: Unease Among ACA Insurers; Medical Device Monitoring
JAMA Internal Medicine: Health And Health Care Use Among Individuals At Risk To Lose Health Insurance With Repeal Of The Affordable Care Act
Using the Integrated Health Interview Series of the 2015 National Health Interview Survey (NHIS), we identified 3 groups of adults ... at risk to lose health insurance if premium tax credits are eliminated and Medicaid expansion is rolled back. ... Adults in the three groups at risk to lose insurance were significantly more likely to be minorities, poor, and unemployed than adults in the employer-sponsored insurance group, and had significantly less educational attainment. [They also] had significantly higher rates of self-reported poor health. (Karaca-Mandic, Jena and Ross, 1/20)
Urban Institute/Georgetown University Health Policy Institute/Robert Wood Johnson Foundation: Uncertain Future For Affordable Care Act Leads Insurers To Rethink Participation, Prices
Insurers participating in the Affordable Care Act’s marketplaces are reassessing their participation and considering premium increases because of uncertainty over the law’s future. Through a series of interviews with 13 insurers participating in the marketplaces in 28 states, researchers explored how companies would respond to different repeal scenarios. They find that repeal of the individual mandate and a “repeal and delay” strategy without a concurrent replacement would lead insurers to exit the market or raise premiums. If payments for cost-sharing reductions cease, insurers would face significant financial losses; many would need to leave the market as soon as legally feasible. (Corlette et al., 1/24)
The New England Journal of Medicine: Registry-Based Prospective, Active Surveillance Of Medical-Device Safety
In our study, we evaluated the feasibility of applying active surveillance to assess the safety of a commonly used vascular-closure device through prospective monitoring of a national clinical registry. ... Our analysis showed a significantly higher risk of vascular complications, access-site bleeding, and transfusion requirement after PCI [percutaneous coronary intervention, or coronary angioplasty] among patients treated with the Mynx vascular-closure device than among those treated with alternative vascular-closure devices, although the absolute risk differences were small. ... a strategy of prospective, active surveillance of a representative clinical registry rapidly identified potential safety signals among recipients of an implantable vascular-closure device after PCI. (Resnic et al., 1/25)
The Kaiser Family Foundation: 5 Key Questions: Medicaid Block Grants & Per Capita Caps
Medicaid provides health and long-term care coverage to more than 70 million low-income children, pregnant women, adults, seniors, and people with disabilities in the United States. The program represents $1 out of every $6 spent on health care in the US and is the major source of financing for states to provide coverage to meet the health and long-term needs of their low-income residents. ... President Trump and other GOP leaders have called for fundamental changes in the structure and financing of Medicaid. ... This brief outlines five key questions to consider as the debate moves forward as well as some potential implications of these changes for states, beneficiaries and providers. (Rudowitz, 1/310
The Kaiser Family Foundation: Private Contracts Between Doctors And Medicare Patients: Key Questions And Implications Of Proposed Policy Changes
Legislation has been introduced in the House and Senate to make it easier for physicians and other practitioners to enter into private contracts with their Medicare patients and charge higher fees than are generally allowed under Medicare .... Private contracting provisions are also included in broader bills to repeal the Affordable Care Act (ACA) ... this brief: Summarizes the three options that physicians and practitioners currently have for charging Medicare patients for services they provide; Explains how the private contracting option works in Medicare under current law ...; Reviews current proposals on changes to private contracting in Medicare, and discusses the implications for Medicare patients, physicians, and the Medicare program. (Boccuti and Neuman, 1/23)
Heritage Foundation: The 2017 Health Insurance Exchanges: Major Decrease In Competition And Choice
One of the stated aims of the Affordable Care Act (ACA) was to increase competition among health insurance companies. That goal has not been realized, and by several different measures the ACA’s exchanges offer less competition and choice in 2017 than ever before. Now in the fourth year of operation, the exchanges continue to be far less competitive than the individual health insurance market was before the ACA’s implementation. Moreover, insurer participation in the law’s government-run exchanges has declined over the past two years and is now at the lowest level yet. This lack of insurer participation leaves exchange customers in 70 percent of U.S. counties with no insurer choice, or a choice between merely two insurers. (Haislmaier and Senger, 1/30)
