Weekly Edition: July 31-Aug. 4
Podcast: ‘What The Health?’ Now What?
In this episode of “What the Health?” Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Sarah Kliff of Vox.com, and Mary Agnes Carey of Kaiser Health News discuss what happens now in the wake of the apparent demise of the Republican-only repeal and replace efforts for the Affordable Care Act.
In Strong-Arm Tactic, Trump Puts Congressional Health Benefits Into Play
Julie Rovner
By taking aim at the subsidies received by some congressional staff members who, under the Affordable Care Act, are mandated to get their health coverage from the Obamacare exchanges, the president reignited an old fight.
Counting On Medicaid To Avoid Life In A Nursing Home? That’s Now Up To Congress.
Susan Jaffe and Heidi de Marco
Tighter Medicaid budgets could jeopardize states’ home-based services that help older adults and disabled people live in their homes instead of more expensive nursing homes.
Covered California Expects 12.5% Average Rate Rise In 2018
Emily Bazar and Anna Gorman
The figure could be higher if President Trump ends an important consumer subsidy, which he has threatened to do. The exchange also announced that Anthem Blue Cross will pull out of Covered California and the overall individual market in 16 of the 19 regions it currently serves.
Anthem’s Retreat Leaves Californians With Fewer Choices, More Worries
Pauline Bartolone and Anna Gorman and Chad Terhune
The nation’s second-largest insurer is shrinking its presence on Obamacare exchanges and in the broader individual market in response to prevailing uncertainty. California is just the latest — and the biggest — example.
Despite Insurers’ Tactical Win On ACA’s Cost-Sharing Payments, Uncertainty Lingers
Jay Hancock
Court allows state attorneys general to join a pending legal challenge to keep billions in subsidies flowing to consumers and insurers, despite the Trump administration’s resistance.
Middlemen Who Save $$ On Medicines — But Maybe Not For You
Francis Ying and Julie Appleby and Stephanie Stapleton
Guess who’s back grabbing headlines? Pharmacy benefit managers — those companies that serve as middlemen in the prescription drug pipeline.
Drug Puts A $750,000 ‘Price Tag On Life’
Julie Appleby
The high cost of Spinraza, a new and promising treatment for spinal muscular atrophy, highlights how the cost-benefit analysis insurers use to make drug coverage decisions plays out in human terms.
Denial, Appeal, Approval … An Adult’s Thorny Path To Spinraza Coverage
Julie Appleby
The FDA granted approval for Spinraza in late December for use on children and adults with spinal muscular atrophy. Insurance coverage is mostly focused on infants and children.
Under Trump, Hospitals Face Same Penalties Embraced By Obama
Jordan Rau
Federal records show that 2,573 hospitals around the country will have their Medicare payments reduced because they have too many patients readmitted.
When Wounds Won’t Heal, Therapies Spread — To The Tune Of $5 Billion
Marisa Taylor
The market for wound care products booms among a growing older and diabetic patient pool, but many treatments are untested and funding for research falls short.
Many Still Sidestep End-Of-Life Care Planning, Study Finds
Michelle Andrews
Only about a third of U.S. adults have advance directives in place to guide the care they receive in the event that they are unable to make their own decisions about life-sustaining medical treatments.
Florida Law Will Let Patients Get All Their Drug Renewals At The Same Time
Michelle Andrews
The new law will help people with chronic conditions that require multiple prescriptions cut down on their shuttles to the drug store and could improve adherence to their drugs.
To Grow Market Share, A Drugmaker Pitches Its Product To Judges
Jake Harper, Side Effects Public Media
Some drug courts offer participants a full range of evidence-based treatment, including medication-assisted treatment. Others don't allow addiction medications at all. And some permit just one: Vivitrol.
EMS Delays In Rural Areas Leave First-Aid Gap For Bystanders To Fill
Katherine C. Gilyard
Response times for emergency medical service units are about twice as long in rural areas as in urban areas, researchers say, underscoring the need for trained lay people to provide first aid until professional help arrives.