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Senators skeptical about ACA repeal, public opposition grows
Republican Senators are skeptical that a health care bill can pass, largely due to disagreements about Planned Parenthood and cuts to Medicaid. However, it is still possible a compromise could be reached. Moderate Republicans have hinted they would accept a delayed roll-back of the Medicaid expansion, and many experts believe the Senate will pass some version of health care reform. If the Senate passes a bill, the legislation will have to be reconciled with the House version that passed in early May.
Public opposition to the House-passed health care plan has grown following a CBO score estimating 23 million people would lose coverage over the next 10 years. A Morning Consult/Politico poll finds 39 percent of voters were more likely to oppose the bill due to the CBO score, and a Kaiser Family Foundation poll finds 55 percent want Senate Republicans to rewrite the House bill.
Verma cites ACA as cause of market woes
In a recent interview, CMS Administrator Seema Verma said the ACA is to blame for rising premiums and the uncertainty around coverage. Verma also said it was unwise to expand Medicaid coverage through the ACA, instead favoring coverage through the private market. Verma is eager to consider state waivers to include work requirements for Medicaid beneficiaries.
Medicare patients do not see drug price discounts
In a JAMA paper that analyzes Medicare drug price negotiations, researchers find that rebates may actually drive up the amount Medicare and its beneficiaries pay for drugs. Savings on medications aren’t always passed along to Medicare patients, as they are often absorbed by pharmacy benefit managers or health insurers. The amount of money Medicare patients pay toward a drug is based on the list price not the price including rebates, so increases in list prices result in higher costs for patients.
Medicare Advantage insurers pay settlement
In a whistleblower lawsuit, two Medicare Advantage plans in Florida agreed to pay more than $30 million on allegations that they exaggerated patients’ conditions and attempted to overbill the government program. The settlement comes as the payment formula for Medicare Advantage plans, which allots higher payments to plans with sicker patients, has been called into question.
CMS adds exercise therapy coverage
CMS will offer Medicare coverage of supervised exercise therapy after cardiologists requested the treatment be included to combat symptoms of heart disease. Medicare beneficiaries can now receive exercise sessions up to one hour supervised by an exercise physiologist, physical therapist or nurse.