The Trump administration moved swiftly this week to implement pieces of its plan to bring down drug prices. The Health and Human Services Department on Wednesday submitted a proposal to the White House that would curb kickback exemptions that allow drugmakers to offer insurers and pharmacy-benefit managers rebates widely blamed for keeping drug prices high. On the same day, the Food and Drug Administration released a plan to boost the market for biosimilars, or generic copies of expensive drugs that contain living organisms. On Thursday, FDA Commissioner Scott Gottlieb also said the agency would consider allowing importation of drugs from other countries under certain conditions, including when a generic-drug company that is the sole provider of a medication significantly raises the price of that drug.
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For Kalena Bruce, a fifth-generation cattle farmer in Stockton, Missouri, finding affordable health coverage under Obamacare hasn’t been easy. She’s a young mom and business owner paying $700 a month in premiums alone, not to mention deductibles and copays.
That’s why she’s become an advocate for allowing more small businesses like hers to bring down their health care costs by pooling together. It’s an idea that’s worked for Missouri businesses for more than 15 years and will now be available nationwide thanks to the Trump administration’s new rule expanding access to association health plans, or AHPs.
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Health insurance companies in Colorado have asked to increase premiums by an average of 5.94 percent for 2019 in the Obamacare market, according to rate filings.
No insurers are leaving the exchange, and every county will have at least one health insurer offering coverage. The requested average premium increase for individual gold plans is 6.85 percent, and 12.3 percent for silver plans. For bronze plans, the requested average premium increase is 0.9 percent. Anthem’s filings requested a decrease in premium rates.
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The Trump administration’s drive to wean poor people from government benefits by making them work has been slowed by a federal judge framing a fundamental question: Are poverty programs meant to show tough love or to help the needy?
U.S. District Judge James E. Boasberg in Washington last week halted Kentucky’s first-in-the-nation experiment with Medicaid work requirements, ruling that the Trump administration glossed over potential coverage losses. He sent the state’s plan back to federal authorities for a harder look.
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The federal Centers for Medicare and Medicaid Services has approved Oklahoma’s Medicaid program for a first-in-the-nation drug pricing experiment that supporters say could save taxpayer dollars and provide patients with the most effective medications for their ailments.
Under the “value-based purchasing” program approved in late June, the state and a pharmaceutical company would agree to a set payment if its medication works as advertised, but only a fraction of that if the drug is not as effective as promised.
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A provision of Obamacare that opponents once saw as a potential loophole allowing a Republican president to unravel the law by executive order is now being used by some states to steady their shaky Obamacare markets.
Since the inception of Obamacare, “state innovation waivers,” which ostensibly provide states with some flexibility to experiment with different ways to provide healthcare for their residents, were eyed by those seeking to repeal the law. During the 2012 Republican presidential primaries, Mitt Romney repeatedly vowed that if elected, “On Day One I would issue an executive order paving the way for Obamacare waivers to all 50 states.” Early in the Trump administration, officials saw the waivers as a backup plan to ease Obamacare regulations if congressional repeal efforts were unsuccessful.
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Sen. Lydia Brasch of Bancroft and former Sen. Mark Christensen of Imperial filed a lawsuit Tuesday attempting to block Nebraska’s proposed Medicaid expansion initiative from reaching the general election ballot.
The lawsuit was filed in Lancaster County District Court after Medicaid expansion supporters completed a petition drive that appears to have gathered sufficient signatures to win a slot on the November ballot.
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The decision by Judge James Boasberg immediately blocked Kentucky from enacting the provision in Campbell County, which had been set to start Sunday and roll out statewide later this year.
Within 36 hours, Kentucky Gov. Matt Bevin, a Republican, eliminated vision and dental benefits to nearly 500,000 Medicaid enrollees, saying the state could no longer afford it.
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Despite receiving billions of dollars in taxpayer money, Medicaid insurers are lax in ferreting out fraud and neglect to tell states about unscrupulous medical providers, according to a federal report released Thursday.
The U.S. Health and Human Services’ inspector general’s office said a third of the health plans it examined had referred fewer than 10 cases each of suspected fraud or abuse to state Medicaid officials in 2015 for further investigation. Two insurers in the program, which serves low-income Americans, didn’t identify a single case all year, the report found.
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The expansion in coverage due to the Affordable Care Act (ACA) increased the number of insured Americans by 20 million. Although access to health insurance has expanded significantly in recent years, and the ACA instituted important protections for patients, those who gained insurance through ACA health insurance exchanges are being offered plans that make them bear an increasing portion of their healthcare costs since the law was implemented. Access to health insurance is not sufficient if patients cannot afford to purchase coverage or utilize their benefits due to high premiums, high out-of-pocket costs, limited networks, and insufficient state and federal patient protections.
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