The Department of Veterans Affairs on Thursday will begin allowing a broad section of its nine million enrollees to seek medical care outside of traditional V.A. hospitals, the biggest shift in the American health care system since the passage of the Affordable Care Act nearly a decade ago.

While department officials say they are ready, veterans groups and lawmakers on Capitol Hill have expressed concerns about the V.A., which has been dogged for years by problems with its computer systems. They worry that the department is not fully prepared to begin its new policy, which Congress adopted last year to streamline and expand the way veterans get care.

The Medicaid Drug Rebate Program (MDRP) was created by Congress nearly 30 years ago. It requires drug manufacturers to pay a rebate for all out-patient drugs dispensed to Medicaid beneficiaries. The percentage for this rebate varies by type of drug, with brand-name drugs requiring the greatest rebate and generics the least. In addition, the rebate must rise until it ensures that the net (of rebate) price of the drug matches the best price available to anyone in the private market. (MDRP is often referred to as the Medicaid “best price” policy.) Finally, there is an inflation penalty — an additional rebate equal to the amount by which the price increase exceeds the rate of inflation, measured by the Consumer Price Index for All Urban Consumers (CPI-U).

 

Two efforts are underway in the Senate to compile bipartisan packages aimed at lowering and bringing transparency to health care costs, with the goal of merging them on the Senate floor this summer:

  • Senate Finance Committee Chairman Chuck Grassley (R-IA) and his Democrat counterpart, Ron Wyden (D-OR), are poised to release a drug pricing proposal by the end of the month.
  • The other top health care committee — Health, Education, Labor and Pensions — is preparing for a hearing on a health care pricing package recently released by its leaders, Chairman Lamar Alexander R-TN) and Patty Murray (D-WA).

Neither package will include one singular big thing to lower health care costs for consumers. Instead, they’ll be full of smaller proposals that legislators say together could help move the needle on prices.

President Trump is expected to issue an executive order soon that could require insurers and hospitals to disclose the prices they’ve negotiated for various services. He hopes such transparency will increase competition and drive down health spending.

The health care industry is less supportive. The nation’s top health insurance lobby, for instance, claims the president’s plan is “bad transparency” that could actually cause prices to go up.

Last year I published a study with the Mercatus Center projecting that enacting Medicare for All (M4A) would add at least $32.6 trillion to federal budget costs over the first 10 years. After the study was published, some advocates misattributed a finding to it, specifically that M4A would lower national healthcare costs by $2 trillion over that same time period. This misattribution has since been repeated in various press reports. Multiple fact-checking sites have pointed out that the study contains no such finding, as did a follow-up piece I published with e21 last year. However, because the mistake continues to appear occasionally, this article provides additional detail about how and why it is wrong.

Medicare Advantage (MA) and Part D applications were up 87% during the open enrollment period between January and March compared to the same period last year, according to a new report from eHealth.

The report looks at the costs and reactions from enrollees of Medicare’s latest open enrollment period. During the first three months of this year, the average MA premium dropped 33% from $12 to $8 from 2018, and average out-of-pocket limits decreased 11%. The average monthly premium for Part D coverage decreased during this time as well from $26 to $25.

Hospitals in Lithuania are to start advertising cheap operations to patients in the UK because of a surge in demand on the back of the NHS crisis. Health Tourism Lithuania claims it has been inundated with enquiries from Britons frustrated at having to wait months for routine treatment.

The body has now revealed that, from next month, it will target patients across the home nations with Facebook and Google adverts. NHS data revealed a total of 4.23million people in England were waiting for hospital treatment in March – the longest the waiting list has ever been.

More than 1 in 4 Americans say they or a family member went without needed health care in the past two years because they felt they could not afford it, according to a new poll.

The survey from Monmouth University released Monday finds that 27 percent of adults say they or a member of their household have avoided necessary medical care in the past two years because of cost. That figure is down slightly from 2017, when 31 percent said they had skipped care.

The era of annual eye-popping Obamacare rate hikes appears to be over.

Premium increases in the law’s marketplaces are on track to be relatively modest for the second straight year, according to the first batch of 2020 rates proposed by insurers. The rate filings are an early indication that this year’s small rate hikes weren’t a fluke and that other Trump administration policies — including support for a lawsuit that could torch the Affordable Care Act — have proven less disruptive than some experts feared.

Nine years after Democrats passed the Affordable Care Act and more than a year after Republicans failed in their effort to repeal it, health care promises once again to be a major issue in the 2020 elections.

Drug costs are rising, as are insurance premiums. Rural hospitals are closing. Even as an estimated 20 million people have gained coverage under the ACA, widely known as Obamacare, nearly 30 million people remain uninsured. Surveys consistently find that Americans see the health-care system as broken.

Americans cited health care as the top issue for the federal government to address, ahead of the economy, immigration, national security and other issues, Wall Street Journal/NBC News polling found this month.

The financial burden of health care was of particular concern for American families, according to a new Gallup poll released last week, trumping worries linked to wages, college expenses, housing and taxes.