We need to be smart about how we use public resources to respond to the coronavirus outbreak. Two major crises are facing the country right now: 1) the negative health impact and associated deaths from the virus, and 2) the enormous economic impact of large numbers of businesses and schools shutting down.
Congress needs to wisely allocate public resources to address both and not be distracted by long-held ideological pursuits. Many people are providing advice on how to best help businesses and workers weather the storm. For health care, it is crucial to recognize that this is a public health crisis and not an issue of longer-term health financing or coverage.
In his recent speech on health care, President Trump highlighted a proposed rule that hospitals make their prices public. It’s time for hospitals to comply. Transparency will likely lead to lower prices and a reduction in health care spending.
Many policy experts dismiss the importance of price transparency in health care. Skeptics argue that because health insurance insulates patients from prices, patients have little incentive to seek out the cheapest provider. These critics also cite studies showing that few patients use price transparency tools and that minimal savings result. On both these points, they are right. But their analysis is incomplete.
Sen. Mark Warner, D-Va., authored the resolution, which would curtail an administration initiative that was the driving force behind the first-ever reduction in average Obamacare premiums: the authority to grant states waivers from certain regulatory requirements in the Affordable Care Act.
The Trump administration’s assault on e-cigarettes is the latest move by the White House to salvage Donald Trump’s health care agenda ahead of the 2020 elections.
Turning away from the bitter Obamacare debates that have been a disaster for Republicans, Trump’s been building his disease-by-disease agenda all year, aimed at suburban voters who may be put off by the Democrats’ left turn on health care.
His 2020 campaign strategists say this is all intentional. Polls show that health care is a top issue for swing voters, but Democrats currently have the edge and Obamacare is polling at all-time highs.
Trump promised in this year’s State of the Union address to wipe out HIV transmission in the United States in a decade. At campaign rallies since then, he’s promised to lower drug costs, end the opioid epidemic and even cure childhood cancer. He’s rolled out a plan to overhaul kidney care for hundreds of thousands of Americans on dialysis and waiting for life-saving transplants. And now he’s taking on the rapidly worsening epidemic of youth vaping.
Far from proving charges that the administration has “sabotaged” Obamacare, new Census Bureau dataprovide compelling support for the president’s actions.
New numbers released this week show a sizable increase in the number of Americans without health insurance—from 26 million in 2017 to 28 million in 2018.
Democrats were quick to argue the Trump administration is sabotaging Obamacare. The truth is that the Trump administration is working aggressively to increase options for consumers to get more affordable, flexible insurance coverage, as Brian explains in his new paper, through:
- Short-term, limited-duration plans
- Health Reimbursement Arrangements
- Association Health Plans (which Democrats have sued to block)
- Flexibility for states to do a better job of helping those with pre-existing conditions, and other actions.
The latest annual Medicare trustees report highlights the program’s growing fiscal challenge and reflects policymakers’ ongoing failure to prepare Medicare for the future. Medicare’s Hospital Insurance trust fund becomes insolvent in 2026, but the program is already in trouble from a budget perspective. More than $300 billion in general tax revenue was needed in 2018 to help fund $740 billion in Medicare spending. Bipartisan legislation will be needed to put the program on a sound basis for future generations. One starting point could be proposals advanced in the president’s budget and other reforms to improve the functioning of traditional fee-for-service Medicare. Adopting premium support, which converts the current uncapped subsidy to a defined contribution, would eliminate the fee-for-service incentives that drive up spending unnecessarily. Such a reform is controversial but less dramatic than many think.
Responding to popular anxiety over prescription drug prices, the Senate Finance Committee last month approved a bill to restructure the Medicare prescription drug benefit.
The bill is part of broader congressional and administration efforts to address rising health care costs, one in which lawmakers are laying aside partisan differences to seek constructive solutions.
The committee is proposing amendments to the Medicare Part D program, which was created in 2003 and requires modifications to address the changing nature of the prescription drug marketplace.
The Prescription Drug Pricing Reduction Act contains a mix of good and bad ideas for amending the program, which relies on choice and competition to provide prescription drug coverage to 47 million seniors. Medicare Part D is widely popular with beneficiaries and has cost taxpayers far less than initially estimated.
The bill’s good ideas include reworking how the program pays for the costliest drugs, relieving taxpayers of some of these costs, and requiring private prescription drug plans and pharmaceutical companies to assume a greater burden.
The worst idea is one that would introduce federal price regulation into the Medicare Part D program. More on that in a bit. First a look at how the bill proposes to restructure Medicare Part D benefits.
Last December, the Trump Administration redesigned and set a new direction for the Shared Savings Program, which is Medicare’s main program for Accountable Care Organizations (ACOs) under “Pathways to Success.” Data on ACO performance in the program the first six performance years showed that, over time, those ACOs taking accountability for cost increases, or “risk,” performed better than those that did not. In fact, ACOs that did not take accountability for cost increases and only shared in savings nominally increased Medicare spending relative to their cost targets. The agency also found that ACOs led by physicians (which tend to be “low revenue” ACOs since they provide mostly outpatient services) performed better than ACOs led by hospital systems (which tend to be “high revenue” ACOs since they provide inpatient and outpatient services).
Hospitals would have to disclose the discounted prices they negotiate with insurance companies under a Trump administration rule that could upend the $1 trillion hospital industry by revealing rates long guarded as trade secrets. Hospitals that fail to share the discounted prices in an online form could be fined up to $300 a day, according to the proposal. The price-disclosure requirements would cover all the more than 6,000 hospitals that accept Medicare, as well as some others, and is likely to face fierce industry opposition.
Millions of Americans in high-deductible health plans associated with HSAs may find it easier to access insulin, inhalers and other treatments for chronic health problems under guidance released last week by the Trump administration. Currently, people in high-deductible plans with pretax health-savings accounts have to pay down their deductible before their insurance covers treatment for chronic diseases such as diabetes or high blood pressure. The rule change will allow insurers to begin providing coverage for those treatments, such as glucose or blood-pressure monitors, before the deductible is paid.