Amgen announced on Wednesday it is creating much lower pricing categories for its innovative biologic, Repatha, reducing the list price by 60%—from the current $14,600 to $5,850 a year. Patients who pay a share of the list price through co-insurance can see immediate savings. The company says it hopes that insurers will see the value of adjusting their formulary tiers to include the drug and make it more accessible and affordable to patients. The list price cut is a market-based approach that is much more likely to succeed in lowering drug prices while allowing investments in research for new innovative therapies to continue.
State proposals to allow residents who don’t qualify for Medicaid to buy into the program are gaining steam, but providers are concerned that could cut deep into state budgets, drive physicians out of Medicaid’s already-skimpier networks and shift more costs to the commercial insurance market.
Providers’ worries about state Medicaid buy-in options are similar to their unease over the “Medicare for all” plan pushed by Sen. Bernie Sanders (I-Vt.), which is gaining steam with progressive Democrats in Congress.
Many Republicans, who swept to recent electoral victories by vowing to topple the ACA, are urgently seeking to reassure voters they want to save these protections. Mr. Rohrabacher says he is “taking on both parties” in an effort to do so; his challenger says the congressman is “falling all over himself to scrub his records on health care.”
Such fights are leading to sometimes bitter races across the country involving the ACA, enacted in 2010 under President Obama.
The text of the Medicare for All bill specifies large and immediate reductions in payments to providers now treating patients under private insurance, cuts of more than 40% for hospitals and 30% for physicians, with these respective cuts growing more severe over time. We do not know the extent to which these cuts would disrupt the supply and timeliness of U.S. healthcare services. But without them, the costs of M4A would be substantially greater than $32.6 trillion in added federal costs over the first ten years.
For political professionals, one of the most bizarre aspects of this bizarre era is the speed at which Vermont socialist Sen. Bernie Sanders has gone from near irrelevance as the Senate’s resident kook to the most influential policy maker in one of America’s two major political parties. Now comes the moment when Democrats who have largely adopted Sanders positions may have to explain them to voters.
In practice, the Democratic Party’s so-called Medicare for All would really be Medicare for None. Under the Democrats’ plan, today’s Medicare would be forced to die. The Democrats’ plan also would mean the end of choice for seniors over their own health care decisions. Instead, Democrats would give total power and control over seniors’ health care decisions to the bureaucrats in Washington, D.C.
The Senate appears poised to vote soon on a Congressional Review Act resolution sponsored by Sen. Tammy Baldwin (D-WI) that would rescind the Trump administration’s final rule on “short-term limited duration insurance.” Nearly every Senate Democrat has cosponsored the Baldwin resolution because they believe it would protect consumers. It would do exactly the opposite.
When Republicans tried to repeal the 2010 health care law last year, Democrats knew they had an issue that would define this election cycle. A year and a half later, health care is still dominating Democratic messaging.
Take New York’s 19th District, which stretches where GOP freshman John J. Faso faces Democratic lawyer Antonio Delgado.
“Everywhere I travel across this district, and it’s big, there’s no doubt that health care is the most important issue on people’s minds,” Delgado said at a recent candidate forum here in the sprawling upstate district. “We’re in crisis.”
As Democrats enter the final sprint in a campaign where health care is a dominant issue and a House takeover seems achievable, they are split on whether to promise coverage for everyone, which would fuel an already revved-up liberal base, or target centrist voters by campaigning on the more modest goal of fixing the Obama-era health law.
Republicans are sending mixed messages on federalism. On “gag clauses,” all Republicans save two voted on Monday to intrude on states’ handling of pharmaceutical negotiations — even though a majority of states have passed legislation on this topic, including 15 just this year. And on “surprise billing,” Sen. Bill Cassidy — sponsor of the Graham-Cassidy legislation — apparently thinks states are smart enough to handle $1.2 trillion in Obamacare spending, yet are too stupid to craft policy regarding out-of-network medical bills.