Virginia is facing a huge bill for unexpected Medicaid costs that hamper proposed new spending on things like school improvements or tax breaks for the poor. State officials said Friday that Virginia has about $460 million in unforeseen Medicaid costs. Secretary of Finance Aubrey Layne said much of the new costs stem from faulty forecasts overestimating the benefits of having private health insurers cover a greater number of some of the state’s more costly Medicaid recipients. Another reason for the increase is a higher-than-expected enrollment of children in the state’s Medicaid program, he said.

Many Democrats have embraced “Medicare for All,” but there’s a big variation in the policies they propose under that banner. This poll asked respondents two related questions—what they think candidates mean by “Medicare for All,” and what they want that policy to mean, if they support it at all. Overall, just 52% of those surveyed said they think “Medicare for All” refers to a single, government-run health care program covering everyone. Voters were more divided over what they want “Medicare for All” to be: 34% said they would favor a single-payer system; 33% said they would prefer an optional public plan alongside private insurance; 30% wanted neither. This poll shows that Medicare for All has different meanings to different people.

President Trump’s administration says on average prices for 2019 are 1.5% lower than they were last year on the federal health exchange. After years of double-digit price hikes on exchange plans, health insurers are starting to turn a profit on the ACA exchanges. For 2019, there are more carriers getting back into the market and offering new plan options. The Trump administration extended the length of cheaper, short-term plans with fewer benefits to provide up to 12 months of coverage. Some analysts predict those cheaper plans could attract healthier members.

CMS has issued a proposed regulation that makes smaller changes to the standards states meet when running their Medicaid plans. The proposed rule would give states some new flexibility in setting rates for their managed care plans and ensuring insurance companies have adequate provider networks. The CMS worked with Medicaid directors to develop the proposal. “Today’s action fulfills one of my earliest commitments to reset and restore the federal-state relationship, while at the same time modernizing the program to deliver better outcomes for the people we serve,” CMS Administrator Seema Verma said in a statement.

President Trump’s Department of Health and Human Services recently announced welcome new guidance to states looking to improve their health care and health insurance systems through “state innovation waivers” under Section 1332 of the ACA. The new guidance gives states significantly more flexibility to devise creative solutions to meet the health care and insurance needs of their constituents and it builds upon new community engagement waivers that made Medicaid more flexible for states earlier this year. Section 1332 allows states to experiment and creatively tailor their health care coverage programs under certain conditions.

The midterm elections abruptly shifted the health-care landscape across the country, resulting in a divided Congress that could mean most changes unfold on the state level. Health care was the No. 1 issue among voters this election, according to an AP survey of about 90,000 people. The voting results suggested a rebuke to repeated Republican efforts to roll back the health law, and that many Americans care deeply about issues such as coverage for pre-existing medical conditions. The split between red and blue states means that statehouses will continue to pursue opposite directions in health care. Voters approved Democratic-backed ballot initiatives to expand Medicaid in three states—Idaho, Utah and Nebraska—while rejecting a similar proposal in Montana.

Remember when Democrats promised that if you liked your plan or your doctor you could keep them? Now they’re pushing another bogus claim, accusing Republicans of wanting to take away health insurance protections for people with pre-existing conditions. Here’s the truth: everyone — Republicans and Democrats — support protecting people with pre-existing conditions.

 

Late last week, President Trump and Health and Human Services Secretary Alex Azar announced a plan to deal with the high cost of prescription drugs in the U.S. relative to the price of the same drugs in other developed countries. The reason for this disparity is well-known: Other countries impose socialized medicine price controls on prescription medicines, while here in the U.S. the price charged is closer to the true market price of the product.

HHS wants to cancel its plans to postpone imposing new ceiling prices for the 340B drug discount program. The agency issued a proposed rulemaking on Wednesday that suggested the long-delayed rule will now be effective Jan. 1, instead of July 1, 2019, as originally announced earlier this year.

HHS has delayed the effective date of the ceiling price rule five times, which would cap the prices drugmakers can charge hospitals that participate in 340B. The American Hospital Association and several other medical trade groups sued the agency last fall to force it to publish the delayed regulations.

Between the election campaign and incidents of terrorism ranging from attempted bombings to a synagogue shooting, an obscure regulatory proposal by the Trump administration has yet to captivate the public’s attention. However, it has the potential to change the way millions of Americans obtain health insurance.