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This Week in Health Care Reform: October 27th, 2017

Cost-sharing reduction subsidies find themselves the focus of legislative and litigious energies; states begin to consider short-term fixes as they prepare for CHIP funding shortfalls; and, the rise in cancer drug prices is shown to outpace inflation.

Week in Review

CSR Focus: As highlighted in the previous newsletter, last week Senate HELP Committee leaders offered up the outlines of a legislative package aimed at stabilizing the health insurance exchange marketplaces.  Despite their efforts to find enough common ground to attract bipartisan support, their proposal was met with no small amount of skepticism, such that, this week, a more conservative approach was advanced by Republicans.  Outlined by Senate Finance Committee Chairman Orrin Hatch (R-Utah) and House Ways and Means Committee Chairman Kevin Brady (R-Texas), that proposal, while still funding cost-sharing reduction (CSR) subsidy payments for two years, departs from its bipartisan legislative precursor by temporarily repealing the Affordable Care Act’s individual and employer mandates.  Separately, late Wednesday a federal court struck down an emergency motion in the case brought by 18 state Attorneys General and the District of Columbia seeking to force the Administration to continue making CSR payments, which it had announced it was no longer going to do.

CHIP Fixes:
With funding for the Children’s Health Insurance Program (CHIP) having expired at the end of last month, stakeholders have begun exploring stop-gap measures that they can employ in lieu of Congress reauthorizing funding in the immediate.  While states haven’t yet been forced to pare back coverage for children from low-income families who earn too much to qualify for Medicaid, there’s growing concern that some may be forced to.  Meanwhile, lawmakers have proposed to extend funding for CHIP for five years, though disagreements over how exactly that would be paid for threaten to push legislative activity to the end of the year.

Cancer Drug Prices:
According to a new study, the prices for some cancer drugs – some more than 20 years old – are rising at a rate that far exceeds inflation.  Published in the Journal of Clinical Oncology, the study examined 24 injectable cancer drugs approved between 1996 and 2012 and found that, on average, those drugs experienced an increase of 18 percent.  Additionally, researchers discovered that, unlike any other product, those increases were unaffected by additional competition.  Even older drugs were shown to have undergone dramatic price increases, some by as much as 55 percent.  In framing the alarming results of the analysis against the ongoing efforts to address rising drug prices, one expert was quick to point out that, “Cancer medications are some of the most expensive medications, particularly when they’re first launched.  To see the price increase even after the launch is a significant addition to the conversation.”      

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