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This Week in Health Care Reform: December 7th, 2018

With the clock ticking down on the current legislative session, advocates rally to delay the return of a harmful tax; Medicaid continues to demonstrate its critical role in connecting vulnerable beneficiaries to the care they need; a deep dive on health care costs provides valuable insights on what’s really driving spending; and, access to in-home support is expanded for Medicare Advantage beneficiaries.

Week in Review

HIT Call-to-Action: As has been recently covered, advocates continue to direct their concerted energies towards pressuring federal lawmakers to protect consumers from the threat of rising health care costs posed by the reimplementation of the universally unpopular health insurance tax (HIT).  Though suspended for next year, the HIT’s return in 2020 is projected to add $16 billion to the costs of health care coverage for millions of vulnerable American families, small businesses, and seniors.  In fact, expert analysis goes on to establish that for every dollar exacted by the HIT, premiums go up by $1.27.  With the window closing on the current lame duck session, a small group of bipartisan senators is urging leadership to include an extension of the HIT delay before they wrap up.  Already this year, hundreds of you, our Health Action Network members, have sent letters of your own to your federal elected officials asking them to protect consumers from the return of the HIT.  We’re making one last push to make sure lawmakers hear from as many voices as possible – be sure to TAKE ACTION today!

Medicaid Value: Despite detractors’ continued opposition to Medicaid expansion, a growing body of research has established that beneficiaries, particularly those with chronic conditions, have far better outcomes than uninsured individuals.  Patients suffering from asthma, diabetes, or mental health issues, are able to access critical interventions that those without coverage aren’t able to receive.  And, not to be overlooked, apart from the improved health outcomes, Medicaid has also been shown to help hospitals and other practices better control costs.

Spending Drivers: While spending on prescription drugs has justifiably consumed much of the oxygen regarding larger spending trends in the health care space, a recent analysis of where our health care dollars are actually spent points to a different culprit.  That’s not to say that we’re not spending a lot of money on drugs – the research indicates that about 10 percent of all health care spending goes to medicines.  However, what the analysis shows is that we, in fact, spend a lot more on hospital care and visits to the doctor.  And, a quick scan of recent headlines quickly reinforces that point, whether it’s astronomical prices for air ambulance services, $48,000 for allergy tests, or the persistent murkiness surrounding hospital prices that results in wild price variations across local jurisdictions

In-Home Support:
Last month, new rules were announced expanding services for some Medicare beneficiaries.  Starting next year, seniors enrolled in Medicare Advantage plans will have access to additional in-home support services, such as help with chores and safety devices.  The rules reflect the growing recognition that not only does the upfront investment in the expansion of these services have a meaningful impact in the lives of patients, but that it can reduce costs for taxpayers, too.  The change will be rolled out slowly, with these services being offered by Medicare Advantage plans in 20 states next year, with plans to gradually expand to more states and, possibly, traditional fee-for-service Medicare.  Until then, it’s estimated that approximately 780,000 beneficiaries will be able to access these new benefits.     

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