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HEALTH ACTION NETWORK - ADVOCATES FOR BETTER HEALTH CARE SOLUTIONS

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This Week in Health Care Reform: January 5th, 2018

Congress reconvenes with a daunting ‘to do’ list; updated open enrollment figures are released; new drug approvals hit a 21-year high; and, how eliminating waste in our system can help bring down health care costs.

Week in Review

New Year Priorities: Lawmakers returned to Washington this week with a packed agenda.  In addition to averting a government shutdown, Congress must also come to an agreement on how to reauthorize funding for the Children’s Health Insurance Program, while also resolving next steps on insurance exchange market stabilization efforts.  With so much already on their plates, experts have a few suggestions for Congressional GOP leaders as they seek to chart their path forward on health care priorities.

Open Enrollment: Over the holiday break, the Centers for Medicare & Medicaid Services (CMS) released updated figures from the most recent open enrollment period.  Between November 1st and December 15th, 8.7 million Americans enrolled in plans offered through HealthCare.gov.  That number represented a slight revision from the previous tally of 8.8 million released earlier by CMS.  By way of comparison, last year, 9.2 million people signed up for coverage through the exchanges during open enrollment – but, it’s worth pointing out that last year’s open enrollment period was twice as long.  Also worth mentioning, seven states extended this year’s deadline to December 31st owing to inclement weather, including Florida and Texas.  CMS said it would put out its final report in March.

Rx Approvals:
Drugmakers kicked off the New Year much the same way they’ve operated the past few years – raising prices on their products.  While initial analysis shows that these increases generally remained within the 10 percent self-imposed limit manufacturers instituted in response to increasing consumer and political backlash, pharmaceutical companies wasted no time raising the prices on dozens of medicines.  Separately, drug approvals in the US hit a 21-year high last year, with 46 new medicines getting the green light in 2017 – more than double the previous year.  Many of those drugs were for rare diseases and sub-types of cancer, which are often targeted to small populations, so they already start off with price tags in the hundreds of thousands of dollars.  Of note, that tally does not include the first wave of cell and gene therapies, which were approved in 2017 under a separate category.

The Cost of Waste:
Focus continues to shift to the role that waste plays in driving up health care costs.  By one estimate, our health care system wastes as much as $765 billion a year – about a quarter of our overall spend.  To put that into context, eliminating that waste would mean insuring 150 million Americans.  In fact, saving just half of that amount would be enough to provide groceries for every household in America for a year.  With so much opportunity cost at stake, it’s hardly surprising that experts and stakeholders have turned their attention to addressing this issue.  Meanwhile, a separate analysis looks to explore why we spend so much more on health care in this country than other nations do.  Conducted by JAMA, the study determined that the majority of the growth seen in our health care spending over the past 20 years is attributable to an increase in care intensity (or, what’s done for patients during a hospital stay or a visit to the doctor), an uptick in what we’re being charged, or a combination of the two.      

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Spotlight

As we close the books on 2017, here’s a quick look back at what drove the health care debate last year.  Meanwhile, here’s what’s in store as we turn our attention to the New Year.
                                            
                                            

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