This Week in Health Care Reform - May 30th, 2014
A pair of groups looks to harness the collective power of their members on a pair of priority issues; premium ‘sticker shock’ looks less likely in the near term; public opinion of the health care law casts an ominous shadow over the campaign trail; and, the health insurance tax continues to wreak havoc.
Health Care Reform
Campaign for Sustainable Rx Pricing: It’s becoming increasingly difficult to turn on the news or visit a website and not find a story about hepatitis C, or, perhaps more accurately, the rising cost of specialty drugs. At issue, the $1,000-a-pill price tag attached to Gilead Sciences’ breakthrough new drug, Sovaldi, which has shown itself to be as close to a cure as we’ve seen for the liver-damaging disease. Still, high prices for specialty drugs are nothing new. But, those treatments are usually targeted to relatively small populations. What sets Sovaldi apart is that more than 3 million Americans are afflicted with hepatitis C. As the full course of treatment for Sovaldi runs 12-weeks, that pegs the cost of treating the typical hepatitis C patient at $84,000. Extrapolated further, across the entirety of the population suffering from the disease, and you start to understand why stakeholders across the health care industry are beginning to get uncomfortable. Last week, at a forum hosted by The Atlantic on the future of medicine, this topic was addressed at length by representatives from the insurance industry, provider and patient groups, and even pharmaceutical companies. And, just this week, a new campaign was launched to address the rising costs of prescription drugs and the exigent threat they pose to, both, the health care industry and future innovation. Organized by the National Coalition on Health Care (NCHC), a group consisting of more than 80 employers, public health organizations, pharmacy benefit managers, and the AARP, the Campaign for Sustainable Rx Pricing was formed to encourage a “national dialogue” on, not only the cost of Sovaldi, but the numerous new specialty drugs already in the pipeline for other conditions affecting millions more Americans. Be sure to visit their website to learn the facts and keep up with the latest developments.
Alliance for Connected Care: As technological advances have enhanced how we interact with our everyday world, it’s hard to deny that our ability to connect with each other in new and ever-more convenient ways is at the heart of these innovations. That’s become increasingly true across every industry, whether we’re paying bills, booking a vacation, or sharing photos of our dinner. So, it should come as no surprise that the practice of care delivery is undergoing a similar evolution. To label our health care system as ‘labyrinthine’ would be putting it mildly. However, the benefits of leveraging technologies in the doctor-patient transaction are already producing results. From modernizing the logistics of health care data to the utilization of technology-based interventions in the development of treatment plans for chronic care, telemedicine represents a paradigmatic step forward in the delivery of health care. Nevertheless, barriers still exist to the widespread adoption of telehealth. But, a growing chorus of voices are advocating on behalf of the promise offered by virtual medical care. One of those groups, the Alliance for Connected Care, is led by a triumvirate of former U.S. Senators, Tom Daschle (D-South Dakota), Trent Lott (R-Mississippi), and John Breaux (D-Louisiana), who have each seen and deeply understand the impact that geographic and economic limitations can have on patients’ access to health care. Last week, the group sponsored a conference on Capitol Hill to educate lawmakers on telemedicine and urge that they adopt policies to accommodate its proliferation. As has been covered in previous newsletters, the Federation of State Medical Boards (FSMB) recently ratified a governing set of telehealth principles at its annual conference. Those principles are meant to serve as an example to states, many of which still prohibit physicians from treating patients or prescribing medicine without an in-person visit. A separate group, the Health IT Now coalition, continues to urge states to adapt to the changing needs of their patient-constituencies and the advancements ushered in by digital technology to their care.
Premium Focus: With health plans already submitting their rates for 2015, many were predicting varying degrees of ‘sticker shock’ as these filings were made public. But, recent reports, in combination with repeated statements from industry executives, would seem to fly in the face of any fears of skyrocketing premiums. Given the (eventual) enrollment successes seen on the insurance exchange marketplaces, more health plans are expected to expand into new markets next year, meaning more robust competition. That’s not to say, however, that there won’t be any sharp increases. It’s just that those might be more common in less competitive markets. Meanwhile, some predict that the real test for premiums under the Affordable Care Act won’t come until 2017, when enrollment in individual plans is expected to drop precipitously. Regardless, given the complexity of factors making up these calculations, it’s clear that the only thing we can be sure of is that premiums will continue to go up – whether that’s because of, or in spite of, the health care law remains up for discussion.
ACA Sentiment: So, now that Americans have had a few months to take the Affordable Care Act out for a spin, what do they really think about the health care law? Well, according to the polling data, generally speaking, the majority of them have yet to warm to life under its sweeping reach. In fact, one recent survey found that more than 7-out-of-10 Americans thinks the Affordable Care Act has either had a negative effect on the country or no impact at all. Almost contradictorily, though, separate polling indicates that the majority of those surveyed are in favor of keeping the law as is or with slight modifications. How, or even whether, this seemingly diametrically opposed public sentiment manifests itself come November, remains to be seen. But, both Republicans and Democrats seem determined to divine their respective midterm election playbooks from these confusing tea leaves.
HIT Impact: We already know how the Affordable Care Act’s newly imposed health insurance tax (HIT) is impacting families, small businesses, and seniors. (The last newsletter touched on the recently released report from the National Federation of Independent Business (NFIB) which estimated up to 286,000 job losses by 2023 as a result of the HIT.) Now a new letter to lawmakers looks to add another group to the growing list of victims left in the HIT’s wake. Sent to members of the Senate Finance Committee last week, that letter, submitted on behalf of Medicaid Health Plans of America (MHPA), argues that the harmful new tax drains much-needed funds from already distressed state Medicaid budgets. Given that these programs serve some of the country’s poorest and neediest citizens, any siphoning off of funding from Medicaid leaves an already vulnerable population even more exposed. MHPA closes its letter by encouraging members of the Committee to support repeal or, at least, a two-year delay of the HIT, both being proposed pieces of legislation in the Senate. To learn more about the issue, visit the Affordable Coverage Project or the Stop the HIT homepages.
Return to archives...
We encourage you to stay involved as implementation efforts surrounding health care reform progress. Visit the Health Action Network and be sure to let us know what's on your mind.
Now that the Affordable Care Act has moved out of the realm of the conceptual and into the actual, some unexpected effects of the health care law are already being experienced.
You can keep up with the latest by following the Health Action Network on Twitter and by liking us on Facebook.