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This Week in Health Care Reform - August 21st, 2015

As more Americans find themselves struggling to afford their medicines, a growing majority wants the government to do something about it; despite growing division amongst its ranks, the GOP stands firm in its opposition to the health care law; and, experts caution that an impending change could upend the small group market.


Week in Review

The Cost of Rx: Prescription drug prices continue to send shockwaves across the health care landscape.  As more groundbreaking drugs – aimed at treating everything from heart disease to cancer to diabetes to hepatitis C – make their way to market, the high costs they bring with them raise some serious ethical and moral questions.  And, while it’s not just consumers that are feeling the impacts of this oversized and growing burden, more Americans find themselves having to make some tough choices in order to pay for the medicines they need.  In fact, a new Consumer Reports survey found that one-third of Americans routinely taking prescription drugs, face an average hike of $40 for an order of those medicines, prompting many to cut back on other expenses in order to afford them.  Unsurprisingly, the issue has found increased traction with the public at-large, as reported in the latest Kaiser Family Foundation poll.  Regardless of party affiliation, the majority of Americans strongly support government intervention in controlling runaway prescription drug prices.  Overall, 72 percent of respondents felt that the cost of medications is unreasonable, demanding greater transparency in how pharmaceutical companies set their prices (86 percent). 

GOP Committed:
With the public’s attention turning to more pressing health care matters (see above), the first cracks are beginning to appear in Republicans’ long-standing platform of repealing and replacing the health care law.  With signs of division threatening to undermine their larger agenda, GOP lawmakers have taken to the airwaves, reaffirming their full commitment to seeing the law rolled back.  Republican Presidential hopefuls also find themselves struggling to find that messaging sweet spot, acknowledging how unpopular the Affordable Care Act remains among primary voters, while recognizing how difficult it would be to unravel the benefits that the law has already bestowed upon millions of Americans.

Small Group Expansion Delay:
As has been covered in previous newsletters, a looming provision of the health care law threatens to severely disrupt a significant portion of the health insurance market.  That provision, which would redefine the small group insurance market to include businesses with 51 to 100 employees, would place upward pressure on premiums – leading to higher costs for many businesses – by removing the flexibility that allows insurers to structure products to mid-sized employers that better match their benefits needs.  Experts continue to raise the warning flag over how the impending change would hurt these businesses.  Luckily, lawmakers have taken heed, with bipartisan legislation having been introduced in both the U.S. House of Representatives and U.S. Senate that would enable states to maintain their current definition of the small group market, thereby maintaining insurers’ flexibility to be able to continue to tailor benefit packages to the needs of their mid-sized business customers.

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