Gregg's Top Three Health Policy Articles

If you can only read three things about health policy this week, I suggest...

The Top Three...

The New York Times: Congress Passes Short-Term Spending Bill To Avert A Shutdown Congress on Wednesday gave final approval to a short-term spending bill to avert a government shutdown just ahead of the November elections, sending the legislation to President Biden’s desk but punting a bigger funding fight to the end of the year. In a pair of votes in quick succession, lawmakers in both chambers overwhelmingly voted to pass the measure to keep federal funding flowing through Dec. 20. The Senate vote was 78 to 18. All the “no” votes were Republicans. Mr. Biden is expected to sign the legislation before the Sept. 30 deadline. (Edmondson, 9/25)

The Washington Post: Democrats To Unveil ACA Tax Credit Plan, Teeing Up Next Health-Care Fight Democrats on Wednesday launched a legislative push to extend federal subsidies that defray the cost of health insurance for millions of Americans. The effort tees up another Affordable Care Act fight that could stretch into next year — and perhaps challenge the next president. Sens. Jeanne Shaheen (D-N.H.) and Tammy Baldwin (D-Wis.) introduced legislation to make permanent tax credits that lower the cost of plans sold through the Affordable Care Act. Rep. Lauren Underwood (D-Ill.), who helped craft the initial legislation to create the expanded tax credits almost four years ago, introduced companion legislation in the House. Senate Majority Leader Charles E. Schumer (D-N.Y.) and House Minority Whip Katherine Clark (D-Mass.) joined Shaheen and Underwood at a news conference to unveil the legislation Wednesday. (Diamond, 9/25)

The New York Times: F.T.C. Accuses Drug Middlemen Of Inflating Insulin Prices
The Federal Trade Commission said on Friday that it had taken legal action against the three largest pharmacy benefit managers, accusing the drug middlemen of inflating insulin prices and steering patients toward higher-cost insulin products to increase their profits. The legal action targets CVS Health’s Caremark, Cigna’s Express Scripts and UnitedHealth’s Optum Rx and subsidiaries they’ve created to handle drug negotiations, agency officials said. The three collectively control 80 percent of prescriptions in the United States. (Abelson and Robbins, 9/20)

For a Deeper Dive...

Modern Healthcare: Cybersecurity Bill Would Set Industry Standards, Penalties
Senate lawmakers rolled out a bill Thursday to set cybersecurity standards in healthcare, promising financial assistance for hospitals to upgrade technology and penalties for organizations that don't measure up. The bill would also toughen standards for companies of "systemic importance" such as UnitedHealth Group's Change Healthcare, which sparked a months long collapse of payment and billing systems when it fell victim to a ransomware hack earlier this year. (McAuliff, 9/26)

Modern Healthcare: Medicare Promoting ‘Age-Friendly’ Hospitals in Quality Push.  Medicare will begin compensating hospitals for providing quality data to support "age-friendly" medical care as the government seeks to bolster private sector efforts to adapt to the aging population. Starting in January, hospitals will report on a slew of measures to assess whether they are improving care for older patients in emergency departments, operating rooms and other settings. The Centers for Medicare and Medicaid Services laid out the new policy in the Medicare Inpatient Prospective Payment System final rule for fiscal 2025, which it published last month. (Early, 9/25)

Axios: Ending ACA Subsidies Could Affect 2 Million Chronically Ill A decision by Congress to let enhanced Affordable Care Act subsidies expire next year could leave 2 million people with chronic conditions uninsured, a new analysis from consulting firm Oliver Wyman shows. Democrats on Wednesday introduced legislation to permanently extend the aid — a long shot, considering it would increase the deficit by $335 billion over a decade. But a short-term extension could be in the cards, especially if one party doesn't control the White House and Congress. (Reed, 9/26)

KFF Health News: KFF Health News' 'What The Health?': Congress Punts To A Looming Lame-Duck Session Congress left Washington for the campaign trail this week, but not before approving a spending bill that expires shortly before Christmas. Lawmakers will be busy after the election working on not just the legislation needed to keep the government running, but also several health programs set to expire. Meanwhile, Republicans continue to downplay abortion as Democrats press it as a campaign issue. (Rovner, 9/26)

Modern Healthcare: Medicare Advantage Overpayments Highlighted In OIG Reports Three health insurance companies overcharged taxpayers by more than $140 million combined by exaggerating the severity of Medicare Advantage members' illnesses, according to reports the Health and Human Services Department Office of Inspector General published Thursday. Humana, HealthAssurance Pennsylvania — a unit of CVS Health subsidiary Aetna — and EmblemHealth deny the accusations and reject the OIG's recommendations that the Centers for Medicare and Medicaid Services recoup a portion of the alleged overpayments. (Early, 9/26)

Roll Call: On Campaign Trail, Vance Lays Out ‘Concept Of A Plan’ For Health Care
J.D. Vance’s comments, made over the last week, have added some details to Republican presidential nominee Donald Trump’s assertion during the Sept. 10 presidential debate that he had a “concept of a plan” to reform the Obama-era health exchanges. “We’re going to actually implement some regulatory reform in the health care system that allows people to choose a health care plan that works for them,” Vance said at a campaign rally last week in Raleigh, N.C., adding that people who use the health care system frequently would be on a different plan from those who are healthy and don’t go to the doctor as often. (Cohen and Raman, 9/26)

Stat: Epic Systems Sued Over Dominance In EHR Software Market The health data company Particle Health has filed an antitrust lawsuit against Epic Systems, alleging that the electronic health record vendor has used its control of patient data to thwart competition and undermine its business. (Ross, 9/23)

For the Visual Among Us...

A few years ago I started a weekly e-mail for friends and colleagues who want to keep up on major federal health policy developments but did not have time to plod through all the minutiae--they were busy doing important things like running organizations and taking care of patients! Much to my surprise, it became pretty popular. I have now converted to a weekly newsletter format so you can manage your own subscription preferences and forward to others that might be interested.

These summaries represent my judgement on health policy issues that may not on the front pages, but are relevant to clinicians, administrators, and educators. I monitor many news sources and clipping services to identify content for this newsletter and I try hard to be as factual, balanced, and non-partisan as possible. While the articles are written by others (with credit attributed), the choice of what to include is entirely mine. If you are interested in receiving a daily summary of health policy news, you might consider signing up for the KHN Morning Briefing. If you enjoy podcasts, I suggest What the Health? and Tradeoffs.

-Gregg S. Margolis, PhD