Gregg's Top Three Health Policy Articles

Health policy impacts everyone, but it can be hard to know what is important. If you can only read three things about health policy this week, I suggest...

The Top Three...

Modern Healthcare: 20M Fewer Medicaid Enrollees Means Trouble For Providers Over the past year, states have removed more than 20 million beneficiaries from Medicaid after suspending eligibility redeterminations during the COVID-19 public health emergency. Thousands of those people are Clinica Family Health patients. The Lafayette, Colorado-based community health center felt the pain of lost reimbursements when patients went from having Medicaid coverage to being uninsured, a fate that has befallen almost one-fourth of these former Medicaid enrollees nationwide, according to KFF. (Tepper, 4/23)

McKnight's Long-Term Care News: Providers: Staffing Rule A CMS ‘Fairy Tale’ That Will ‘Exacerbate’ Nursing Home Access Issue Despite minor concessions in a nursing home staffing mandate issued Monday, many providers were stunned by federal regulators’ intractable stance on minimums at a time when nearly all US facilities are confronting labor shortages. ... “RNs are leaving the workforce, leaving the profession and those who are working typically choose to work in environments that are not long-term care,” LeadingAge President and CEO Katie Smith Sloan said in a statement late Monday. “The final rule does not include additional funds to pay RNs comparable or higher wages to work in long-term care.” She noted that this element alone will require an additional 3,267 additional nursing home RNs. “How can providers hire more RNs when they do not exist?” (Marselas, 4/23)

Modern Healthcare: Medicaid Managed Care Rules Aim To Increase Transparency Regulators enacted a pair of wide-reaching rules on Monday intended to increase transparency and improve the patient experience for the more than 80 million enrollees in Medicaid managed care plans. The Centers for Medicare and Medicaid Services will require states and Medicaid insurers to annually report how carriers spend state-directed payments to providers, how their rates compare to Medicare, and survey managed care enrollees about their experience with insurance companies. (Tepper, 4/22)

For a Deeper Dive...

KFF Health News: FTC Chief Says Tech Advancements Risk Health Care Price Fixing New technologies are making it easier for companies to fix prices and discriminate against individual consumers, the Biden administration’s top consumer watchdog said Tuesday. Algorithms make it possible for companies to fix prices without explicitly coordinating with one another, posing a new test for regulators policing the market, said Lina Khan, chair of the Federal Trade Commission, during a media event hosted by KFF. “I think we could be entering a somewhat novel era of pricing,” Khan told reporters. (Rovner and Hilzenrath, 4/23)

Stat: Trump Surrogates Hint At How He Could Reshape U.S. Health Care Policy Seven months before the presidential election, Donald Trump’s health care priorities remain fuzzy at best. But one thing is certain: A second Trump administration would put its own stamp on a host of critical issues that are top of mind for voters. (Owermohle, 4/23)

AP: New California Rule Aims To Limit Health Care Cost Increases To 3% Annually Doctors, hospitals and health insurance companies in California will be limited to annual price increases of 3% starting in 2029 under a new rule state regulators approved Wednesday in the latest attempt to corral the ever-increasing costs of medical care in the United States. The 3% cap, approved Wednesday by the Health Care Affordability Board, would be phased in over five years, starting with 3.5% in 2025. Board members said the cap likely won’t be enforced until the end of the decade. (Beam, 4/24)

Modern Healthcare: Cross-Market Mergers Can Raise Prices By 12% For Patients: Study Regulators have largely overlooked merger proposals that involve health systems operating in different markets, but new research shows those that acquired out-of-market hospitals tended to increase prices. Larger health systems that purchased hospitals at least 50 miles away increased prices by 12.9% after six years relative to a peer group of hospitals not involved in mergers or acquisitions, according to a study published Tuesday in Health Services Research. (Kacik, 4/23)

Modern Healthcare: Vertical Integration In Healthcare Under Fire From Republicans The call to rein in giant healthcare corporations isn't just coming from the left. Conservative lawmakers on Capitol Hill are growing increasingly vocal with their own demands to crack down on consolidation and vertical integration in the industry, spurred on most recently by the Change Healthcare ransomware attack. (McAuliff, 4/24)

AP: More Doctors Can Prescribe A Leading Addiction Treatment. Why Aren't More People Getting Help? It’s easier than ever for doctors to prescribe a key medicine for opioid addiction since the U.S. government lifted an obstacle last year. But despite the looser restrictions and the ongoing overdose crisis, a new study finds little change in the number of people taking the medication. Researchers analyzed prescriptions filled by U.S. pharmacies for the treatment drug buprenorphine. The number of prescribers rose last year after doctors no longer needed to get a special waiver to prescribe the drug, while the number of patients filling prescriptions barely budged. (Johnson, 4/24)

USA Today: More Americans Breathing Toxic Air, Lung Report Finds Americans are breathing more toxic air now than in the past quarter century, according to a new report from the American Lung Association. The findings released Wednesday show the worst toxic particle pollution in the 25 years the ALA has released its annual “State of the Air” report. The recent spike in pollution, experts say, is likely the result of climate change including the increase in wildfires. More than 131 million Americans lived in areas that showed unhealthy levels of air pollution, the report showed. (Cuevas, 4/24)

Politico: Xavier Becerra Plots His Political Future After Biden Administration Health and Human Services Secretary Xavier Becerra’s plans to leave the Biden administration and run for California governor are more advanced than previously known — with hiring discussions and spending further developed than he’s letting on. Not only has Becerra had conversations over the past weeks about making the move, he or emissaries have approached political firms about standing up a gubernatorial campaign to succeed Gov. Gavin Newsom in 2026, two people briefed on those discussions told POLITICO. (Cadelago and Lippman, 4/23)

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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