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: Congress Passes Stopgap Funding Bill That Delays DSH Cuts Congress delayed looming cuts to hospitals, extended community health center funding and addressed a slew of other healthcare priorities in a temporary spending bill that passed Thursday. The measure prevents a partial government shutdown that would have started Friday. Once President Joe Biden signs the legislation, Congress will face a pair of deadlines to fund the government and reauthorize various programs with action on some issues needed by March 1 and others by March 8. (McAuliff, 1/18)

Axios: How A Supreme Court Case Over Federal Power Could Affect U.S. Health Care A Supreme Court hearing on a case that could significantly curtail the federal government's regulatory power has big implications for America's health care system. The justices on Wednesday are considering whether to overturn the 40-year-old legal doctrine known as the "Chevron deference," in which the courts have given leeway to federal agencies to reasonably interpret ambiguous laws or ones subject to multiple interpretations. (Millman, 1/17)

Stat: Prior Authorization Will Have To Move Faster Under New Biden Rule The Biden administration moved Wednesday to force insurance companies to give specific reasons for denying coverage, and to speed up the pre-approval process in general. The new rule applies to health insurance companies that offer Medicare, Medicaid, Children’s Health Insurance Program, and Obamacare plans. It concerns so-called prior authorization requests, and will require insurers to return urgent requests within 72 hours and non-urgent requests within seven days. (Trang, 1/17)

For a Deeper Dive...

NPR: 2024's Drug Price Hikes Are Rolling In — And Some Decreases Drug companies often increase prices at the start of the new year, and 2024 seems to be no exception. There have been about 600 price hikes so far in January, according to the drug price nonprofit 46Brooklyn Research. But the increases haven't been as steep as they were in some previous years. In the 2010s, drug price hikes were typically much bigger — up to 10% on average (Lupkin, 1/17)

Modern Healthcare: Hospital Financial Pressures Push More M&A Nearly a third of announced hospital and health system mergers and acquisitions last year involved a financially distressed partner, a new report shows. Waning COVID-19 relief funds and high labor costs pinched hospital margins in 2023, causing many health systems to seek financial stability with M&A partners. About 28% of announced merger and acquisition proposals included a hospital or health system in financial distress, up from 15% in 2022, according to a report published Thursday by Kaufman Hall. (Kacik, 1/18)

Modern Healthcare: CMS Unveils Integrated Mental Health Pilot Program The Centers for Medicare and Medicaid Services is testing a new community-based behavioral health services model that aims to improve access and quality, the Health and Human Services Department announced Thursday. Under the Innovation in Behavioral Health Model, physical and mental healthcare providers will form interprofessional care teams with community organizations, which will coordinate care for Medicare and Medicaid enrollees with mental illnesses and substance-use disorders. (Bennett, 1/18)

The New York Times: What To Know About The Federal Law At The Heart Of The Latest Supreme Court Abortion Case One of the newest battlefields in the abortion debate is a decades-old federal law called the Emergency Medical Treatment and Labor Act, known by doctors and health policymakers as EMTALA. The issue involves whether the law requires hospital emergency rooms to provide abortions in urgent circumstances, including when a woman’s health is threatened by continuing her pregnancy. But, as with many abortion-related arguments, this one could have broader implications. Some legal experts say it could potentially determine how restrictive state abortion laws are allowed to be and whether states can prevent emergency rooms from providing other types of medical care, such as gender-affirming treatments. (Belluck, 1/18)

The New York Times: Six Reasons Drug Prices Are So High In The U.S. Florida’s plan to save money by importing medications from Canada, authorized this month by the Food and Drug Administration, has renewed attention on the cost of prescription drugs in the United States. Research has consistently found that drug prices in America are significantly higher than those in other wealthy countries. In 2018, they were nearly double those in France and Britain, even when accounting for the discounts that can substantially reduce how much American health plans and employers pay. Here are six reasons drugs in the United States cost so much. (Robbins and Jewett, 1/17)

Reuters: Minority Children In US Get Poorer Healthcare, Analysis Finds The quality of healthcare for minority children in the United States is universally worse than it is for white children, even after accounting for insurance coverage, an analysis of dozens of recent studies found. The pattern was similar across all medical specialties, including newborn care, emergency medicine, primary care, surgery, hospital care, endocrinology, mental health care, care for developmental disabilities, and palliative care, researchers said. (Lapid, 1/17)

KFF Health News: Women And Minorities Bear The Brunt Of Medical Misdiagnosis Charity Watkins sensed something was deeply wrong when she experienced exhaustion after her daughter was born. At times, Watkins, then 30, had to stop on the stairway to catch her breath. Her obstetrician said postpartum depression likely caused the weakness and fatigue. When Watkins, who is Black, complained of a cough, her doctor blamed the flu. (Szabo, 1/18)

The Guardian: Majority Of Debtors To US Hospitals Now People With Health Insurance People with health insurance may now represent the majority of debtors American hospitals struggle to collect from, according to medical billing analysts. This marks a sea change from just a few years ago, when people with health insurance represented only about one in 10 bills hospitals considered “bad debt”, analysts said. “We always used to consider bad debt, especially bad debt write-offs from a hospital perspective, those [patients] that have the ability to pay but don’t,” said Colleen Hall, senior vice-president for Kodiak Solutions, a billing, accounting and consulting firm that works closely with hospitals and performed the analysis. (Glenza, 1/11)

Axios: Health Insurance Premiums Are Eating Into Workers' Wages Families with workplace health insurance may have missed out on $125,000 in earnings over the past three decades as a result of rising premiums eating into their pay, according to a new JAMA Network Open study. (Owens, 1/17)

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