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...

KFF Health News: Biden Wants States To Ensure Obamacare Plans Cover Enough Doctors And Hospitals  The Biden administration plans to push states to boost oversight of the number of doctors, hospitals, and other health providers insurers cover in Obamacare plans, under rules proposed in November. The annual regulatory proposal, known as the payment parameters rule, also seeks to expand access to adult dental coverage in Affordable Care Act marketplaces and would require states to hold open enrollment periods for Obamacare plans at the same time of year. It’s likely one of the last major ACA policy efforts of President Joe Biden’s first term — and, if he loses reelection, could represent his final touches on the landmark health program created when he was vice president. (Appleby, 12/6)

Politico: Targeting Costly Meds, Biden Admin Asserts Authority To Seize Certain Drug Patents The Biden administration has determined that it has the authority to seize the patents of certain high-priced medicines, a move that could open the door to a more aggressive federal campaign to slash drug prices. The determination, which was described by three people familiar with the matter, represents the culmination of a nearly nine-month review of the government’s so-called march-in rights. Progressives have long insisted that those rights empower the administration to break the patents of pricey drugs that were developed with public funds, in an effort to create more competition and lower prices. The framework is likely to face sharp opposition from pharmaceutical companies that argue it’s illegal for the government to seize its patents and would disincentivize the development of new drugs. (Cancryn, 12/6)

KFF Health News: California’s Ambitious Medicaid Experiment Gets Tripped Up In Implementation Nearly two years into Gov. Gavin Newsom’s $12 billion experiment to transform California’s Medicaid program into a social services provider for the state’s most vulnerable residents, the institutions tasked with providing the new services aren’t effectively doing so, according to a survey released Tuesday. As part of the ambitious five-year initiative, called CalAIM, the state is supposed to offer the sickest and costliest patients a personal care manager and new services ranging from home-delivered healthy meals to help paying rental security deposits. (Hart, 12/5)

For a Deeper Dive...

Politico: ‘Stalemate’ On AIDS Relief To Drag Into 2024 The top Republican working to extend the United States’ global HIV/AIDS relief work admitted negotiations are deadlocked, jeopardizing one of the most successful U.S. foreign interventions of this century. “I’m disappointed,” Rep. Michael McCaul (R-Texas) told POLITICO. “Honestly, I was looking forward to marking up a five-year reauthorization, and now I’m in this abortion debate.” (Ollstein and Paun, 12/7)

AP: Census Bureau Wants To Change How It Asks About Disabilities. Some Advocates Don't Like It  The U.S. Census Bureau wants to change how it asks people about disabilities, and some advocates are complaining that they were not consulted enough on what amounts to a major overhaul in how disabilities would be defined by the federal government. Disability advocates say the change would artificially reduce their numbers by almost half. At stake are not only whether people with disabilities get vital resources for housing, schools or program benefits but whether people with disabilities are counted accurately in the first place, experts said. (Schneider, 12/8)

The Wall Street Journal: Exclusive: CVS Plans To Overhaul How Much Drugs Cost  CVS Health, the nation’s largest drugstore chain, will move away from the complex formulas used to set the prices of the prescription drugs it sells, shifting to a simpler model that could upend how American pharmacies are paid. Under the plan, CVS’s roughly 9,500 retail pharmacies will get reimbursed by pharmacy-benefit managers and other payers based on the amount that CVS paid for the drugs, in addition to a limited markup and a flat fee to cover the services involved in handling and dispensing the prescriptions. Today, pharmacies are generally paid using complex measures that aren’t directly based on what they spent to purchase specific drugs. (Mathews, 12/5)

Healthcare Dive: A Cigna-Humana merger could face a long regulatory delay. But it might get approved.  A merger between major health insurers Cigna and Humana would go through the wringer of an intense antitrust review, but could come out finalized, experts say. Though, to receive the regulatory green light, a combined company would probably have to emerge looking different from the Cigna and Humana of today.  The insurers are in talks to merge and could announce a deal by the end of this year. The stock of both companies tanked following the news as investors balked over the uncertainty of a deal review from increasingly aggressive antitrust regulators in the Federal Trade Commission and Department of Justice. (Pifer, 12/4)

Modern Healthcare: Biden, Trump 2024 Healthcare Debate Already Begun Since enacting the Inflation Reduction Act of 2022, President Joe Biden and the Democrats have talked up its Medicare drug pricing and health insurance subsidy provisions, but haven't gotten much traction. Now, Trump has jump-started the healthcare debate by again proposing to repeal the Affordable Care Act of 2010, a goal that eluded him during his presidency. (McAuliff, 12/1)

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