Anyone ElseTerrified about Repeal of ACA Bill
Comments
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Lumpie, I think we are stuck in the “rugged individualism” mentality when, in fact, there is very little of it in this country anymore. Many people who have employment with good benefits are most guilty of this kind of thinking. I am a retired health care provider and was in private practice. No one paid half of my social security, health insurance and any time off for illness or vacation was unpaid.....if I wasn’t working, I wasn’t making any money. My retirement benefits were totally from contributions I made with no matching from anyone else. To add insult to injury, I spent way too much time fighting with insurance companies about services for pts and when I would turn it over to the pt they saw this through an entirely different set of lenses. I was eternally grateful when I turned 65 and qualified for Medicare.....my healthcare premium went from $750.00/mo to $130.00 and the deductible went from $5000 to $189. So, you can believe I support a national health plan. If more people really were operating in “rugged individualism” they might view this differently. Thanks for letting me rant
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Trump wants to erase anything that Obama did. Even the things that his supporters actually like. There was polling that showed people who voted republican/conservative were happy with the ACA but wanted to get rid of Obamacare.
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DogMom, you are exactly right. Obama is DT’s greatest threat and frankly, I understand that. DT’s overinflated ego is a result of profound insecurity. Additionally, he’s not very smart and has no command of the language. Barack Obama on the other hand has a very healthy ego, is brilliant and his eloquence is unmatched by any president in my lifetime, including JFK, Reagan & Clinton. And Michelle is rivaled only by Eleanor Roosevelt. So, I get it. I am so impressed that Obama seemingly lets DT’s rants roll off his back but I have to believe he is scared to death for our country.
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DogMom, your comment about people were happy w ACA but wanted to do away with Obamacare proves the point of how we can't cure stupid. They really don't get that ACA IS Obamacare. So stupid!! If we renamed it Trumpcare, they would be all in.
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Supreme Court Ruling on Risk Corridor Case
On Monday, the U.S. Supreme Court ruled in favor of insurers in the Affordable Care Act (ACA) risk corridors case. The ACA included so-called risk corridor payments to compensate insurers for the risks that they might bear from participating in the marketplaces without knowing who would purchase coverage. If medical costs exceeded the premiums collected, an insurer would be eligible for payments from the federal government. After Congress refused to appropriate the funds for the risk corridor payments, several insurers sued. Justice Sotomayor, writing for the majority, said that the government was bound by a simple principle of honoring its commitment as spelled out in the ACA. The insurers will receive the payments now. Health experts have already raised questions about how the payments will be distributed among insurers.Courtesy of the National Coalition for Cancer Survivorship Health Care Roundup
See also:
Supreme Court Rules for Insurers in $12 Billion Obamacare Case
In an 8-to-1 decision, the court said the government must shield insurers from losses under the Affordable Care Act.
https://www.nytimes.com/2020/04/27/us/supreme-cour...
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It would be interesting to know why Congress refused to pay. I wonder how much that lawsuit cost taxpayers.
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Marijen, The NYT says that Republicans refused to provide funding because doing so would stabilize the ACA... and they oppose the ACA. I thought I read that the Kaiser Family Foundation may have some coverage of this issue but I cannot find it. I get depressed researching and thinking about it. They shouldn't be playing politics with our health. (Although I know that is naive.)
Here are some links relevant to the topic:
https://www.nytimes.com/2020/04/27/us/supreme-cour...
https://twitter.com/larry_levitt/status/1254784358...
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Fundamental health reform like 'Medicare for All' would help the labor market
Job loss claims are misleading, and substantial boosts to job quality are often overlooked
Medicare for All may or may not be your thing, but if you are interested enough read a position piece which examines some advantages of this option and provides more depth than abbreviated propaganda pieces, you may find this article worthwhile.
Source disclosure: Economic Policy Institute, a nonprofit, nonpartisan think tank; left leaning, connections to labor.
https://www.epi.org/publication/medicare-for-all-would-help-the-labor-market/
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Potential Implications of Lowering the Medicare Eligibility Age to 60
By expanding Medicare while maintaining choice for consumers, this targeted public option takes a substantive step towards universal coverage within the confines of today's mixed insurance system. At the same time, it would deliver a financial boost to states faced with raising taxes or cutting services as falling tax revenues and rising Medicaid enrollment combine to deplete state budgets. The various underlying effects of this proposal would touch the health care system and economy in more nuanced ways.
Song Z. Potential Implications of Lowering the Medicare Eligibility Age to 60. JAMA. Published online May 29, 2020. doi:10.1001/jama.2020.7245
Audio version available here:
{No subscription required, but you may need to register to access the site.}
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Hi Ladies. If this is not allowed, please delete and accept my apology.
I am reaching out for a dear friend. Have high prices in prescription drugs hit you hard? Now or in the past? Would anyone like to share their story with a government board that is right now asked to approve yet another BigPharma merger between two drug makers? My friend is coordinating letters to the Federal Trade Commission to make sure the voice of consumers is heard. Please comment and send me a private inbox message if interested in learning more and sharing details of your personal experience with expensive prescription costs. Deadline is midnight tonight. Sorry for the short notice. My friend came to me asking about my experience as well as the experiences of my sister and mom. Fortunately, we all have very good insurance and have not experienced high out-of-pocket cost.
Hugs!
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SugarCakes, I will PM you. I think it is too late now. The cost of my drugs is astronomical. I have good insurance coverage.... for now...which should last a few more months.... but I have lost multiple jobs because employers just can't afford my healthcare. I am grateful for the drugs, which are saving me... but whether you blame "access to care" or the high cost of drugs...it's a problem.
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Trump Rolls Back Health Care Nondiscrimination Protections
...the Trump administration has moved to officially rollback the vital regulations implementing ACA's nondiscrimination protections for people historically discriminated against in our health care system.
The ACA's Section 1557 prohibits discrimination in health care programs based on race, color, national origin, language proficiency, sex, sex stereotypes, gender identity, age, or disability. ...these safeguards ... provided critical anti-discrimination protections against discrimination on the basis of sex and gender identity in health care. It also provided strong protections for people with *disabilities* or limited English proficiency.
"Until the ACA, women were charged more for insurance and were denied coverage for essential care, such as contraception and maternity care. The ACA's Section 1557 explicitly prohibits those practices and was the first federal law to prohibit sex discrimination in health care.
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Thank you so much, Lumpie, for keeping this thread going. Lots of great information.
I just wish we, as a country, could push past all the noise and have an honest dialogue about the challenges facing this country, including our abysmal health care system. But with current polarization I don't see it happening any time soon.
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Thanks, Trishyla! Yes. Difficult. Should not be such a partisan issue - we all need access to healthcare - but I fear that things will get even worse before they get any better.
To everyone, I will just say, speak up! The mantra is that if elected officials hear from even as few as five constituents, it can impact their position on an issue and their inclination to take action. Our voices count.
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I'm in California, Lumpie. All of my representatives, local, state and federal, are 100% behind health care for all. I feel for those who live in states without supportive representation.
Stay safe.
Trish
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US Medical Cancer Care Costs Substantial, Expected to Increase
The national costs of cancer care in the United States in 2015 are estimated to have been about $183 billion, according to a new study. Based on population growth, these costs are projected to increase by more than one-third to $246 billion by 2030.
Reference
Mariotto AB, Enewold L, Zhao J, et al. Medical care costs associated with cancer survivorship in the United States [published online June 10, 2020]. Cancer Epidemiol Biomarkers Prev. doi: 10.1158/1055-9965.EPI-19-1534
{Interesting reporting on cost of care. Some figures seem low to me.}
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Late Thursday night: The Trump administration filed a brief to the Supreme Court on this case, asking the justices to get rid of the entire law. "The entire ACA must fall," they wrote of the Affordable Care Act.
Dismantling the ACA would leave more than 23 million people without healthcare plans, according to a recent analysis by the liberal-leaning think tank Center for American Progress.
The Centers for Medicare and Medicaid Services revealed earlier Thursday that 487,000 people signed up for health-care plans during the special enrollment period on Healthcare.gov after losing their employer-covered plans, probably as a result of the economic crisis caused by the novel coronavirus.
The 82-page brief submitted late Thursday night by Trump's representatives states crisply that the president wants to get rid of every provision of the Affordable Care Act.
The justices are unlikely to make a final decision until after the November election on the legal challenge by Republican state attorneys general, ensuring that this looms as an issue in the fall campaign.
Read the brief here:
https://www.supremecourt.gov/DocketPDF/19/19-840/146406/20200625205555069_19-840bsUnitedStates.pdf
Press coverage:
https://www.washingtonpost.com/nation/2020/06/26/trump-obamacare-supreme-court-brief/
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H.R. 1425 The Patient Protection and Affordable Care Enhancement Act is expected to come to the House floor for a vote on Monday, June 29. This legislation will, among other things, strengthen and expand upon the Affordable Care Act (ACA), shore up the Medicaid program, and lower prescription drug prices to the benefit of all Americans.
Here is the summary from Congress.gov:
This bill establishes the Improve Health Insurance Affordability Fund. States must use allocated funds to (1) issue reinsurance payments to health insurers (i.e., reimbursements to protect insurers against exceedingly high claims) for individual health insurance coverage, or (2) provide other assistance to reduce out-of-pocket costs (e.g., copayments, coinsurance, and deductibles) for qualified health plans offered in the individual market.
You may read more about the bill and see co-sponsors here:
https://www.congress.gov/bill/116th-congress/house-bill/1425
NBCC has signed on to support this legislation. You can see their letter of support here:
http://act.stopbreastcancer.org/site/DocServer/HR_1425_Letter_of_Support.pdf?docID=8543
{A key function of this legislation would be stabilizing the market by providing funding for "reinsurance." Reinsurance provides relief to health insurers when they have expensive patients - like those who need expensive cancer treatments - so that there is not a huge disincentive for them to provide care to those patients. Without re-insurance, cancer patients will face ongoing barriers to accessing high quality coverage and care.}
If you want to dig in to the wonky details, you can read more here:
https://www.healthaffairs.org/do/10.1377/hblog20190307.432910/full/
https://www.healthaffairs.org/do/10.1377/hblog20200624.197845/full/
Cross-posting on the Advocacy Smorgasbord thread.
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Court Rules Against Hospitals In Price Transparency Lawsuit
In late June, U.S. District Court Judge Carl Nichols ruled against the American Hospital Association (AHA) and hospital plaintiffs in a lawsuit challenging the U.S. Department of Health and Human Services' sweeping rule regarding price transparency. That rule, finalized in November 2019, requires hospitals to publish negotiated rates with commercial insurers, as well as a list of 300 "shoppable" services. The rule is scheduled to take effect on January 1, 2021 and hospitals will face fines of up to $300 per day for failure to comply with its requirements.
In the ruling, Judge Nichols wrote that "HHS has the right to issue the rule because it considered the concerns of providers and payers, acknowledged conflicting information and explained its decision. The agency fulfilled its duty to examine evidence before it and connect it to the final rule." The AHA plans to appeal the ruling.
Source: Virginia Hospital & Healthcare Association
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The Future of Telehealth
No area of health care has evolved as rapidly during the COVID-19 pandemic as telehealth. As providers, payers, and elected officials consider the next steps for health care, preserving and expanding the progress made in telehealth is a top priority.
Federal Action
The U.S. Senate Committee on Health, Education, Labor & Pensions held a hearing on June 17 titled "Telehealth: Lessons from the COVID-19 Pandemic." The committee invited a panel of four experts to testify, including Dr. Karen Rheuban of UVA Health System. In addition to being a pediatric cardiologist and professor of pediatrics, Dr. Rheuban is the Director of the UVA Center for Telehealth, which was renamed in her honor in 2016. She is also Chair of the Virginia Department of Health (VDH)/VHHA COVID-19 subcommittee on telehealth. She was introduced by U.S. Senator Tim Kaine (D-VA), who serves on the committee.
During her testimony, Dr. Rheuban stated, "The simplest and most important action needed is for Congress to authorize the Secretary of Health and Human Services to make permanent many of the telehealth policy changes enacted during the public health emergency. In addition, Congress should provide support for further broadband deployment…to reduce geographic and demographic disparities in access to care. Also needed is increased funding for the HRSA-funded telehealth resource centers and for innovative models of virtual continuing education programs for health professionals to improve outcomes."
Goals expressed by the Senate committee members include improved health equity, better geographic and demographic access to care, expanded access to behavioral health and substance abuse services, and use of remote patient monitoring for chronic conditions. Among the concerns expressed are patient privacy, broadband access, price transparency, pay parity, and potential impact on workforce.
Watch the full committee hearing here https://www.help.senate.gov/hearings/telehealth-lessons-from-the-covid-19-pandemic
... and read Dr. Rheuban's written testimony here. https://www.help.senate.gov/imo/media/doc/Rheuban.pdf
Source: Virginia Hospital & Healthcare Association
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Commonwealth of Virginia
Medicare; supplement policies for certain individuals under age 65. (SB250)
Becames Law: 7/1/2020
Description
Medicare supplement policies for certain individuals under age 65. Requires each insurer issuing Medicare supplement policies or certificates in the Commonwealth to offer the opportunity of enrolling in at least one of its issued Medicare supplement policies or certificates to any individual under age 65 who resides in the Commonwealth, is enrolled in Medicare Part A and B, and is eligible for Medicare by reason of disability. The provisions of the measure are applicable to health plans and health maintenance organizations.
https://lis.virginia.gov/cgi-bin/legp604.exe?201+sum+SB250&201+sum+SB250
{This is huge. Virginia residents under 65 who qualify for Medicare based on disability now have access to Medicare supplement policies or certificates.}
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Medicaid Expansion Linked With Fewer Late-Stage Breast Cancers
— Black, younger women seemed to benefit most from increased access, study shows
The expansion of Medicaid as part of the Affordable Care Act was associated with an almost 10% absolute reduction in the number of patients with breast cancer without insurance, and a significant reduction in the number of women diagnosed with late-stage disease, researchers reported. {Researchers} found that the percentage of uninsured women with breast cancer decreased from 22.6% in 2012-2013 to 13.5% in 2015-2016 in states that expanded Medicaid. ...in the states that did not expand Medicaid, there was only a 1% absolute reduction -- from 36.5% to 35.6%.
The study also showed a significant decrease in late-stage disease after Medicaid expansion compared with before among states that expanded Medicaid (21.0% vs 19.0%, P<0.001), but there was no change among states that did not expand Medicaid access.
"...This study, in addition to others, continues to demonstrate that when you expand coverage to those who previously did not have it, you end up seeing more illness, but you see it at an earlier stage."
Primary Source: JAMA Surgery
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Lumpie - you bring up a critical point that the current administration is blind to. You will find more cases, BUT Catch it earlier when more treatable. Voters expanded medicaid where I live (ballot intiative) , and the legislature tried to take it away. Fortunately I have fairly good private and am trying to figure out how much to keep when I am eligible for Medicare.
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Medicaid Expansion Passes in Oklahoma
Last week, Oklahoma voters said "yes" to expanding Medicaid within their state. Oklahoma currently has the second-highest uninsured rate in the country, but with this vote, health care will be expanded to nearly 200,000 of the state's most vulnerable people. This success was made possible by the hard work of dozens of patient advocacy organizations, including Susan G. Komen.
A recent study from Kaiser Family Foundation found that more than 4.7 million uninsured adults could become eligible for Medicaid by 2020 if the remaining states expanded this program under the Affordable Care Act. Missouri voters in their August 4th primary election will decide whether to join the other 37 states that have chosen to expand this crucial program.
This update courtesy of Susan G. Komen Center for Public Policy
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Trump to sign 3 executive orders on drug prices
White House Chief of Staff Mark Meadows said President Donald Trump will be signing three executive orders that will significantly lower prescription drug prices. Meadows did not specify the content or timing of the executive orders.
This year, multiple bills on prescription drug reform have been unveiled in both chambers of Congress, but none of them have made it to the President's desk.
https://www.foxbusiness.com/money/trump-addressing-prescription-drug-prices-with-executive-orders
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Pandemic could drive spike in ACA exchange enrollment
Job losses resulting from the COVID-19 pandemic could drive a spike in new health insurance enrollments through Affordable Care Act exchanges, and more insurers might enter or re-enter the individual market, according to an Avalere analysis. More than 750,000 people new to the publicly run exchanges have enrolled in a health plan since regular open enrollment periods closed, and more than a million new enrollments could be added, Avalere says.
Enrollment numbers have only been released for eight of the 12 exchanges so the total could be higher, Avalere said.
Avalere's proprietary COVID-19 enrollment model also predicts the enrollment in the exchanges is going to last due to the availability of premium subsidies.
Avalere cautioned that consumers should be aware that the most popular types of plans on the exchanges have fewer covered benefits and more limited drug formularies than employer-sponsored insurance.
"Even for individuals who are able to enroll in exchange coverage, the transition from employer-sponsored coverage to the exchanges is not seamless, and can have implications for access and affordability,"
The ACA exchanges have started to recover in terms of premium hikes and plan participation. Major insurers such as UnitedHealth who left the exchanges have announced they are expanding their presence again.
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'How painful is the cost of your health care?' The case for a new vital sign
"On a scale of 0 to 10, how painful is the cost of your health care?"
That's a question all physicians should ask their patients, and one that has become increasingly more relevant in everyday patient care due to the relentlessly rising costs of health care and prescription drugs. These are now compounded by the economic devastation of the Covid-19 pandemic.
When government assistance tapers, the dust settles, and the fundamental economy reemerges, more and more Americans will find themselves suffering financially and unable to withstand more assaults on their pocketbooks.
{Brief op ed regarding physician insight - or lack thereof - on the cost of care.}
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Does anyone answer the surveys from their Insurance? I did once several years ago. This year when it came I ignored it as well as the repeated requests to answer it. The survey was not about health care, insurance etc or how to make it better, but mostly how often did you try to get seen by someone, how long did it take, who did you see, etc. For visits that get billed to insurance, they already have most of that information. A friend who has the same plan, said she made the mistake of agreeing to talk to one of their specialist who spent the time trying to convince her to take a much cheaper generic drug (not cancer related) rather than the brand name that she and her doctor had determined worked the best for her. As I spend more and more on health care, and insurance covers less, the cost has definitely become more painful. I guess I should be thankful for what I have when I hear people who are unable to get insurance or only minimal plans, and forgo care they need. But we have a long ways to go on improving access to health care.
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BlueGirlRedState: That is interesting. I don't recall getting those types of surveys from my insurance. I get things like... how was your experience? How long did you wait? Was it easy to get an appointment? Come to think of it, those may be from the physician group or a third party vs insurance. Most of us have probably taken a mix of generic and name brand drugs with varying results. It's one thing to switch when you have a minor irritation or condition, another when you have a life threatening issue. I think you'd be entirely justified in saying "thanks for that suggestion" and wrapping that discussion up.
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New Medicare Drug Rule Potential Impact on Cancer Patients
SEPTEMBER 17, 2020 By Cancer Support CommunityBackground
The White House recently released the Executive Order on Lowering Drug Prices by Putting America First. This Executive Order (EO) would create demonstration projects across the country through the Centers for Medicare and Medicaid Innovation at the Department of Health and Human Services (HHS) to test a requirement that Medicare pay the same price for prescription drugs as other countries (with comparable gross domestic product otherwise known an indicator of a country's economic health). This includes all drugs, both Medicare Part B (typically infused in a physician's office such as chemotherapy or immunotherapy) and Part D (prescriptions typically sold at the pharmacy counter like oral medications).CSC strongly supports, and has long advocated for, policies that improve access and affordability for cancer patients. Patients should have the right to determine the most appropriate therapies by engaging in a shared decision-making process with their providers.Process
This EO leaves several unanswered questions. First, there have been public reports that the White House could bypass traditional rulemaking for the Part B portion which would take immediate effect. It remains unclear how or when the related Part D proposal might be issued. Changes that will impact patients deserve to be made transparently and with ample opportunity for all stakeholders to engage in the process and to make their voices heard.Access to Innovation
It is also unclear if this EO will impact the ability of America's cancer patients to access appropriate, innovative therapies. Changes to the nation's largest health insurance program, which covers the majority of cancer patients (those over the age of 65), must be undertaken with caution and with an understanding of the full implications on how it will impact patients in America, as our health care system differs from systems in other countries. Further, changes to reimbursement models must ensure that ongoing innovation is not impacted.Next Steps
CSC looks forward to participating in all opportunities to engage on this issue and will provide updated information to patients and advocates regarding opportunities to learn more and stay involved.https://www.cancersupportcommunity.org/blog/new-me...0
