Author Archive

How to Solve the Pre-Existing Condition Problem

moneyThe primary sticking point in health reform is what to do with high -cost individuals who have pre-existing health conditions. People with episodic medical needs are easy to insure, while those with persistent needs are far more difficult unless insurers are allowed to underwrite enrollees’ risk. Republicans have long favored high-risk pools to cover individuals who are otherwise uninsurable. Prior to the Affordable Care Act (ACA) just over two-thirds of states had some type of high-risk pool. Most people turned down prior to the Affordable Care Act could ultimately obtain coverage either at a higher price or after meeting some preconditions. In 2011, high-risk pool enrollment varied from 0.1% in Alabama to a high of 10.2% in Minnesota. By most accounts only about 2% of people are uninsurable. However, one Kaiser Family Foundation study argues the actual rate may be a dozen times higher.

Does Medical Weed Lower Medicaid Drug Costs?

ReeferA new study in Health Affairs looked at the effect medical marijuana has on prescription drug use in state Medicaid programs. It found positive correlation between states that have passed medical marijuana laws and lower Medicaid drug spending. Just over half of states (28) have pass some type of law that allows for medical marijuana. Researchers reviewed fee-for-service (FFS) drug utilization (2006 – 2014) in state Medicaid programs to compare states that allowed medicinal marijuana with states that did not.

Weak Idea at Bernie’s: Bureaucrats Should Not Negotiate Seniors’ Drug Prices

Capture14Senator Bernie Sanders and Representative Elijah Cummings — along with a few other liberal Members of Congress — want to change the way Medicare purchases drugs for seniors. It is a popular talking point mainly because many Americans naively assume Medicare does not bargain over the price of drugs. Even President Trump has perpetuated the bogus idea that having the government negotiate the price of drugs would lower Medicare’s drug costs. This may sound appealing to many because drug makers don’t elicit much sympathy these days. Yet, seniors, drugmakers and taxpayers alike have a stake in the outcome because drug therapy is the most convenient and efficient way to care for patients.

Shopping for Health Care is Easier than You Realize

yuConventional wisdom holds that it is nearly impossible to compare prices for medical care like consumers do in other markets. It’s easier than you realize — my wife and I do it just about every time we see our doctors or fill a prescription. Health plan deductibles have nearly tripled over the past decade. Shopping for medical care is more important than ever.

Advice to the New FDA Commissioner

prescription-drug-shortageWriting in The Hill, Mercatus Senior Research Scholar Robert Graboyes discussed ways to boost the U.S. Food and Drug Administration’s productivity.  He and coauthor Jordan Reimschisel discussed seven things the FDA could do to speed approval of drugs and medical devices.

John R. Graham Appointed Principal Deputy Assistant Secretary at HHS

Capture24The political website Politico (gated) broke the news that NCPA senior fellow, John R. Graham, will be the next principal deputy assistant secretary for planning and evaluation at the U.S. Department of Health and Human Services. The Daily Caller also broke the news earlier this week with a rather provocative headline: “Trump Admin Appoints Healthcare Reform Expert To HHS Amid Obamacare Negotiations.” The photo was taken during Graham’s Congressional testimony on the individual mandate, which can be viewed here.

An announcement by NCPA CEO Jim Amos can be found here:

We at NCPA are excited to learn that President Trump and Secretary Tom Price have chosen our trusted and accomplished colleague, NCPA Senior Fellow John R. Graham, to lead the Division of Planning and Evaluation at the U.S. Department of Health & Human Services. Mr. Graham has a record of accomplishment in many areas of health policy, including payment reform, regulation of drugs and devices, comparing international health systems, and the importance of incentives in medical innovation. Everyone who has worked with Mr. Graham has experienced his collegiality, humor, intelligence, and organizational and thought leadership. Although we are sorry to lose him from our team, we know his new colleagues – and the American people – will benefit greatly from his skills and drive to put patients before politicians in health reform. Mr. Graham’s senior appointment by the Trump Administration is yet another example of NCPA’s impact on public policy.

 

 

Invisible High-Risk Pools

Five people waiting in waiting roomThere has been some discussions about invisible high-risk pools. That is a condition where the state assumes responsibility for some subset of sick enrollees’ high claims cost. For instance, Alaska began subsidizing the cost for a few individuals so the remaining 25,000 Alaska Obamacare enrollees would not be priced out of the market.

Propping Up Obamacare: Playing the (Bad) Hand You’re Dealt…

Caduceus with First-aid Kit --- Image by © Royalty-Free/Corbis

Caduceus with First-aid Kit — Image by © Royalty-Free/Corbis

Obamacare is enrolling too many sick people and too few healthy ones to prevent a death spiral. The Centers for Medicare & Medicaid Services (CMS), a unit of the U.S. Department of Health & Human Services (HHS), has proposed a new rule to stabilize the Obamacare markets for individual health insurance. This was the first rule issued since Dr. Tom Price was appointed HHS secretary. The proposed Market Stabilization rule includes a number of measures to prevent people from entering the market when sick and exiting when healthy.

Obamacare Repeal & Replace 2.0: Where Do We Go From Here?

220px-Tom_PriceThe failed House Republican American Health Care Act (AHCA) was always a work in progress. The three-phased approach to reform health care called for passage of the AHCA to repeal the Affordable Care Act (ACA) taxes and mandates; and slow the growth in Medicaid (phase one). Phase two was the selective tweaking of Obamacare regulations by the Secretary of Health and Human Services. Phase three was to be a forthcoming health care bill to revamp onerous insurance regulations.

House Obamacare Repeal Bill Limits HSAs for Millions of Americans

Hand Holding Cash ca. 1998

Hand Holding Cash ca. 1998

The House Republican American Health Care Act Managers Amendment would not allow Americans to use their tax credits to fund an HSA. Instead of using their tax credit/HSA to pay for doctor visits, prescriptions and OTC drugs, Americans will only be allowed to use their credit for insurance. This is a big mistake – and a giveaway to insurers. Millions more Americans would have an HSA if the proposed $2,000 to $4,000 tax credits were automatically deposited into individuals’ HSAs for use on health insurance premiums, copays, cost-sharing and paying for direct care.