Drug prices have become a hot topic – and a significant source of the ongoing challenges to achieving affordable premiums and out-of-pocket costs in both Affordable Care Act exchange plans and employer-sponsored coverage. Drug costs are now the single largest health care concern of Americans across the political spectrum, according to some polls.
But it can be hard to know where to go to find out information about drug pricing and drug value (which aren’t the same thing). Continue reading
Once again, the Affordable Care Act was in court.
In a case brought by House Republicans, a federal district judge ruled on May 12 that the cost-sharing subsidies are illegal. Congress had never explicitly appropriated those funds. The White House contends that the authority to spend the money is in the ACA statute itself. The judge didn’t buy it. Continue reading
The Affordable Care Act created many opportunities for Medicare to test new ways of paying for health care. One of the biggest and most dramatic tests is now getting underway: bundled payments for hip or knee replacement.
Unlike most Center for Medicaid and Medicare Innovation (CMMI) projects on payment and delivery reform, this one is mandatory for hospitals in 67 geographic areas designated as participants. The test began April 1 and is supposed to run for five years. Continue reading
“Across state lines.” That’s shorthand for what many GOP politicians see as part of an acceptable replacement for the Affordable Care Act.
They see the approach as reducing barriers, so insurers can base themselves in one state, but sell in other states without having to include all the coverage mandates and benefit rules in those other states. Continue reading
For several years now, I’ve moderated an AHCJ conference panel on health reform in the states and will do it again this year at Health Journalism 2016 in Cleveland. We’ll get pretty granular this year, looking at two specific states – Massachusetts and Washington state – and provide a national overview of how states are looking ahead to next year to solve some of their persistent challenges.
Those challenges include a relatively low rate of young and healthy people signing up, persistent public misconception about what the law does and does not do, and of course, affordability, affordability, affordability. Continue reading