About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.

View all posts by Joseph Burns →

Source: Aimee Cicchiello and Lovisa Gustafsson, “Brand-Name Drug Prices: The Key Driver of High Pharmaceutical Spending in the U.S. — An International Comparison of Prescription Drug Spending and Costs,” chartpack, Commonwealth Fund, November 2021.

Last week, when the U.S. House of Representatives passed and sent to the U.S. Senate H.R.5376, the Build Back Better Act, speculation began on which parts of the bill would survive a vote in the senate.

For journalists covering the health care elements in the bill (including provisions that would affect what consumers pay for prescription drugs), the question of which parts will remain will require following the money. As we’ve seen in recent years, the health care industry has spent multiple millions of dollars on lobbying and advertising to get members of Congress to water down various parts of the bill they don’t like.

 Reporting on spending for advertising and lobbying shows how much the pharmaceutical industry has spent in Congress to weaken provisions designed to make health care and prescription drugs more affordable for consumers.

Story angles to consider

Among the angles to cover in this story are how much money members of Congress in your district or state have received from pharmaceutical companies. One way to identify how much members of Congress have received is to use the Pharma Cash to Congress database from Kaiser Health News. This data set shows who’s received the most money this cycle, who’s in the million-dollar club and how much each member has received, and from which pharma companies.

Other angles to cover include how some of the advertisements from pharmaceutical companies can mislead consumers and how some consumers have been affected by high costs for prescription drugs. To find consumers willing to discuss high prescription drug costs, call patient-advocacy organizations such as Patients for Affordable Drugs and the Leukemia and Lymphoma Society.

When covering this story, keep in mind two reports that came out this year: In U.S., an Estimated 18 Million Can’t Pay for Needed Drugs, from Gallup in September; and, Prescription Drug Prices in the United States Are 2.56 Times Those in Other Countries, from RAND in January.

Continue reading →

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.

View all posts by Joseph Burns →

A report from the U.S. Census Bureau shows the percentage of Americans who were uninsured in 2018 and 2020 by age group. The uninsured are eligible to sign up for health insurance coverage during the Affordable Care Act’s open enrollment period through Jan. 15. (Photo courtesy of the U.S. Census Bureau)

Health insurance scammers plagued consumers online and on the phone during the special enrollment period for the Affordable Care Act (which ran from February 15, 2021- September 15, 2021), a recent study showed.

The study, conducted by researchers from the Georgetown University Center for Health Insurance Reform found that consumers were likely to be referred to alternative health insurance plans that do not comply with the rules of the Affordable Care Act (ACA). Those noncompliant alternative plans included fixed indemnity insurance, health care sharing ministries, short-term plans and other health care options that were impossible to categorize based on the information the insurers provided, the researchers noted.

Scammers also told consumers that ACA-compliant plans were extremely expensive, which is false because Congress passed the American Rescue Plan in March. Under that law, monthly premiums for many low-income consumers buying ACA plans cost $10 per month or less. Also, the law capped the amount all consumers pay for ACA plans at no more than 8.5% of income, as we reported last month in this blog post.

Reporting on the research from CHIR and other sources is particularly important during the annual open enrollment period for ACA plans (which runs through Jan. 15 in most states) because it shows that it’s difficult (and may be nearly impossible) for consumers to know if they’re getting scammed into buying noncompliant health plans, said Dania Palanker, an assistant research professor at CHIR and one of the researchers on the study. Palanker and her colleague JoAnn Volk, a research professor, collaborated to produce this research.

“For consumers looking to buy ACA health insurance, I wouldn’t even start with a search engine,” Palanker warned. “It’s best to go directly to healthcare.gov. That will help to keep you safe. Once you’re connected to a navigator or a broker through healthcare.gov, then you know they’re selling marketplace plans.”

Continue reading →