Tag Archives: Health Policy

Biotech billionaire in talks with Trump about a senior health care role, sources say

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Biotech billionaire in talks with Trump about a senior health care role, sources say

Dr. Patrick Soon-Shiong, an audacious biotech billionaire who has pledged to “solve health care,” has been in talks with the Trump administration about the possibility of serving in a senior role overseeing the US health care system, according to individuals familiar with the discussions.

Soon-Shiong, a trained surgeon, has met with President Trump and his advisers at least twice in recent weeks. During those discussions, he raised the possibility that he could serve as a “health care czar” with a broad portfolio in the administration as it seeks to reshape the health care system and replace the Affordable Care Act, according to two individuals, who spoke on the condition of anonymity.

Asked about the discussions, an adviser to Soon-Shiong told STAT that the word “czar” had not been used but did not dispute that the biotech mogul has discussed the possibility of taking on a senior role overseeing health care in the Trump administration.

Trump revives policy eliminating funding for foreign groups that provide abortion services

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Trump revives policy eliminating funding for foreign groups that provide abortion services

President Trump on Monday reinstated a US policy preventing foreign nonprofit groups that receive federal funds from administering abortions or providing abortion counseling or referrals.

Originally enacted by President Ronald Reagan in 1984, the “Mexico City Policy” was rescinded by Bill Clinton and Barack Obama — and reinstated by George W. Bush and now Donald Trump — in the first days of each new administration.

Known as the “global gag rule” by pro-abortion rights groups, the Mexico City Policy goes a step further than existing legislation, which prevents federal dollars from being used for abortions. Instead, it prevents organizations that receive any federal funds from paying for their own abortion programs.

Existing legislation known as the Helms Amendment already prevents federal funding of foreign abortions “as a method of family planning,” a restriction abortion rights advocates say has led to excessive interpretation. George W. Bush’s administration clarified that the amendment exempted abortions performed in cases of rape, incest, or when the mother’s life would be endangered by the pregnancy.

Trump’s move forces nonprofit groups to choose between cutting abortion services altogether or looking to fill a major budget gap left by the withholding of federal dollars.

The executive order comes as part of a broader salvo on federally funded abortion and contraceptive coverage.

Separately, a bill under consideration by the House rules committee aims to change the Hyde Amendment, a provision in annual appropriations bills that prohibits federally funded abortions, into permanent law. The proposal would also make employers with insurance plans that cover abortion ineligible for tax credits under the Affordable Care Act.

Trump also issued an executive order on Friday that, depending on how the Department of Health and Human Services interprets it, could eliminate the ACA requirement that private insurers include contraception in their coverage.

Trump’s Vow to Repeal Health Law Revives Talk of High-Risk Pools

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Image result for high risk pools

About 27 percent of people under 65 are thought to have some sort of pre-existing condition that will most likely leave them without individual insurance if the law is repealed, according to a recent study. The guarantee of coverage has already become a rallying cry for people who want to keep the law.

The issue “is the third rail” for the Republicans, said Michael Turpin, a longtime health industry executive.

Before the law, a fairly typical life event — like a divorce or the loss of a job — and a relatively minor medical condition could upend a person’s health coverage options. Stories of sick people unable to get coverage when they needed it most were legion.

Mr. Trump insists he wants to keep the pre-existing requirement for insurers, and other top Republicans say people who want coverage should not be turned away. Details about how they will cover people with existing medical conditions have not yet emerged, but many lawmakers have started pushing an idea — known as high-risk pools — that left many people uncovered or with strict limits to their coverage in the past.

The challenge for lawmakers is this: How do you get insurers to cover people who will definitely need costly medical care — and do so without making insurance too expensive for everyone?

Trump’s Health Plan Would Convert Medicaid to Block Grants, Aide Says

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President Trump’s plan to replace the Affordable Care Act will propose giving each state a fixed amount of federal money in the form of a block grant to provide health care to low-income people on Medicaid, a top adviser to Mr. Trump said in an interview broadcast on Sunday.

The adviser, Kellyanne Conway, who is Mr. Trump’s White House counselor, said that converting Medicaid to a block grant would ensure that “those who are closest to the people in need will be administering” the program.

A block grant would be a radical change. Since its creation in 1965, Medicaid has been an open-ended entitlement. If more people become eligible because of a recession, or if costs go up because of the use of expensive new medicines, states receive more federal money.

If Congress decides to create block grants for Medicaid, lawmakers will face thorny questions with huge political and financial implications: How much money will each state receive? How will the initial allotments be adjusted — for population changes, for general inflation, for increases in medical prices, for the discovery of new drugs and treatments? Will the federal government require states to cover certain populations and services? Will states receive extra money if they have not expanded Medicaid eligibility under the Affordable Care Act, but decide to do so in the future?

 

 

THE HEROISM OF INCREMENTAL CARE

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http://www.newyorker.com/magazine/2017/01/23/the-heroism-of-incremental-care

We devote vast resources to surgeons and the like, while starving the physicians whose steady, intimate care helps many more.

We devote vast resources to intensive, one-off procedures, while starving the kind of steady, intimate care that often helps people more.

Medicare ACO explosion: CMS boasts 570 participants for 2017

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http://www.fiercehealthcare.com/healthcare/cms-more-than-570-new-returning-participants-enroll-medicare-acos-for-2017

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More than 570 Medicare accountable care organizations will participate this year in Centers for Medicare & Medicaid Service models, including the Shared Savings Program, Next Generation ACO Model and The Comprehensive ESRD Care Model, with 131 in a risk-bearing track.

MSSP added 99 new participants and 79 ACOs renewed their commitment to the program, bringing the total number of MSSP ACOs to 480 across all U.S. states, the District of Columbia and Puerto Rico, according to a CMS announcement. Medicare officials have also revealed a new track under MSSP to begin in 2018, the Medicare ACO Track 1+ Model, that offers lower risk to encourage smaller practices and rural hospitals to participate.

After three high-profile members left the Next Generation ACO program last year, many questions emerged about the future of the model. However, the agency said that 28 new participants have joined the Next Generation program for 2017, bringing the total to 45 and more than doubling the number in the program.

Atrius Health is among the new participants in the program for 2017, and in an announcement officials at the Boston-region health system said its previous experience in the Pioneer ACO program have prepared it to take on the higher financial risks associated with the Next Generation model.

“Our experience as a Pioneer ACO has enabled us to build upon our strengths in providing high-quality, coordinated care for our patients across the continuum,” CEO Steven Strongwater, M.D., said in the announcement. “CMS has been an excellent partner in this work, and we look forward to further collaboration and innovation with them in the years to come.”

Joe Damore, vice president for population health, Premier, said the growing number of participants is a “clear signal” that the shift to value-based care will continue.

In an emailed statement, Cliff Gaus, CEO and president of The National Association of ACOs, agreed. “We, along with the ACO community, are feeling confident about the future of the program and we’re looking forwarding to seeing the ACO program grow and stabilize in the coming years,” he said.

Women’s March: Protesters fight for healthcare access, reproductive health

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http://www.fiercehealthcare.com/healthcare/women-s-march-protestors-fight-for-healthcare-access-reproductive-health?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiWW1JeU5XWTJNREUwWWpReCIsInQiOiJnXC83WGlnU0E3ZnV5YnRYSTBpbW1TYWdOaVhcL1gxU01Cb0pFSHM0dzVyUjJ5TTlVV2JSNmJhSFhoYnJOWjFGbzdmdCtpd0JcLzdlOENkcGE2alV6dkFPcHdXQlZ2VjFPZWgyb0p5RkV2N082NmYxQmw2N0hFQ01UK2QyMG9xM0EyMCJ9

Fears that the new White House administration will limit Americans’ access to healthcare inspired many physicians and healthcare advocates to join thousands of protesters and take to the streets Saturday as part of the Women’s March on Washington.

The protest was organized in response to the election of President Donald Trump. But concerns over the future of healthcare in the United States drove many to join the hundreds of thousands of women and men in rallies all over the country and the world.

“Right now, women’s health is in greater danger than it has been at any time in the last 3 or 4 decades,” Kyle Ragins, M.D., a board member of Doctors for America and an emergency resident at the University of California, Los Angeles, told Medscape Medical News.

Healthcare providers not only fear the impact of a repeal of the Affordable Care Act leaving millions without healthcare coverage, but they also worry that lawmakers aim to limit access and coverage for contraception, abortion and other women’s health services, and change the vaccination criteria for U.S. children.

Many protesters carried signs and banners with messages that support reproductive rights and “Medicare for All,” noted MedPage Today.

“We want women to have access to anything they need to make the right choices for their bodies,” Katie MacMillan, a fourth-year medical student at Quillen College of Medicine in Johnson City, Tennessee, told the publication.

The most immediate threat to healthcare access is the repeal of the Affordable Care Act. Shortly after Donald Trump was sworn in as president, he issued an executive order to push for a quick repeal of President Barack Obama’s signature healthcare legislation.

Although many of the physicians interviewed by MedPage Today noted that the ACA was flawed, they also praised the fact that 20 million previously uninsured people received healthcare coverage under the health reform law. It was one reason why Ragins joined the protest. He told Medscape that he wanted Congress and the Trump administration to know that doctors see the benefits of the ACA every day.

But protesters vowed to fight for their right to healthcare. During a postmarch event, Planned Parenthood urged participants to call their senators urging them to protect their access to healthcare, The New York Times reported. Repeal of the ACA and defunding Planned Parenthood is going to “create havoc,” Cecile Richards told David Axelrod on “The Axe Files,” a podcast from the University of Chicago Institute of Politics and CNN.

State Experiences Show Why Repealing the ACA’s Premium Subsidies and Individual Mandate Would Cripple Individual Health Insurance Markets

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http://www.commonwealthfund.org/publications/blog/2017/jan/state-experiences-aca-repeal?omnicid=EALERT1156084&mid=henrykotula@yahoo.com

Image result for aca repeal

President-elect Donald Trump and congressional Republicans favor repealing major provisions of the Affordable Care Act (ACA) early in the new administration. Republicans may have enough votes from within their own party to do away with the health law’s premium and cost-sharing subsidies, individual mandate, and Medicaid expansion. But a broader repeal of the ACA’s insurance market reforms, and adoption of a replacement health care plan, may be more challenging. These steps need bipartisan support for passage and require Republicans to resolve ongoing internal differences regarding what a replacement law should look like; they may do so, but haven’t yet.

With the substance of an alternative plan up in the air, uncertainty has grown over when the law might be replaced. Republican leaders have suggested Congress should repeal parts of the ACA now and leave the details of replacement until later. But “repeal and delay” has drawn criticism from stakeholders and policy experts who point out the strategy is likely to cause significant harm to insurance markets and consumers long before a replacement plan materializes, and a growing number of lawmakers have expressed discomfort about the proposal.

What happens if Congress and the new president push ahead with partial repeal without securing support for a replacement? The resulting regulatory landscape would look like what several states had in place prior to the ACA. Their experiences were poor.

The Myth of a Cheap Obamacare Replacement

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http://www.latimes.com/business/hiltzik/la-fi-hiltzik-trump-paul-20170117-story.html?utm_campaign=CHL%3A+Daily+Edition&utm_source=hs_email&utm_medium=email&utm_content=41037755&_hsenc=p2ANqtz-8pBWi30RdOLslYQ89FMuSTb8hSonUKKpIqWGUR6-WRPjXZJxVIUiM49YQ6dDiBROgviwVLxtxSEKFVcIPLyvnTm-UpMQ&_hsmi=41037755

The 10 essential health benefits required of any qualifying Obamacare plan: Which would you want to do without?

News on the Obamacare-replacement front was dominated this past weekend by Donald Trump and Sen. Rand Paul (R-Ky.), who both touted their Obamacare replacement plans.

To be absolutely precise, they touted the claim that they had Obamacare replacement plans. They didn’t go into any great detail about what would be in those plans. (That didn’t stop CNN from captioning its interview with Paul, “Rand Paul Releases Obamacare Replacement Details.”)

The few details, or guideposts, or guidelines that they did disclose only underscored how difficult it will be for Trump, Paul and the the Republicans on Capitol Hill to fashion a replacement that meets all their stated goals. For Trump, according to an interview with the Washington Post published Sunday, this includes “insurance for everybody” that will encompass “great health care … in a much simplified form. Much less expensive and much better.” He promised “lower numbers, much lower deductibles.”

Paul, speaking on CNN’s Sunday morning “State of the Union” program, said his plan would “insure the most amount of people, give access to the most amount of people, at the least amount of cost.” That sounds like a set of concrete goals, but actually they’re ambiguous. “Most people” compared to what? “Least cost” compared to what?

Before we get into the details, such as they are, we should recognize that if one takes as the goal of healthcare policy to provide universal coverage in which everyone is “beautifully covered,” as Trump promised, then a few limitations immediately appear. Health coverage is the product of three factors: How many people are covered; the benefits provided; and the cost of those benefits. Since the 1940s, U.S. politicians and policymakers have tried to find a balance among these factors. Every effort has been confounded by the immutable facts that treating the sick costs money and treating more people costs more money. One can save money by treating fewer people, or giving the same number of people less treatment. So any politician who says he can do more for less money is almost certainly blowing smoke.

How do the Trump and Paul “details” stack up?

Rampaging goats and $10 million mansions: your guide to the weird world of Obamacare rhetoric

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Rampaging goats and $10 million mansions: your guide to the weird world of Obamacare rhetoric

The Obamacare repeal effort is just getting underway and already the political wordplay is dizzying. On the GOP side, the rhetoric has gone from “repeal and replace” to “insurance for everybody” to “repair and rebuild.” Meanwhile, Democrats continually warn that the Republicans are trying to “rip apart our health care system.”

To help you keep pace with the debate, we’ve assembled this handy glossary of buzzwords and talking points. Enjoy.

From the Republicans:

Repair and rebuild

This is the GOP’s attempt to describe its legislative strategy for Obamacare, and an evolution of the phrase “repeal and replace.” As Politico reported Thursday, it is the mantra of Oregon Representative Greg Walden, who is leading the offensive against Obamacare in the House. It is meant to soften the GOP’s tone and suggest the replacement effort will be carefully staged and surgical. It also opens the door to delay tactics if things don’t quickly shape up in the GOP’s favor.

From the Democrats:

‘Make America Sick Again’

A play on Donald Trump’s campaign slogan, this phrase emerged in early January as Democrats held rallies to generate support for Obamacare. Judging by the nation’s $3.2 trillion tab for health care costs in 2015, a number expected to jump as high as $3.6 trillion this year, it seems clear a lot of us are pretty sick already. But you get the point.