Below are Legislative and Regulatory Updates Related to the Health Care Industry, July 10, 2020
Biden-Sanders Unity Task Force Releases Health Care Recommendations – This week, Joe Biden’s presidential campaign rolled out the policy recommendations reached by its joint task forces with supporters of Sen. Bernie Sanders ahead of the Democratic National Convention, which is slated for next month. The task forces formed once rival Sen. Bernie Sanders dropped out of the race, with the goal of enticing his followers into supporting the Biden campaign. In the platform (P.28), the health care task force pushes for a public option, including a plan with no deductible. “Democrats believe we need to protect, strengthen, and build upon our bedrock health care programs, including the Affordable Care Act, Medicare, Medicaid, and the Veterans Affairs system,” the task force members wrote. “Private insurers need real competition to ensure they have incentive to provide affordable, quality coverage to every American.” The task force also supported Biden’s plan to lower the Medicare eligibility age to 60 instead of 65, which some progressives panned as lacking ambition. The task force also proposed finding “financially sustainable” ways to add vision, dental and hearing benefits to Medicare. The task force was co-chaired by Rep. Pramila Jayapal, D-Washington, and former Surgeon General Vivek Murthy, M.D.
Study Shows Exchange Enrollment Could Grow by 1M due to COVID Related Job Loss – A new analysis released by the consulting firm Avalere, finds that the ACA insurance exchanges could add more than 1 million new members as a result of the impact the COVID-19 pandemic has had on unemployment rates. Currently, there are more than 750,000 new exchange enrollees that have signed up since the end of open enrollment. “With unemployment rates at or near 10% in almost all states, many consumers have been separated from their previous employer-sponsored plans,” the analysis finds. “The economics of Medicaid eligibility in many states and the recent boost to unemployment assistance indicate that many are turning to the exchanges for coverage.” 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 analysis said.
Prescription Drug Prices Continue to Rise – According to a study by GoodRx, this July, 42 drugs have increased in cost by an average of 3.5%, surpassing the price increases seen last July. Drugmakers generally raise prices twice a year, in January and at mid-year, but some have delayed or staggered increases amid increased scrutiny. The Trump administration campaigned on a pledge to slash high prescription drug costs, but has struggled to push through some of its drug pricing agenda. A court rejected a regulation that would have required prescription drug television advertisements to include prices. Another rule to eliminate the rebates drugmakers give to payers — which manufacturers blame for rising costs — stalled last year over concerns it would raise seniors’ insurance premiums. The industry “is sticking with the industry’s business-as-usual, price-hiking playbook,” said Campaign for Sustainable Rx Pricing Executive Director Lauren Aronson in a statement. “Engaging in price hikes during a pandemic, while receiving billions of dollars from taxpayers to help develop COVID-19 treatments, demonstrates why policymakers must act,” she added.
Supreme Court Issues Ruling on Employer Birth Control Coverage – Earlier this week, the Supreme Court issued a decision finding that employers that object to the coverage of contraceptives for religious or moral reasons can decline to cover contraceptives for their employees. The ACA includes a section that requires coverage of preventive health services and screenings and the Obama administration issued regulations that required employers and insurers to provide women with coverage at no cost for all methods of contraception approved by the FDA. The regulations exempted houses of worship — including churches, temples and mosques — from the contraception requirement, but nonprofit groups like schools and hospitals affiliated with religious organizations were covered.
Following a 2017 executive order from President Trump, the Departments of Health and Human Services, Labor, and Treasury issued interim final rules (IFRs) that dramatically expanded the Obama-era policy to allow exemptions to the contraceptive mandate for moral or religious reasons. These exemptions applied to any employer that objects to “establishing, maintaining, providing, offering, or arranging [for] coverage or payments for some or all contraceptive services” based on sincerely held religious beliefs and extended to include for-profit and publicly traded entities. The Trump administration finalized the religious and moral exemption rules in 2018. Last year, a unanimous three-judge panel of the United States Court of Appeals for the Third Circuit, in Philadelphia, blocked the regulations, issuing a nationwide preliminary injunction, and the case was appealed to the Supreme Court. The Supreme Court’s decision means that the two rules can now go into effect.
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