Suit on Health Law Puts Focus on Funding Powers –

November 30, 2014

In mounting the latest court challenge to the Affordable Care Act, House Republicans are focusing on a little-noticed provision of the law that offers financial assistance to low- and moderate-income people.

Under this part of the law, insurance companies must reduce co-payments, deductibles and other out-of-pocket costs for some people in health plans purchased through the new public insurance exchanges. The federal government reimburses insurers for the “cost-sharing reductions.”

In their lawsuit, House Republicans say the Obama administration needed, but never received, an appropriation to make these payments to insurance companies. As a result, they contend, the spending violates the Constitution, which says, “No money shall be drawn from the Treasury, but in consequence of appropriations made by law.”

via Suit on Health Law Puts Focus on Funding Powers –

Crisis In Pharma R&D: It Costs $2.6 Billion To Develop A New Medicine; 2.5 Times More Than In 2003

November 28, 2014

The high nominal prices of new drugs do not compensate for the smaller patient populations that they target. Deloitte and Thompson Reuters estimate that the IRR internal rate of return of R&D spending has dropped in half since 2010, from 10.5 percent to 4.8 percent. Sales of new drugs are not overcoming the loss of patents, weak pricing power for older drugs, or reduced productivity of R&D.

via Crisis In Pharma R&D: It Costs $2.6 Billion To Develop A New Medicine; 2.5 Times More Than In 2003.

Cost Still a Barrier Between Americans and Medical Care

November 28, 2014

One in three Americans say they have put off getting medical treatment that they or their family members need because of cost. Although this percentage is in line with the roughly 30% figures seen in recent years, it is among the highest readings in the 14-year history of Gallup asking the question.

via Cost Still a Barrier Between Americans and Medical Care.

Health-Insurance Site Snags Immigrants – WSJ

November 28, 2014

Legal immigrants are running into fresh problems signing up for insurance on, presenting a hurdle in the Obama administration’s efforts to cover more Hispanics.Immigrant groups say people born outside the U.S. who are entitled to private insurance under the Affordable Care Act are having trouble proving their identities to the federal insurance marketplace and uploading documents that demonstrate they are in the country legally. Some also are being routed first to Medicaid, the state-federal insurance for the poor, even though they don’t qualify.The 2010 health law excluded illegal immigrants but extended benefits to certain legal ones. In trying to keep unlawful immigrants out of the system, the enrollment process has made it difficult for lawful ones to get through, immigrant groups say.“A lot of advocates are frustrated,” said Angel Padilla, health policy analyst at the National Immigration Law Center.

via Health-Insurance Site Snags Immigrants – WSJ.

Wyoming Devises Plan to Expand Medicaid –

November 28, 2014

With a plan released Wednesday by the administration of Gov. Matt Mead, a Republican, Wyoming has become the latest state seeking to expand Medicaid.

The plan would provide Medicaid coverage to an additional 18,000 low-income people, according to the state’s health department. If it wins federal and state legislative approval, Wyoming will join 27 states that have expanded the program under the Affordable Care Act, including nine with Republican leadership.

As several other Republican governors have done, Mr. Mead wants to require some people who receive coverage under the expansion to pay something toward the cost. Under his plan, those earning 100 to 138 percent of the federal poverty level — for a single person, $11,670 to $16,105 a year — would have to pay monthly premiums. The premiums could range from about $20 to $50 a month, depending on household size and income, according to a summary of the plan.

via Wyoming Devises Plan to Expand Medicaid –

The Problem With Prostate Screening –

November 26, 2014

As a result, those physicians who have not examined the data in depth are now treating patients on the basis of deeply flawed data. How flawed? That’s the real issue: Because the authors won’t release their data, we don’t know.

It is imperative that, as part of America’s continuing efforts at health care reform, we develop a declaration of principles about the need for data transparency. Our regulatory bodies must insist that clinical trials, and especially taxpayer-funded ones, be open to scrutiny by independent investigators who have no ties to industry. Hoarding data, especially flawed data, is unacceptable when lives are at stake.

via The Problem With Prostate Screening –

NIHCM – Concentration of Health Care Spending Chart Story

November 26, 2014

One percent of the U.S. population accounts for nearly 23 percent of overall health care spending, and 5 percent are responsible for a full 50 percent of spending. In stark contrast, the lowest-spending half of the population generates less than 3 percent of total spending—or only about $234 per person, per year. Any meaningful effort to control spending growth must account for this extreme concentration. This chart story uses newly-released data to take a closer look at the top spenders, noting factors driving their higher spending and examining the persistence of spending patterns over time.

via NIHCM – Concentration of Health Care Spending Chart Story.

Sen. Chuck Schumer: Obamacare Focused ‘On The Wrong Problem,’ Ignores The Middle Class

November 26, 2014

Despite the enduring unpopularity of Obamacare, Congressional Democrats have up to now stood by their health care law, allowing that “it’s not perfect” but that they are proud of their votes to pass it. That all changed on Tuesday, when the Senate’s third-highest-ranking Democrat—New York’s Chuck Schumer—declared that “we took [the public’s] mandate and put all our focus on the wrong problem—health care reform…When Democrats focused on health care, the average middle-class person thought, ‘The Democrats aren’t paying enough attention to me.’”

via Sen. Chuck Schumer: Obamacare Focused ‘On The Wrong Problem,’ Ignores The Middle Class.

Jonathan Gruber warned of Obamacare premium spike as president promised savings – Washington Times

November 26, 2014

While President Obama campaigned on a promise that his universal health care plan would lower premiums, his controversial adviser and plan architect was privately warning the state of Wisconsin that Obamacare was poised to massively increase insurance costs for average residents, internal documents show.

Jonathan Gruber, the MIT economist currently under fire for suggesting the Obama administration tried to deceive the public about the Affordable Care Act, was hired by former Democratic Wisconsin Gov. Jim Doyle in 2010 to conduct an analysis on how the federal health-care reform would impact the state.

Mr. Gruber’s study predicted about 90 percent of individuals without employer-sponsored or public insurance would see their premiums spike by an average of 41 percent. Once tax subsidies were factored in, about 60 percent of those in the individual market were projected to see their premiums go up 31 percent, according to his analysis.

via Jonathan Gruber warned of Obamacare premium spike as president promised savings – Washington Times.

Democrats Erred by Acting on Health Care in 2010, Schumer Says – Bloomberg

November 25, 2014

Democrats made a mistake by passing President Barack Obama’s health-care law in 2010 instead of first focusing more directly on helping the middle class, third-ranking U.S. Senate Democrat Charles Schumer said today.“Unfortunately, Democrats blew the opportunity the American people gave them” in electing Obama and a Democratic Congress in 2008 amid a recession, Schumer of New York said in a speech in Washington. “We took their mandate and put all our focus on the wrong problem — health care reform.”

via Democrats Erred by Acting on Health Care in 2010, Schumer Says – Bloomberg.