Today's News and Commentary

About health insurance

Appeals court sets July hearing in ObamaCare case: Recall that in December U.S. District Court Judge Reed O'Connor said the ACA could not stand if the individual mandate no longer has a penalty for non compliance. The 5th U.S. Circuit Court of Appeals in New Orleans will hear the appeal on July 9.

Read the story

Public Health Insurance Legislation Announced in Connecticut: Connecticut is poised to join a trend to create a state-based public health insurance option.

Read the story(Wall Street Journal, subscription required)

More than Half of All OCM Providers Could Owe CMS Money if Required to Join in 2-Sided Risk Model: As part of CMS’s bundled payment programs, oncologists can participate in the Oncology Care Model. Analysis by Avalere indicates that under a new risk program 48% of participants would end up paying CMS. The good news is that under the old system it was about 70%.

Read the research

Moody's: Health insurers off to strong financial start in 2019—but political uncertainties loom: Bond-rating firm Moody’s found that:  “Of the eight insurers included in the analysis—Aetna, Anthem, Centene, Cigna, Humana, Molina, UnitedHealth and WellCare—none were given a negative credit implication rating for their performance…” Medicare Advantage growth was a significant contributor to their financial health. The report pointed out, however, that political instability (such as Medicare for All proposals) may make the financial future more volatile for these companies and others.

Read the story

About the public’s health

Scientists spy on superbugs to see how they outsmart our antibiotics: This is a fascinating explanation of how bacteria can persist even if they face antibiotics to which they should be sensitive. It could open up a whole new mechanism for designing antibacterial medications.

Read the story

“Best if used by." The FDA renders its decision on food expiration date labels: When is food no longer safe to eat? Because there were so many term used on labels, “after a two-year effort by industry, the FDA on Thursday came out with its own guidance on labels, saying it favored a single designation to guide consumers when they opened the cupboard or fridge door: ‘Best if used by.’”

Read the story (Washington Post- may require subscription)

Association of Black Race With Prostate Cancer–Specific and Other-Cause Mortality: Physicians assumed that worse outcomes in African American men who have prostate cancer were because of biologic factors. This research shows the differences are due to “nonbiological differences, notably access to care and standardized treatment.” Other cause mortality was also higher in black men.

Read the research (Abstract is accessible; full article requires subscription)

New Trump administration rule would weaken protections for transgender people in health care: The Trump administration said it would interpret the civil rights term of nondiscrimination “on the basis of sex” to mean the biological state at birth; it changes the Obama administration’s inclusion of transgender people in the law’s protection.

Read the story (Washington Post, may require subscription)

About pharma

Colorado becomes first state in the nation to cap price of insulin: Diabetics will pay a maximum of $100 per month under the new law.

Read the story (Denver Post, requires subscription)

House Bill: To amend title XVIII of the Social Security Act to reduce the Medicare part D reinsurance subsidies, eliminate beneficiary out-of-pocket costs above the Medicare part D catastrophic threshold, and for other purposes: This as-yet unnumbered Medicare Part D bill was proposed yesterday with bipartisan support by House health care leaders. Among its major provisions are setting an out of pocket cap for beneficiaries and reducing the catastrophic subsidy the federal government will pay when limits are reached from the current 80% to 20% (four years after passage).

Read the proposed bill

‘‘Lower Health Care Costs Act’’: This proposed bipartisan bill came from the Senate and is much more complex than the one from the House described above. It addresses: ending surprise medical bills (including independent dispute resolution); reducing the price of prescription drugs; improving transparency in healthcare; improving public health (including grants to address vaccine-preventable diseases); and improving the exchange of health information.

Read the proposed bill
Read a summary

About healthcare IT

Healthcare breach of 1.5M records made worse by notifications sent to wrong addresses: Unfortunately, data breaches are so frequent they are not really newsworthy. This one deserves attention for two reasons. First, 1.56 million records were involved. Second, the company ,Inmediata Health Group, is a healthcare clearinghouse rather than a provider organization or payer.

Read the story

HealthcareInsights.MD will resume on May 28 after Memorial Day