Today's News and Commentary

About health insurance

In a blow to HHS, Supreme Court sides with hospitals in legal battle over DSH payments: Prior to the ACA’s insurance and Medicaid expansions in 2014, certain hospitals received extra federal payments to care for the uninsured and low-paying Medicaid patients. Those facilities were called disproportionate share hospitals (DSH). After 2014, the federal government anticipated more patients would be insured, and thus it proposed cutting the DSH payments after a period of time. Now the Supreme Court has ruled that HHS cannot cut payments. The reason: “Because the government has not identified a lawful excuse for neglecting its statutory notice-and-comment obligations, its policy must be vacated.” In other words, HHS did not institute a comment period for the payment change- which law requires it to do.

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Toward 2020: A Survey of ACA Market Insurers: Among the survey results for this eHealth study:

Nearly two thirds of insurers said the lack of a tax penalty for 2019 led to reduced ACA plan sales

—Two thirds of insurers say elimination of the ACA tax penalty has had no impact on member retention to date

—60 percent said they intend to broaden their market participation next year, compared to 53 percent the year before

—42 percent of respondents said they expect to raise premiums between 5 and 10 percent over 2019 rates.

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Obamacare rate hikes appear modest for 2020: This article corroborates the one above about modest rate hikes for ACA plans in 2020. Those kinds of pronouncements, however, always come with the caveat that actual rates vary widely among states.

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About the public’s health

Are industry-funded charities promoting “advocacy-led studies” or “evidence-based science”?: a case study of the International Life Sciences Institute [ISLI]: The results of this research are disturbing. “Between June 2015 and February 2018, U.S. Right to Know, a non-profit consumer and public health group, submitted five U.S. state Freedom of Information requests (FOIs) to explore ILSI engagement with industry, policy makers, and/or researchers, which garnered a total of 17,163 pages for analysis…” Researchers found that “ILSI seeks to influence individuals, positions, and policy, both nationally and internationally, and its corporate members deploy it as a tool to promote their interests globally. Our analysis of ILSI serves as a caution to those involved in global health governance to be wary of putatively independent research groups, and to practice due diligence before relying upon their funded studies and/or engaging in relationship with such groups.” The research cites some very worrisome emails.
I cannot find a list of contributors to the ISLI on its website . The ISLI Research Foundation Annual Report lists sources for funding (2018 Financial Contributors, Collaborators, and Partners) and states 40% come from the private sector.

Read the research and draw your own conclusions

About pharma

US aims to help more cancer patients try experimental drugs: A physician can seek FDA approval for compassionate use of a drug if it has not yet been approved. But the application process is very cumbersome and time consuming. At this week’s ASCO meeting (see yesterday’s blog), the FDA announced that it will provide assistance to physicians by assigning a caseworker to help fill out the paperwork and expedite the compassionate use process.

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FDA wins groundbreaking case against for-profit stem cell company: Some for-profit companies have sought to exploit possible loopholes in regulations to treat patients with unproven stem cell therapies. In a groundbreaking decision, the FDA has succeeded in a lawsuit that accused a company of “openly violating the law and endangering patients by manufacturing an unapproved, experimental drug.” In other words, the FDA can regulate stem cell treatments as drugs.

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