Feds approve Cigna-Express Scripts mega-merger

Federal regulators have approved health insurer Cigna’s $52 billion acquisition of drug benefits manager Express Scripts, a mega deal that’s the latest evidence of health care giants bulking up, the companies said in an announcement Monday.

The combination represents a major reshuffling of the health care industry as companies try to constrain costs and gird for the long-expected entrance of Amazon into the sector.

The Justice Department reportedly is also close to approving CVS Health’s blockbuster acquisition of Aetna, which would create one of the country’s biggest health care companies.

The looming approval of the deals comes two years after Obama administration regulators blocked a major proposed consolidation in the health insurance industry over concerns about diminished competition. DOJ successfully sued in 2016 to halt Anthem’s proposed acquisition of Cigna and Aetna’s merger with Humana.

By contrast, the Cigna-Express Scripts deal was expected to be approved with few strings attached. Continue reading “Feds approve Cigna-Express Scripts mega-merger”

What we don’t know about Bernie’s favorite healthcare idea

Since Bernie Sanders made “Medicare-for-all” a central plank of his wildfire presidential campaign, support for a once-fringe idea has exploded. Democratic senators with eyes on the 2020 presidential contest – including Cory Booker, Kirsten Gillibrand and Kamala Harris – have conspicuously lined up as co-sponsors of the “Medicare-for-all” legislation that Sanders introduced last year; a similar proposal in the House has 123 co-sponsors. All of those politicians are Democrats, but among voters, support appears to cross the aisle: A recent Reuters/Ipsos poll showed that “Medicare-for-all” was supported by 70 percent of American adults, including a slight majority of Republicans.

It’s easy to understand the political appeal of a phrase that invokes the broadly popular Medicare program and promises new benefits for everyone. But scratch beyond the slogan, and “Medicare-for-all” starts to raise more questions than it answers. The American health care system is a vastly complicated $3 trillion slice of Continue reading “What we don’t know about Bernie’s favorite healthcare idea”

Obama touts Medicare for all as evidence of Democrats’ new ideas

Former President Barack Obama blasted Republicans on Friday for their attempts to dismantle Obamacare and touted "Medicare for all" as evidence Democrats are proposing fresh policy ideas ahead of the midterm elections.

“They’re sabotaging the Affordable Care Act, already cost more than 3 million Americans their health insurance,” Obama said in a wide-ranging speech that also criticized the Trump administration‘s policies. “And if they’re still in power next fall, you better believe they’re coming at it again. They’ve said so.”

The remarks at the University of Illinois Urbana-Champaign launched Obama’s midterm campaigning and drew attention to calls for universal health coverage, a cause that has rallied progressives in congressional races and statewide initiatives.

“Democrats aren’t just running on good old ideas like a higher minimum wage, they’re running on new ideas, Medicare for all,” Obama said.

The Affordable Care Act, Obama’s signature domestic policy achievement, has provided coverage to Continue reading “Obama touts Medicare for all as evidence of Democrats’ new ideas”

Red states take Obamacare back to court, picking up where Congress left off

The latest bid to kill Obamacare begins Wednesday, when lawyers from 20 states march into a federal courthouse in Fort Worth, Texas, seeking to end the health law immediately.

Attorneys general from mostly conservative states will try to pick up where the GOP-led Congress left off, seeking a permanent injunction halting enforcement of the law. They argue that because Congress gutted the individual mandate — zeroing out the penalty for not having coverage starting next year — the rest of the law needs to go as well.

Numerous legal experts have deemed the argument a stretch, but Attorney General Jeff Sessions has thrown the Trump administration’s weight behind key parts of the assault — with Sessions notably opposing the law’s popular protection for people with pre-existing conditions.

An injunction is unlikely, but these first oral arguments will serve as an overture for a high-profile court battle that could reach the Continue reading “Red states take Obamacare back to court, picking up where Congress left off”

Why ‘Medicare for all’ is playing poorly in Democratic primaries

Most of the prominent Democrats eyeing 2020 presidential bids — including Sens. Kirsten Gillibrand of New York, Cory Booker of New Jersey and Elizabeth Warren of Massachusetts — champion the idea of “Medicare for all,” suggesting it’s become almost a litmus test for the party’s base.

But the notion of government-funded health care has proved a tough sell to Democratic voters in swing districts that will determine control of the House.

Many Democratic candidates who made that a centerpiece of their campaigns in key districts this year lost their primaries, in some cases getting clobbered by rivals who offered vaguer health care plans or backed a more incremental approach. Democratic primary voters in battleground districts in Iowa, Texas, Kansas and New York passed over candidates who emphatically supported single payer.

“The problem is Medicare for all just isn’t one of those litmus tests for Democratic primary voters,” said John Anzalone, Continue reading “Why ‘Medicare for all’ is playing poorly in Democratic primaries”

Oral arguments in Texas Obamacare suit set for Sept. 10

Oral arguments have been scheduled for Sept. 10 in a Texas lawsuit seeking to strike down Obamacare as unconstitutional.

The case was filed in February by 20 Republican state attorneys general. They’re seeking a preliminary injunction halting enforcement of the federal health care law.

The Trump administration has partly sided with the plaintiffs in seeking to strike down the Affordable Care Act’s insurance protections, including the prohibition on denying coverage to individuals with pre-existing medical conditions.

The lawsuit is certain to factor in the mid-term elections. Democrats have already pilloried Republicans for trying to eliminate one of the most popular provisions of Obamacare. Polling shows widespread support for pre-existing condition protections across party lines.

The arguments are scheduled to take place at 9:30 a.m. before Judge Reed O’Connor.

Trump whacks Obamacare by boosting short-term health plans

The Trump administration has finalized rules making it easier to enroll in short-term insurance plans, another blow to Obamacare markets that increases access to cheaper, skinnier coverage that doesn’t adhere to the health care law’s standards.

Critics deride short-term plans as “junk” insurance that won’t protect people with pre-existing conditions, and they argue the plans will undermine Obamacare’s fragile exchanges by siphoning off healthy customers. The Trump administration has prioritized expanding coverage options, arguing that the Affordable Care Act severely eroded choice for individuals shopping for insurance.

In June, the Trump administration finalized rules making it easier for small businesses and independent contractors to band together to offer association health plans that aren’t subject to the ACA’s coverage mandates. The moves stem from an executive order signed by President Donald Trump in October — after congressional repeal efforts fell through — directing administration officials to overhaul regulations and allow more Continue reading “Trump whacks Obamacare by boosting short-term health plans”

The Sex-Trafficking Case Testing the Limits of the First Amendment

In June 2015, an ad appeared on Backpage.com in Texas with a series of alluring photos of a naked woman, who described herself to potential dates as “fun, young, exotic,” and “ready to be your fantasy girl.” By the end of the month, the woman had been murdered by a customer who responded to the ad. He set her corpse on fire in an attempt to destroy the evidence. When the victim’s father contacted Backpage.com to try and get the pictures of his dead daughter removed from the site, the company didn’t immediately comply.

At the time, Backpage was the largest online publisher of sex ads in the world with city-specific sites spanning 97 countries. In the 11 years since it had been launched, it had earned some $500 million for its owners. But it was also the scourge of law enforcement officials across the country whose Continue reading “The Sex-Trafficking Case Testing the Limits of the First Amendment”

Reversal of fortune: Obamacare rate hike pose headache for Republicans

Obamacare premiums are once again poised to spike by double digits in 2019, causing heartburn for politicians as voters will head to the polls within days of learning about the looming hit to their pocketbooks.

But unlike recent campaign cycles, when Republicans capitalized on Obamacare sticker shock to help propel them to complete control of Congress and the White House, they’re now likely to be the ones feeling the wrath of voters.

That’s because Republicans are now in total control of the federal government and therefore on the hook for the health care system’s chronic shortcomings. Polling data has consistently suggested that more voters will blame Republicans for future problems with Obamacare. In addition, the GOP’s repeated failures to repeal Obamacare after eight years of campaign promises will make it difficult to galvanize the base on health care.

Democrats and their allies have been hammering President Donald Trump and congressional Continue reading “Reversal of fortune: Obamacare rate hike pose headache for Republicans”

Trump’s new health insurance rules expected to hurt Obamacare

Obamacare will suffer another blow on Tuesday when the Trump administration finalizes plans to make it easier for small businesses and trade groups to band together to purchase health coverage outside of the law’s insurance markets.

The White House is touting the expansion of so-called association health plans — which offer fewer consumer protections than Obamacare coverage — as a much-needed cheaper alternative. The administration will also soon finalize rules boosting short-term plans that offer skimpier coverage than the 2010 health care law.

The new rules, which the Labor Department will release Tuesday afternoon, are an effort to follow through on President Donald Trump’s frequent campaign promise to allow the sale of health insurance across state lines. Critics have warned Tuesday’s announcement will further drive up Obamacare premiums and weaken the law.

“They’ll be able to cross state lines and they will get great competitive health care and it will Continue reading “Trump’s new health insurance rules expected to hurt Obamacare”

Court: Federal government doesn’t owe insurers Obamacare payments

The federal government doesn’t have to pay health insurers money they claim they’re owed from an Obamacare program, a federal appellate court ruled Thursday morning in a case with billions of dollars at stake.

A divided three-judge panel rejected claims from two Obamacare insurers that the federal government was required to make good on payments from a program meant to protect insurers who attracted customers who were sicker and more expensive than anticipated.

The two insurers were seeking hundreds of millions of dollars in payments from Obamacare’s risk corridors program, and at least three dozen other insurers have filed similar lawsuits. In all, insurers say they’re owed more than $12 billion from the risk corridors program.

The court, siding with the Trump administration, said that the federal government didn’t have to make the payments because Congress took action requiring the program to be budget neutral.

“Congress clearly indicated its intent Continue reading “Court: Federal government doesn’t owe insurers Obamacare payments”

Medicare to go broke three years earlier than expected, trustees say

Medicare’s hospital trust fund is expected to run out of money in 2026, three years earlier than previously projected, the program’s trustees said in a new report published this afternoon.

The more pessimistic outlook is largely due to reduced revenues from payroll and Social Security taxes and higher payments than expected to hospitals and private Medicare plans last year.

The solvency report is the first since the repeal of Obamacare’s Independent Payment Advisory Board earlier this year as part of a massive spending agreement in Congress. The panel of outside experts was designed to tame excessive Medicare spending growth, but costs never grew fast enough to trigger the controversial board and no members were ever appointed.

Social Security faces depletion in 2034, the program’s trustees also said today. That’s identical to last year’s projection.

President Donald Trump has avoided major changes to Medicare or Social Security after promising not to Continue reading “Medicare to go broke three years earlier than expected, trustees say”

Opioid court fights risk repeating tobacco’s failures

The litigation stemming from the opioid crisis is staggering in its scope: hundreds of cities, counties, states, Native American tribes and hospitals seeking damages from drugmakers and distributors.

It’s arguably the most complex, potentially lucrative litigation since the $240 billion tobacco settlements 20 years ago. And this time around, public health experts want to ensure that resources to combat the opioid epidemic aren’t squandered.

Only a pittance of the billions in tobacco company payouts has been spent on combating tobacco use. Instead, much of the money, which the industry continues to pay out, is plowed into state slush funds and used to patch budget shortfalls. In the most extreme cases, states sacrificed future payments for much smaller, but immediate infusions of cash to pay workers, or build schools and roads. One state even renovated a morgue.

“It didn’t matter if it was a blue state or a red state,” said Continue reading “Opioid court fights risk repeating tobacco’s failures”

Obamacare insurers just had their best year ever — despite Trump

Obamacare is no longer busting the bank for insurers.

After three years of financial bloodletting under the law — and despite constant repeal threats and efforts by the Trump administration to dismantle it — many of the remaining insurers made money on individual health plans for the first time last year, according to a POLITICO analysis of financial filings for 29 regional Blue Cross Blue Shield plans, often the dominant player in their markets.

The biggest reason for the improvement is simple: big premium spikes. The Blue plans increased premiums by more than 25 percent on average in 2017, meaning many insurers charged enough to cover their customers’ medical costs for the first time since the Affordable Care Act marketplaces launched in 2014 with robust coverage requirements.

“2017 was the first year we got our head above water in the individual market since the ACA passed,” said Steven Udvarhelyi, CEO Continue reading “Obamacare insurers just had their best year ever — despite Trump”

Head of major insurer lobby stepping down after turbulent term

Marilyn Tavenner is stepping down after three tumultuous years at the helm of America’s Health Insurance Plans, a K Street powerhouse that’s seen its influence decline as Washington grew more hostile to Obamacare.

Tavenner oversaw AHIP as Republicans took full control of the federal government, hellbent on dismantling the 2010 health care law. The industry group was forced to take on that fight with diminished resources, with three of the country’s largest insurers — UnitedHealth Group, Aetna and Humana — dropping out of the organization in recent years. AHIP spent $6.5 million on lobbying last year — a nearly 40 percent decline from four years earlier.

Tavenner will be replaced by Matt Eyles, who is currently the lobby’s chief operating officer.

The 2015 hiring of Tavenner, who served as CMS administrator under former President Barack Obama, was initially seen as a coup following the departure of AHIP’s longtime, dynamic Continue reading “Head of major insurer lobby stepping down after turbulent term”

White House pitch to bolster Obamacare includes tough trade-offs for Democrats

The White House is seeking a package of conservative policy concessions — some of which are certain to antagonize Democrats — in return for backing a legislative package bolstering Obamacare markets, according to a document obtained by POLITICO.

The document indicates the administration will support congressional efforts to prop up the wobbly marketplaces, in exchange for significantly expanding short-term health plans and loosening other insurance regulations.

The document also makes several references to abortion language that will be problematic for Democrats. A potential stumbling block in passing any stabilization package is whether conservatives will insist on including language prohibiting the use of government dollars to pay for abortions.

"Although congressional efforts to provide taxpayer money to prop up the exchanges is understandable, any such efforts must also provide relief to middle-class families harmed by the law and protect life," the document states.

The source of the document provided to POLITICO Continue reading “White House pitch to bolster Obamacare includes tough trade-offs for Democrats”

Trump proposal boosts skimpy insurance plans, again undercutting Obamacare

The Trump administration is proposing to expand the availability of short-term health insurance plans that some deride as “junk insurance” — an effort that could give consumers cheaper coverage options but undermine Obamacare’s marketplaces and popular protections for pre-existing medical conditions.

Proposed rules issued this morning follow an executive order from President Donald Trump this fall seeking to expand access to more affordable health insurance alternatives to comprehensive, but pricey Obamacare plans. The HHS proposal, released weeks after the Trump administration issued a rule encouraging small businesses to find coverage outside the Affordable Care Act marketplaces, represents the administration’s latest effort to unwind the health care law with repeal efforts stalled in Congress.

“The status quo is failing too many Americans who face skyrocketing costs and fewer and fewer choices," said Health and Human Services Secretary Alex Azar in a statement. "The Trump Administration is taking action so individuals and Continue reading “Trump proposal boosts skimpy insurance plans, again undercutting Obamacare”

Amazon’s new health care business could shake up industry after others have failed

Three corporate behemoths are promising to shake up the health care industry — a notoriously inefficient sector that represents nearly a fifth of the U.S. economy.

Though the surprise Tuesday morning announcement from Amazon, JPMorgan Chase and Berkshire Hathaway was grand in ambition, it was scarce in details, leaving plenty of questions about just how the companies could tackle an unsustainable $3.3 trillion health care system when so many others have tried and failed.

“The ballooning costs of healthcare act as a hungry tapeworm on the American economy,” Berkshire Hathaway CEO Warren Buffett said in a statement. “Our group does not come to this problem with answers. But we also do not accept it as inevitable.”

Their partnership, at least at the outset, may be limited. The three companies said they will band together to provide cheaper coverage to their employees, relying on technology in some unspecified Continue reading “Amazon’s new health care business could shake up industry after others have failed”

Trump administration rolls out bid to expand association health plans

The Trump administration Thursday proposed new rules following up on the president’s pledge to let certain small businesses and trade groups band together to buy health care, a move that could weaken the Obamacare insurance marketplaces.

The expansion of so-called association health plans is part of a broader effort to encourage the rise of cheaper coverage options that don’t comply with certain Obamacare patient protections and benefit rules.

The proposed rules stem from an executive order President Donald Trump signed in October directing federal agencies to loosen restrictions on short-term health insurance and association health plans, in a bid to create more competition and drive down premiums. However, state insurance regulators and Obamacare advocates have warned the lax rules could open the door to a new wave of poorly regulated health plans that offer limited coverage.

The proposed rule issued Thursday by the Labor Department would rewrite existing regulations under Continue reading “Trump administration rolls out bid to expand association health plans”

Obamacare sign ups surge, despite Trump’s declaration on ‘repeal’

The latest HealthCare.gov enrollment season closed with a surge of sign-ups, unexpectedly putting Obamacare enrollment on track to potentially match last year’s figures despite the GOP’s attacks on the health care law.

A total of 8.8 million individuals signed up for coverage through the Dec. 15 deadline in the 39 states relying on HealthCare.gov, a top Trump administration health official announced on Twitter Thursday afternoon. And more than 2.5 million have so far enrolled through state-run insurance marketplaces, many of which are still allowing people to sign up over the new few weeks.

The robust enrollment pace defies President Donald Trump’s insistence that Obamacare is "dead" and will likely make Republican efforts to dismantle the 2010 health care law even more challenging after failed repeal efforts this year.

Obamacare supporters say sign-ups far surpassed their expectations, given the ongoing repeal effort in Congress, the president’s harsh Continue reading “Obamacare sign ups surge, despite Trump’s declaration on ‘repeal’”