What US Budget Cuts To Global Health Could Mean For Future Funding
On May 23, 2017, President Donald Trump released his FY 2018 budget request to Congress that includes approximately $2.5 billion in cuts to global health. These cuts had been foreshadowed in the administration’s earlier “Budget Blueprint,” which sought “deep cuts to foreign aid” to “free up funding for critical priorities here at home and put America first.”
Cuts to global health of this magnitude would be unprecedented and, while they already face opposition in Congress, provide a key statement of administration policy in an already constrained budget environment. In this post, we seek to assess what such a ...
Source: Health Affairs Blog - July 26, 2017 Category: Health Management Authors: Jennifer Kates, Nafis Sadat, Adam Wexler and Joseph Dieleman Tags: Costs and Spending Featured Global Health Policy development assistance for health Institute for Health Metrics and Evaluation Source Type: blogs
We Need To Raise The Bar To Improve Cancer Treatments. What ’s The Best Way To Do It?
Over the past 20 years, we have witnessed an unprecedented development of new life-science technologies. Although clinical outcomes have also improved, the benefits often remain out of reach for many patients. Translating scientific and technological gains into clinically meaningful outcomes that are accessible and affordable to all who need them is one of the great challenges of our time.
Several prominent voices have called on the field to “raise the bar” and aim higher in research efforts, to measurably and meaningfully lengthen and improve patients’ lives. The American Society of Clinical Oncology (ASCO), for exa...
Source: Health Affairs Blog - July 26, 2017 Category: Health Management Authors: Jacqueline Zummo Tags: Drugs and Medical Innovation clinical trials Source Type: blogs
Senate GOP Wins Vote To Debate Health Care, Then Loses Vote On ACA Replacement Bill
On July 25, 2017, the United States Senate began its long-awaited debate on repealing the Affordable Care Act. At around 2 in the afternoon, Senate Majority Leader McConnell called up a motion to proceed on consideration of the American Health Care Act, which the House of Representatives had passed on May 4, with a 217 to 213 vote. A motion to proceed on a budget reconciliation bill needs only to pass by a bare majority, but the Republicans hold only 52 of the chamber’s 100 votes, and Republican Senators Collins (ME) and Murkowski (AK) voted against proceeding.
What’s Happened So Far
There was high drama as Senator McC...
Source: Health Affairs Blog - July 26, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage abortion coverage ACA repeal and replace employer mandate individual mandate Planned Parenthood Source Type: blogs
Universal Health Coverage? Why?
The Congressional health care debate has become a war between two seemingly irreconcilable extremes, coverage versus budget control. Health care is a right, thunders Bernie Sanders (I-VT). There’s no free lunch, roars back Rand Paul (R-KY). We think both sides miss the boat. Forcing health care into this simplistic left-right straitjacket misleads the nation. It is time to recast the issue properly.
Public Investment
Universal health coverage is better viewed as neither owed to us by government nor a government give-away; both labels misinform. A more insightful analogy is universal public education. Does government ...
Source: Health Affairs Blog - July 25, 2017 Category: Health Management Authors: Walter McClure, Alain Enthoven and Tim McDonald Tags: Featured Following the ACA Insurance and Coverage ACA repeal and replace single payer Source Type: blogs
Universal Health Insurance? Why?
The Congressional health care debate has become a war between two seemingly irreconcilable extremes, coverage versus budget control. Health care is a right, thunders Bernie Sanders (I-VT). There’s no free lunch, roars back Rand Paul (R-KY). We think both sides miss the boat. Forcing health care into this simplistic left-right straitjacket misleads the nation. It is time to recast the issue properly.
Public Investment
Universal health insurance is better viewed as neither owed to us by government nor a government give-away; both labels misinform. A more insightful analogy is universal public education. Does government...
Source: Health Affairs Blog - July 25, 2017 Category: Health Management Authors: Walter McClure, Alain Enthoven and Tim McDonald Tags: Following the ACA Insurance and Coverage ACA repeal and replace single payer Source Type: blogs
Diffusion Of Community Health Workers Within Medicaid Managed Care: A Strategy To Address Social Determinants Of Health
Clinic notes from a Community Health Worker:
A 63 year old client and her 70 year old husband had been evicted from their apartment while they were hospitalized and were living in a motel. I was able to assist the elderly couple in finding a new apartment… I’ve helped other clients find housing, jobs, and medical homes, no longer living on the streets.…Another client has been sober for one month, attending church which helped her through the trauma of being a victim of human trafficking…We then helped a woman escape a violent relationship and obtain affordable legal help. We…helped [her son] grapple with his own ...
Source: Health Affairs Blog - July 25, 2017 Category: Health Management Authors: Carolina Nkouaga, Arthur Kaufman, Charlie Alfero and Claudia Medina Tags: Diffusion of Innovation Featured Medicaid and CHIP Organization and Delivery Population Health Public Health Quality Medicaid Managed Care Social Determinants of Health Source Type: blogs
IRS Finalizes Premium Tax Credit Rules Virtually Unchanged
On July 24, 2017, the Internal Revenue Service finalized proposed and temporary regulations governing Affordable Care Act (ACA) premium tax credits that had been issued in July of 2014. Except for one minor technical change, the 2014 proposed and temporary rules are adopted unchanged. The temporary regulations were apparently about ready to expire. The preamble to the regulation rejects a number of suggestions to extend the earlier rules, but does so in a calm and reasonable manner that is almost jarring given the current inflamed rhetoric surrounding the ACA. Until the ACA is amended, it is still the law of the land and t...
Source: Health Affairs Blog - July 25, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage Source Type: blogs
House Appropriations Committee Approves Draft Bill Affecting ACA Funding For 2018
On July 18, 2017, the House Appropriations Committee approved a draft Labor, Health and Human Services, Education, and Related Agencies Appropriations bill for 2018 (Committee Report). The bill includes a number of provisions relevant to the Affordable Care Act. It would:
Require the Department of Health and Human Services (HHS) to establish a website providing detailed information as to grants provided through the Prevention and Public Health Fund;
Require HHS to provide information on all full-time equivalent employees and contractors who have been engaged in implementing the ACA since its enactment, subject to certain ...
Source: Health Affairs Blog - July 24, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Source Type: blogs
Senate Health Care Legislation Would Grant HHS Unprecedented Power Over States
In an earlier Health Affairs Blog post, we described several provisions in the Senate’s Better Care Reconciliation Act (BCRA) that would grant the U.S. Department of Health and Human Services (HHS) largely unchecked authority to make decisions that could significantly affect state budgets. We noted that, based on past interactions between state and federal Medicaid officials, HHS might use its resulting leverage to pressure states to fall in line with the current Administration’s policy preferences.
Perhaps inevitably, exceptionally broad delegation of policymaking authority has become a defining feature of the Senate ...
Source: Health Affairs Blog - July 24, 2017 Category: Health Management Authors: Stan Dorn and Sara Rosenbaum Tags: Featured Following the ACA BCRA Source Type: blogs
Introducing A New Series Of Health Affairs Policy Primers: Prescription Drug Pricing
For policy makers at every level of government it is easy to recognize the deep impact of soaring prescription drug prices. Bold headlines, countless hearings, and recent legislation have all raised the alarm about, and floated policy solutions to address, sharp price spikes, sudden shortages, growing out-of-pocket costs, and other serious obstacles to patients’ access.
Much more difficult is the work required to untangle the complicated interplay of forces that are driving prices so high. Health Affairs has long published the work of researchers doing the critical work of identifying, evaluating, and measuring those for...
Source: Health Affairs Blog - July 24, 2017 Category: Health Management Authors: Rob Lott Tags: Elsewhere@ Health Affairs Source Type: blogs
Medicaid Expansion Reduced Unpaid Medical Debt And Increased Financial Satisfaction
As federal lawmakers continue to debate whether to repeal, and perhaps eventually replace, the Affordable Care Act (ACA), it is clear that Republican health care proposals would significantly scale back a key feature of the ACA: allowing states to expand Medicaid for adults up to 138 percent of the federal poverty line. This policy decision should be informed by a thorough accounting of the ACA’s Medicaid expansion’s effects.
In this post, we present new evidence that the ACA’s Medicaid expansion reduced the share of low-income Americans with unpaid medical debt and improved their satisfaction with their own financia...
Source: Health Affairs Blog - July 24, 2017 Category: Health Management Authors: Aaron Sojourner and Ezra Golberstein Tags: Following the ACA Medicaid and CHIP medicaid expansion states medical debt Source Type: blogs
Senate Parliamentarian Rules Several BCRA Provisions Violate The Byrd Rule
Democrats are reporting that on July 21, 2017, the Senate Parliamentarian ruled that a number of provisions of the Republican Better Care Reconciliation Act (BCRA) violate the Byrd Rule, and thus cannot be passed by the Senate using the reconciliation act procedure through which Congress has been trying to repeal the Affordable Care Act (ACA). The Byrd Rule requires, among other things, that a provision adopted through a reconciliation act affect the revenues or outlays of the United States in a manner than it not merely incidental to another purpose. A provision that the Parliamentarian rules to be impermissible under the...
Source: Health Affairs Blog - July 21, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage ACA repeal and replace BCRA byrd rule Source Type: blogs
CBO ’s Estimates Of The Revised Senate Health Bill
The Congressional Budget Office (CBO) produced cost estimates for two of the three versions of the Better Care Reconciliation Act (BCRA), sponsored by Senate Republican leaders. A comparison of the June 26 and July 20 estimates confirms that the two BCRA versions do not differ substantially from each other. CBO has not estimated the impact of the much-discussed amendment to the BCRA sponsored by Senator Ted Cruz (R-TX), which is included in the July 13 draft. That provision would allow insurers to sell products to consumers that are out of compliance with the requirements of the Affordale Care Act (ACA), as long as they ...
Source: Health Affairs Blog - July 21, 2017 Category: Health Management Authors: Joseph Antos and James Capretta Tags: Following the ACA Insurance and Coverage ACA repeal and replace BCRA Source Type: blogs
Orphan Diseases Or Population Health? Policy Choices Drive Venture Capital Investments
The US exhibits a remarkable pipeline of biopharmaceutical innovation, with 170 new drugs and biologics launched into the market between 2011 and 2015 and another 22 drugs approved in 2016. A striking feature of the pharmaceutical pipeline is the large percentage launched for the treatment of small “orphan” indications, defined by the Food and Drug Administration (FDA) as including fewer than, often many fewer than, 200,000 patients in the United States. Almost half (74) of the products approved by the FDA between 2011 and 2015 were for orphan indications, twice the number (36) approved during the same period by the Eu...
Source: Health Affairs Blog - July 21, 2017 Category: Health Management Authors: Dayton Misfeldt and James C. Robinson Tags: Costs and Spending Drugs and Medical Innovation Orphan Drug Act orphan drugs venture capitalism Source Type: blogs
The Latest CBO Score Of The Better Care Reconciliation Act Leaves 22 Million Uninsured by 2026 (Update)
July 21 Update. The July 21, 2017 Congressional Budget Office report did not score the Cruz amendment to the BCRA. The Cruz amendment would allow insurers to sell plans that would not be required to comply with a number of ACA requirements—including guaranteed issue, community rating, preexisting condition coverage, and the essential health benefits—as long as the insurers sold plans that complied with the ACA. It is reported that the CBO would have to take some time to produce a score, in part no doubt because the ACA non-compliant coverage permitted by the Cruz amendment might not qualify as health insurance...
Source: Health Affairs Blog - July 20, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage ACA repeal and replace BCRA Source Type: blogs
