December 20, 2018 

Volume 5, Number 15

In This Issue

2019 Open Enrollment Falls Slightly

TX Judge: ACA is Unconstitutional

ACA: What happens Now?

CVS and Aetna Integration

Sen. Booker Seeks Medicaid Rx Transparency

Sen. Alexander Will Not Pursue Reelection

Health Insurance on Demand?

Officials Fret Vaping Boom of Teens

Cigna Predictions of Opioid Abuse

US: Most Expensive for ‘Biologic’ Drugs

182K VA Enrolled New Health Coverage

More Pets, Fewer Allergies

2018: Health & Meds

TJG On Facebook

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The New York Times: Despite Challenges, Health Exchange Enrollment Falls Only Slightly
In the open enrollment period that ended on Saturday, the number of sign-ups totaled 8.45 million, down from 8.82 million at the same point last year, a drop of about 367,000, or 4 percent, despite warnings that a more precipitous drop could be in the offing. Democrats have repeatedly accused President Trump of sabotaging the Affordable Care Act and its marketplace by promoting short-term health policies with skimpier coverage, substantially cutting enrollment promotion efforts and nearly eliminating funds for “navigators” who help potential enrollees through the process. Congress also zeroed out the health law’s penalty for not being covered, starting in 2019. But Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, said that “enrollment remained steady through HealthCare.gov.” (Pear, 12/19)

Source: The NY Times

Kaiser Health News: Judge Strikes Down ACA Putting Law In Legal Peril — Again
The future of the Affordable Care Act is threatened — again — this time by a ruling Friday from a federal district court judge in Texas. Judge Reed C. O’Connor struck down the law, siding with a group of 18 Republican state attorneys general and two GOP governors who brought the case. O’Connor said the tax bill passed by Congress last December effectively rendered the entire health law unconstitutional. (Rovner, 12/14)

Source: Kaiser Health News

Kaiser Health News: What Just Happened To The ACA And What Happens Now? A Special Bonus Edition
Federal District Judge Reed O’Connor again thrust the Affordable Care Act into uncertainty with his ruling Friday that eliminating the tax penalty for not having insurance renders the entire law unconstitutional. The panelists for this special bonus episode of KHN’s “What the Health?” are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Stephanie Armour of The Wall Street Journal and Paige Winfield Cunningham of The Washington Post. (12/17)

Source: Kaiser Health News

The Wall Street Journal: CVS Urges Judge Not To Halt Integration Of Aetna
CVS has argued that halting all integration would cause irreparable harm to the company and its customers. Instead, it offered four measures it said would help facilitate Judge Leon’s review. Among them, CVS pledged that Aetna would maintain its historical control over pricing of products and services for its insurance customers, and that CVS and Aetna wouldn’t exchange competitively sensitive information for the time being. (Kendall, 12/18)

Source: The Wall Street Journal

NPR: Sen. Cory Booker Seeks Increased Transparency In Medicaid's Drug Decisions
Sen. Cory Booker, D-N.J., says he will introduce federal legislation this week that would require more transparency surrounding states' Medicaid drug decisions. The bill comes in response to a recent investigation by the Center for Public Integrity and NPR. The measure, known as the "Medicaid Drug Decisions Transparency Act," would require pharmaceutical companies to disclose their payments to pharmacists and others who serve on state Medicaid drug boards. These boards help decide which drugs Medicaid patients will be able to access easily. Currently drugmakers must only disclose perks given to doctors, such as free dinners, speaking fees and consulting gigs. In addition, the bill would increase penalties for companies that fail to comply with reporting requirements. (Whyte, 12/17)

Source: NPR

Stat: Sen. Alexander, Leading Republican On Health Care, Will Not Seek Reelection
One of Washington’s most influential health policymakers, Sen. Lamar Alexander, will not seek reelection in 2020, he announced Monday. The Tennessee Republican has chaired the powerful Senate Health, Education, Labor, and Pensions Committee since 2015, where he presided over a number of high-profile health care bills, including the 21st Century Cures Act, and the Republican party’s eventually abandoned effort to repeal Obamacare. (Florko, 12/17)

Source: Stat

The Associated Press: Health Insurance On Demand? Some Are Betting On It
People with health insurance often pay for coverage they never use. A startup wants to shake that up. It's a radical idea: On-demand insurance that lets customers buy some of their coverage only if and when they need it, similar to how TV viewers might rent a new release from Amazon instead of paying every month for a pricey cable package they rarely use. This approach from Bind Benefits is one of the latest wrinkles in a yearslong push by companies and insurers to control costs and make patients smarter health care shoppers. (12/17)

Source: The Associated Press

The Associated Press: Most Teen Drug Use Is Down, But Officials Fret Vaping Boom
Twice as many high school students used nicotine-tinged electronic cigarettes this year compared with last year, an unprecedented jump in a large annual survey of teen smoking, drinking and drug use. It was the largest single-year increase in the survey's 44-year history, far surpassing a mid-1970s surge in marijuana smoking. (12/17)

Source: The Associated Press

The Wall Street Journal: Cigna’s Algorithms Aim To Predict Opioid Abuse
Cigna Corp. is using artificial intelligence to predict whether patients might abuse and or overdose on prescription opioids as part of the company’s commitment to reducing the substance’s use among its consumers, said Mark Boxer, executive vice president and global chief information officer. Cigna’s proprietary algorithms are aided by the use of machine learning, a subfield of artificial intelligence that refers to the science of getting computers to act intelligently without being explicitly programmed. (Castellanos, 12/13)

Source: The Wall Street Journal

Kaiser Health News: Why The U.S. Remains The World’s Most Expensive Market For ‘Biologic’ Drugs
Europeans have found the secret to making some of the world’s costliest medicines much more affordable, as much as 80 percent cheaper than in the U.S. Governments in Europe have compelled drugmakers to bend on prices and have thrown open the market for so-called biosimilars, which are cheaper copies of biologic drugs made from living organisms. The brand-name products — ranging from Humira for rheumatoid arthritis to Avastin for cancer — are high-priced drugs that account for 40 percent of U.S. pharmaceutical sales. (Tribble,12/20)

Source: Kaiser Health News

The Associated Press: Northam: 182K Enrolled In New Health Coverage
More than 182,000 Virginians have enrolled in new health coverage that begins in the new year. Gov. Ralph Northam announced the enrollment in the new coverage under Medicaid expansion on Wednesday. The coverage is available to 19- to 64-year-olds who are not eligible for Medicare and meet income requirements, which vary by family size. SNAP recipients and parents whose children receive Medicaid coverage can use a short-form application to sign up by Jan. 4. (12/19)

Source: The Associated Press

The New York Times: More Pets, Fewer Allergies
Children who live with cats and dogs when they are infants are less likely to develop allergies later in childhood — and the more pets they have, the better, a Swedish study of 1,278 children has found. Researchers interviewed the parents of 249 of the children when they were 6 to 12 months old, gathering information on pet ownership, and had clinical evaluations done at 18 months, 3 years and 8 to 9 years. (Bakalar, 12/19)

Source: The New York Times

The New York Times: What We Learned In 2018: Health And Medicine
It’s not easy to say that any particular development in health or medicine was the most important in a given year. But if we had to choose some highlights, we’d opt for these unforgettable events and findings. (12/20)

Source: The New York Times

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