What’s New in Health Care Reform: Jan. 13


What's New in Health Care Reform provides an overview of the past week’s news, updates, and commentary in health care reform and utilization management.

Medicare Expands Coordinated Care for 8.9M Beneficiaries

Medicare is expanding a major experiment that strives to keep seniors healthier by coordinating basic medical care to prevent common problems that often lead to hospitalization, the agency said. Officials announced 121 new "accountable care organizations," networks of doctors and hospitals that collaborate to better serve patients with chronic medical conditions. A limited number will be able to directly recruit patients. Via AP.

ObamaCare Costs Set to Spike for Thousands

About 43,000 ObamaCare enrollees are bearing the full cost of their insurance plans after losing the tax credits that are meant to make coverage more affordable. Those enrollees no longer receive ObamaCare tax credits because they failed to file a tax return for 2014, according to the Department of Health and Human Services (HHS). The number has never before been released. Via The Hill. 

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Gaming ObamaCare

ObamaCare customers are gaming the system, buying coverage only after they find out they’re ill and need expensive care — a trend insurers warn is destabilizing the fledgling health law marketplaces and spiking premiums for everyone. Via Politico.

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Obama Vetoes Bill to Repeal Signature Health Care Law

Protecting his signature domestic achievement, President Barack Obama vetoed Republican-inspired legislation to repeal his health care law, saying to do so “would reverse the significant progress we have made in improving health care in America.” Republican lawmakers have pushed many repeal measures since 2010, when Obama signed the health care program into law. This bill was the first one to make it through Congress and reach his desk. Via Washington Post.

Insurers Say Costs Are Climbing as More Enroll Past Health Act Deadline

Eager to maximize coverage under the Affordable Care Act, the Obama administration has allowed large numbers of people to sign up for insurance after the deadlines in the last two years, destabilizing insurance markets and driving up premiums, health insurance companies say. Via NY Times.

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ObamaCare Enrollment Passes 11.3 Million Mark

Twenty-four percent, or 2.7 million, of this season’s enrollees signed up on one of the 13 individual state exchanges as of Dec. 26, while 8.6 million people have signed up on the federal exchanges through Jan. 2. Via Morning Consult.

Health Care’s $605 Billion Buying Binge May Slow in 2016

When it comes to dealmaking, the health-care industry defied belief in 2015 with $605 billion of takeovers. While 2016 may be a good year, it’s unlikely to beat that record. Some of the most active acquirers, like drugmaker Pfizer Inc., are going to be busy digesting purchases instead of hungering for new ones. Pfizer last year agreed to buy Allergan Plc, itself a prolific merger partner, for $160 billion. And Valeant Pharmaceuticals International Inc., another major player, is busy resetting after a scandal in its drug distribution channels.  Via Bloomberg.

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Number of Uninsured Parents, Children on the Decline

A pair of research briefs out today from the Urban Institute show declines in the number of uninsured parents and children between 2013 and 2015, though many uninsured parents say they still feel that health insurance is too expensive. The growth in the number of insured parents is especially important, the researchers said, because children are less likely to be covered if their parents don’t have insurance. Via Morning Consult.

Lawmakers Propose Bipartisan Bill to Boost Mental Health Funding

The bill would expand on a 2014 law that provides funding for a trial program for eight states to create community mental health centers. The centers are to offer services such as 24-hour crisis psychiatric care. The bill expands on this effort by providing funding for 24 states to have the new clinics, an increase from the eight states designated in the 2014 law. Via The Hill.

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New Breast Cancer Screening Guidelines at Odds With Congress

The controversy over when a woman should get mammograms is about to heat up again. The U.S. Preventive Services Task Force, an independent panel of experts whose members are appointed by the federal government, issued a final set of  recommendations saying that women between the ages of 50 and 74 should get routine screening once every two years. The task force's guidelines are important because insurers and government programs often follow the panel's recommendations in deciding whether to cover certain preventive services. The task force's final recommendation is likely to be controversial because some other groups say the screening should start earlier. Via Washington Post.

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Kelley Schreiber

Kelley Schreiber is a Marketing Channel Manager at Mayo Medical Laboratories. She is the principle editor and writer of Insights and leads social media and direct marketing strategy. Kelley has worked at Mayo Clinic since 2013. Outside of work, you can find Kelley running, traveling, playing with her new kitten, and exploring new foods.