What’s New in Health Care Reform: March 16


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.

Three Changes Consumers Can Expect in Next Year’s Obamacare Coverage

Health insurance isn’t simple. Neither are government regulations. Put the two together and things can get confusing fast. So it’s not surprising that federal regulators took a stab at making things a bit more straightforward for consumers in new rules unveiled in late February and published in the Federal Register. Because those rules are part of a 530-page, dizzying array of changes set for next year and beyond, here are three specific changes finalized by the Department of Health and Human Services that affect consumers who buy their own health insurance in one of the 38 states using the online federal insurance exchange. Via Kaiser Health News.

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4.9 Million New People Bought Insurance on State, Federal Exchanges

4.9 million new people signed up for health insurance on the state and federal exchanges during the third open enrollment period, the Department of Health and Human Services announced. The report is the first to include details about new customers on both the federal and state exchanges. Via Morning Consult. 

Obama Health Law Missed 2016 Enrollment Target

Last year's final enrollment numbers under President Barack Obama's health care law fell just short of a target the administration had set, the government reported. The numbers are important because the insurance markets created by the president's 2010 health care law face challenges building and maintaining enrollment. The marketplaces offer subsidized private insurance to people who don't have access to job-based coverage. Via NY Times.

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Doctors Ponder Delicate Talks As Medicare Pays for End-Of-Life Counsel

Physicians can now bill Medicare $86 for an office-based, end-of-life counseling session with a patient for as long as 30 minutes. Medicare has set no rules on what doctors must discuss during those sessions. Patients can seek guidance on completing advance directives stating if or when they want life support measures such as ventilators and feeding tubes, and how to appoint a family member or friend to make medical decisions on their behalf if they cannot, for instance. Via USA Today.

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Health-Care Providers Aim to Fight Medicare Drug Plan

Specialty physicians and other health-care providers have launched efforts to derail a federal proposal to test whether paying doctors less for drugs administered under a Medicare program reduces spending, one day after the Obama administration released the plan. The administration would change other variables in 2017—for example, eliminating some Medicare beneficiaries’ out-of-pocket costs. Via Wall Street Journal.

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Obama Administration to Announce Investment to Fight Opioid Epidemic

Secretary of Health and Human Services Sylvia Burwell will make an announcement about a federal investment by the Obama administration to combat the nation’s opioid epidemic. The announcement will come a day after the Senate passed a bill authorizing nearly $80 million for drug abuse treatment and prevention programs. The White House has said the bill does not go far enough because it does not provide new funding. Via Morning Consult.

$1.2 Billion In Loans to Affordable Care Act Health Insurance Co-Ops May Be a Loss, Report Warns

The failures of a dozen non-­profit health insurance plans created by the Affordable Care Act could cost the government up to $1.2 billion, according to a harsh new congressional report that concludes federal officials ignored early warnings about the plans’ fragility and moved in too late as problems arose. Via Washington Post.

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Obamacare Payments Break the Law

Republicans are putting heightened scrutiny on Obamacare payments that they argue break the law. They say the administration is violating the Affordable Care Act by prioritizing payments to insurers over payments to the U.S. Treasury, and have grilled Health and Human Services Secretary Sylvia Burwell about the matter at recent hearings. Via The Hill.

High Deductibles Clash With Care Coordination and Primary Care

High deductibles add to consumers' financial stress and dissuade some patients from getting needed medical care. That is not only worrisome, but it could also block attempts to reform U.S. healthcare, health-policy experts warn in the latest New England Journal of Medicine. Via Modern Healthcare.

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Drugmakers, Insurers Blame Each Other For High Drug Prices

The rift between the insurer industry and the prescription drug industry exposes a conundrum. Who is responsible for the high cost of prescription drugs? Insurers say drug prices are too high, and drugmakers say insurers pass on too much of the tab for drugs to consumers. Via Morning Consult.


Andy Tofilon

Andy Tofilon is a Marketing Segment Manager at Mayo Medical Laboratories. He leads strategies for corporate communications, public relations, and new media innovations. Andy has worked at Mayo Clinic since 2003. Outside of work, Andy can be found running, hiking, snapping photos, and most importantly, spending time with his family.