Anthem May Pare Its Health Law Offerings If Profits Don’t Improve In 2017
Chief Executive Officer Joseph Swedish said he will be watching for significant changes that are aimed at improving the sustainability of the marketplace. If such changes aren't evident, the company will reassess its level of participation in the federal exchanges.
Reuters:
Anthem Says It May Trim Obamacare Participation In 2018
U.S. health insurer Anthem Inc on Wednesday raised the prospect of smaller participation in the individual Obamacare exchanges in 2018, saying it would have a market-by-market strategy that hinges on 2017 profitability. The company said that losses due to sicker-than-expected customers in its individual Obamacare plans were a bit less than foreseen in the third quarter and that it was planning for a slight profit in that business next year. (11/2)
The Associated Press:
CDC: Progress Reducing Uninsured Rate Threatens To Stall
President Barack Obama's legacy health care law has reduced the number of Americans going without health insurance to historically low levels, but continued progress threatens to stall this year, according to a new government report. The study released Thursday by the Centers for Disease Control and Prevention suggests the law may be reaching a limit to its effectiveness in a nation politically divided over the government's role in guaranteeing coverage. (11/3)
In other national health care news —
Stat:
Backlash Over High Prices Hits Pharma's Bottom Line
The simmering public outrage over drug prices finally seems to be catching up to the pharmaceutical industry. Earnings reports in recent days have laid out a grim picture of slumping sales and anemic growth projections at several large drug makers and wholesalers. Executives blame many factors — including heavy competition and hardball tactics from insurers — but analysts say the bottom line is crystal clear: Pharma can no longer count on steadily hiking drug prices. That realization has sent some drug stocks on a roller coaster. It’s also battering the middlemen in the prescription supply chain, who have made their money by taking a cut of ever-rising prices. (Keshavan, 11/3)
The Washington Post:
Medicare To Begin Paying For Diabetes Prevention Strategy
Medicare will start paying for a strategy to help millions of older Americans at high risk of diabetes from developing the disease, federal health officials announced Wednesday. The new benefits, scheduled to begin in 2018, are part of an increasing shift in the federal entitlement program, from its half-century tradition of mainly covering treatment when beneficiaries are sick to paying to try to keep them healthy. The strategy to avert diabetes also is the first disease-prevention experiment, tested under part of the Affordable Care Act, which federal officials have concluded is worthwhile enough to adopt nationwide. (Goldstein, 11/2)
Politico Pro:
Lawmakers Press CMS To Reopen Shuttered Mental Health Experiment
Months after Congress unanimously voted to extend a three-year-old mental health payment experiment, the Obama administration shuttered it. Several key senators are now fighting to get it back. Ben Cardin (D-Md.), Pat Toomey (R-Pa.) and Susan Collins (R-Maine) last year pushed through Congress a three-year extension of the Medicaid Emergency Psychiatric Services Demonstration after the program — created under the Affordable Care Act — ran out of money. Under the demonstration, the 11 participating states and the District of Columbia used Medicaid funds to pay for inpatient emergency psychiatric care in private hospitals with more than 16 beds. Current law restricts these hospitals from billing Medicaid under a decades-old restriction detested by the mental health care community, known as the “IMD exclusion.” (Ehley, 11/2)