Week in Washington 07092020

Week in Washington is brought to you by Michael Cohen, PhD. Tune in each week to read the latest on healthcare policy and get a glimpse of what’s on the horizon.

Week in Washington

7/09/2020

Unfortunately, an extremely bad week for COVID cases and COVID related hospitalizations as cases reached their highest point ever, and hospitalizations reached the highest point at least since March, as noted in this Business Insider graphic.

Unfortunately, only about 60% percent of states report hospitalizations. For example, Florida doesn’t publicly report hospitalizations, so the data above is an undercount in terms of hospitalizations. That said, of the available data, COVID related hospitalization numbers are up in recent weeks. For example, Arizona hospitalization cases are up 2.6x and California 1.7x. As can be seen in the below COVID related death data, understanding state-specific dynamics are very important for understanding what is happening in the US currently.

Deferred Care – In terms of claims cost, one question is how the increases in infections are affecting deferred care levels. At a policy level, according to Axios, so far, hospitals aren’t selecting to reduce non-essential procedures, as they did previously. However, consumer behavior may be changing regardless of hospital (or state) policy. There is some evidence that the recent spike in infections is reducing the utilization of using hospital services as captured in this survey data.

State Actions: As expected in the face of increasing infection, generally states have reversed course, in terms of opening up. While no state has implemented as rigid shutdown policies as happened in March, many have stopped opening further or imposed new restrictions (for example, on indoor seating).

Congress: Congress is currently on recess until mid-July. There is a small window of time for bills between the July recess and before Congress goes back on recess in August/unemployment insurance expires. The expectation is that if an agreement to address the pandemic and its effects comes together, it is most likely in this late July time frame.

Public Health Emergency: Politico reported that the Administration is leaning towards renewing the public health emergency declaration, scheduled to expire July 25. Many current requirements on insurers (for example, no cost-sharing for COVID testing) is linked to the renewal of the public health emergency.

Individual Market

• Charles Gabba is updating his summary of 2021 rates. Of the states that have released proposed rates to date, the enrollment weighted premium increase is 1.9%.
• A newly released analysis on Washington’s public option can be found here. The analysis found that that 19 counties would go without a public option.

Medicaid

• An article in Health Affairs about an interesting new analysis on prescription drug spending in Medicaid can be read here. The research found that shifting away from list prices did not reduce Medicaid spending.

Shameless Plug

I was on the Society of Actuaries Podcast on its recent COVID model release. It’s a fun listen.

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