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
With less than a month until the midterm elections, it is worth a quick summary of some of the major policy changes that could happen. Most notable, several congressional and Senate Republicans recently signed onto a legislation to repeal the Medicare drug negotiations provisions that were in the Inflation Reduction Act. A change in control of either the House or Senate could result in changes to the recently passed law.
Therapy Drug Costs – Several new therapy drugs – namely Relyvrio (the ALS drug priced at $158,000) and Lecanemab (the Alzheimer drug) could result in much higher Medicaid costs. Additionally, there are a number of potential huge specialty drugs that could drive costs higher. For example, Politico reported that Zynteglo has a list price of $2.8 for a one-time treatment.
SCOTUS- An important under the radar Supreme Court case this fall could have major implications for Medicaid. The case Health and Hospital Corp of Marion County, Indiana v. Talevski surrounds the issue of if individuals can sue if they are harmed by state violation. If SCOTUS sides with the Hospital, it could seriously change what state benefit and enrollment policies are.
Medical inflation is expected to double next year as increases in input costs are expected to put pressure on premiums according to new research from the Dallas Fed
Rules and Information
- The Biden Administration finalized the Family Glitch fix rule would extends Premium Tax Credit eligibility to some people. The White House previously estimated that an additional 200,000 people currently uninsured could take-up coverage as a result of the rule change.
- CMS released the 2023 MA and Part D Star Ratings. The results showed a drastic decrease in average Star ratings, primarily because of the COVID-19 protections put in place for the 2022 Star Ratings. You can read more here.
Flu season seems to be coming sooner this year. Australia’s flu season, which typically predicts the kind of flu season that the US has, had a particular bad flu season.
The FDA approved the new bivalent vaccine boosters for everyone five and older this week. To date take-up of the booster has been exceedingly low with approximately 5% of the eligible population receiving the booster. The Biden Administration will be pushing to increase take-up rate in the coming weeks.
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