May 17, 2018
Secretary Azar – Continued to provide the public with insights into potential regulatory changes on prescription drugs. High on the list continues to be the idea of shifting all Medicare prescription drug coverage to Part D. While HHS does not have the power to do this unilaterally, it can shift certain drugs from Medicare Part B to Medicare Part D, specifically by using authorities around experimental designs (i.e., CMMI). Azar believes that some savings can be achieved by shifting drug coverage to Part D, given the difference insurers pay for drugs in Part D and what the government does in Part B.
New Analyses- The Office of the Actuary (CMS) released new analysis on the effect of the proposed changes to regulations surrounding short term duration plans. The analysis estimates that in 2019, 1.4 million individuals would have coverage through short term duration plans and the new policy would result in an increased premium for Marketplace enrollees on average 1.3%. This analysis already accounted for the effects of the mandate repeal. OACT estimates that the individual market would contain approximately 13.7 million lives if the regulatory changes to short term duration plans were finalized.
New Analyses Part II – A few weeks ago, CBO testified before Congress that its revised estimated impact of the mandate repeal would be about a third lower than it initially estimated. It initially estimated that the repeal of the mandate would increase the number of uninsured by approximately 13 million by 2025.
New Analyses Part III -- Kaiser Family Foundation analyzed individual market profitability in 2017. They found that issuer profitability was way up, relative to 2016. On average, they found that issuers had a MLR of 82% in 2017.
Research of the Week -- Jospeh Dieleman et al analyzed trends in US spending from 1996 to 2013. They used over 183 data sources to estimate spending across 155 conditions and across age and gender demographics. The graphics are truly remarkable here. They found personal health spending increased for 143 of the 155 conditions during the measurement period, with the largest increases in low back and neck pain and on diabetes.