May 3, 2018
A potpourri of stories this week:
Rx Rebates
FDA Commissioner, Scot Gottlieb, gave a speech on Thursday that raised some eyebrows. Within the speech Gottlieb raised the potential for the Federal government to “reexamine the current safe harbor for drug rebates under the Anti-Kickback Statute”. Such a move would have a dramatic impact on how drugs are currently priced. However, no pending action has been reported.
Individual Market
Repeal and Replace: A number of conservative activist groups (Heritage Foundation, Galen Institute, and Rick Santorum) are planning on pushing for an ACA repeal (this year). There doesn’t appear to be a lot of a backing at the Senate level at the moment but it could make news in the coming weeks.
Litigation Watch: Texas is suing the Federal government over the ACA. The contention is with the effective repeal of the individual mandate; the entire law should be invalidated. Furthermore, the state is seeking an immediate injunction. The next major date for this case is June 7th, at which time the government must respond to the litigation.
2019 Rates: As many of you are aware individual market rates for 2019 are starting to roll. One of the first sets of rates to be posted is Virginia’s. All seven of the current Virginian Exchange insurers will continue to offer coverage in 2019 and a new insurer (Virginia Premier) will join.
Catastrophic Plans: A few weeks ago, HHS released rules expanding the definition of who was eligible for a hardship exemption to include any individual in a county with only one issuer. Normally hardship exemptions are thought of exempting individuals from the mandate, which effectively goes away in 2019. However, hardship exemptions also allow individuals to gain eligibility to catastrophic plans, should they so choose. As such, in 2019 single issuer counties could experience larger enrollments in catastrophic plans.
Medicaid
Medicaid Expansion: Sufficient signatures were obtained to put the issue of Medicaid Expansion on the ballot in Idaho. Maine’s governor was sued this week over failing to implement Medicaid expansion. Maine’s voters approved Medicaid expansion via a ballot initiative.