Week in Washington: Research Here, Get Your Research!

March 18, 2018:  Research Here, Get Your Research!

This week in Washington a lot of quality research was published with some eye-opening implications. But first, a few bits of policy….

ACA Stabilization: If ACA stabilization will happen at all this year, it will likely happen by the end of this week. A revised version of Alexander-Murray has been circulating on the Hill. The bill would fund CSRs for 3 years, provide reinsurance for 3 years, expand access to copper (catastrophic) plans, and make 1332 waivers easier and faster to be approved.  Politico reported that CBO scored the bill as reducing premiums by 10% in 2019 and 20% in 2020/2021 (relative to the baseline). Disagreements over abortion continue to be the largest sticking point.

Interesting Research Part I (Uninsured Rate) – Ben Sommers and colleagues analyzed Gallup poll data and found that the increase in the uninsured rate between 2016 and the end of 2017 was statistically significant. They estimated the uninsured rate increased 1.3% percentage points. Overall 1/5 of the coverage gains achieved between 2013 and 2016 were likely reversed in 2017.

Interesting Research Part II (Prescription Drugs) - A new study in JAMA examined the frequency in which copays on prescription drugs exceeded the cost someone would pay if they purchased the drug directly without insurance.  Of the 9.5 million claims examined, copay costs exceeded direct purchase costs nearly a quarter of the time. In many cases pharmacists are prevented legally from informing consumers if their copay exceeds the drug’s cash price.

 Interesting Research Part III (Prices) - Nearly fifteen years ago Uwe Reinhardt’s work identified prices as the key reason for relatively higher US healthcare costs. Using better and more recent data, a team of researchers confirmed Dr. Reinhardt’s original work. They found that the US did not differ in terms of healthcare utilization. Instead prices of labor, goods, and administrative costs are the main drivers of differences. In 2016 the US spent nearly twice as much as the average high-income country and by several measures had worse outcomes.

Other Tidbits

-Marilyn Tavenner, head of AHIP, announced that she would be stepping down in June. Matt Eyles will replace her.

-A ruling on if the Federal government owes issuers payment for risk corridors is expected any day now.

-The FDA announced new efforts to lower nicotine levels in cigarettes.