In this week’s summary: Two new reports detail the positive effects of the Affordable Care Act; New York City is looking at a legislative solution to crack down on questionable spending by adult day care facilities, all that and much more below!
Affordable Care Act & other insurance news
A new report from the Kaiser Family Foundation estimates that U.S. consumers who purchase their own health insurance saved $2.1 billion last year due to tougher rules in the Affordable Care Act (ACA). The report estimates that individual premiums would have been $1.9 billion higher in 2012 without the requirements in the ACA. In addition, the nonprofit group said individual policyholders nationwide should receive $241 million in rebates this summer (Terhune, 6/6).
Late last week, the Centers for Medicaid and Medicare Services (CMS) confirmed that a piece of the 2010 health-care law aimed at helping small businesses provide insurance to their workers will be delayed by a year. CMS announced that it was on track for an October 1st launch of the federal SHOP Exchange, an online marketplace where companies with fewer than 50 employees would be able to buy insurance for their workers and get a tax credit. But employees will not be able to choose from a variety of plans, as was initially expected. They will be able to choose only one plan. The full range of options will not be available until 2015.
A new report from the Urban Institute and the Robert Woods Johnson Foundation concludes that the ease of obtaining affordable insurance through state insurance exchanges will lead to a national boom in people starting their own businesses and becoming self-employed entrepreneurs. The rationale is that employees will be more willing to take risks and start their own businesses if they can purchases health insurance on their own instead of having to rely on their jobs to provide insurance. The researchers estimate that there will be 65,000 jobs created in New YorkState as a result of individuals having flexibility in how they obtain insurance.
A study in the journal Health Affairs found that accepting the Medicaid expansion under the Affordable Care Act would help states save money. Fourteen states that opted not to extend coverage will spend an additional $1 billion on uncompensated care, and they will forgo $8.4 billion in federal money.
State & city enforcement
The New York Times reported that New York City officials announced this week that they would introduce legislation to crack down on Medicaid-supported senior day care centers that lure relatively healthy clients with enticements like free takeout food and even cash (Bernstein, 6/6).
New York State Attorney General Eric Schneiderman announced this week that his office sent letters to 15 health plans asking them to allow certain patients to purchase a list of special prescription drugs in local pharmacies, instead of by mail, as required by their policies. The Attorney General is building off an agreement he reached with the insurer Empire in March which authorized these patients to fill their prescriptions at a list of approved pharmacies that agree to certain conditions, such as having a 24-hour medical hotline and toll-free phone access to disease-management programs.
NPR reports on efforts by the Obama administration to foster the development of new antibiotics to combat the growing number of drug resistant infections showing up in health care facilities. The administration is investing tens of millions in private drug companies to foster new germ-killing drugs. It’s setting up a new research network to develop new antibiotics. And, federal health officials are pushing to loosen up the approval process for new antibiotics targeted at patients with life-threatening infections and dwindling treatment options (Knox, 6/4).
The Washington Post writes that a federal appeals court has dealt the Obama administration yet another blow in its quest to keep some age restrictions on the sale of emergency contraceptive pills. The federal appeals court has decided to permit girls of any age to buy generic versions of emergency contraception without prescriptions while the federal government appeals a judge’s ruling allowing the sales. It is the latest in a series of rulings in a back-and-forth over access to the drug (6/6).