In this week’s summary, you’ll find info on Gov. Cuomo’s decision to stay the course with the health exchange, why NY’s struggling hospitals are working hard to enroll consumers in Medicaid, controversy over a new cholesterol risk calculator, and more!
Affordable Care Act/Health Insurance Exchanges
Governor Cuomo sees no reason to change New York’s health exchange, since it is working so well, according to the Daily News. Despite calls at the federal level to impose a one-year delay on the cancellation of individual insurance policies that are considered substandard, New York will carry on with its exchange as originally planned. One reason New York may not be experiencing problems in the individual market is that policies issued in the state already provided coverage as mandated by the Affordable Care Act.
Kaiser Health News reports that doctors are concerned with payment rates under the Affordable Care Act and fear that low payment rates could result in a two-tiered healthcare system where few doctors participate and consumers will be unable to access necessary care. Doctors are weighing in with their state medical societies, including doctors in New York. In a survey done by the Medical Society of the State of New York (MSSNY), 40% of doctors who responded stated that they will not be participating in the state’s exchange and one-third had not made a decision on participation.
Struggling New York hospitals are working hard to enroll consumers in the state’s Medicaid and health exchange program, according to the Wall St. Journal. This drive comes as hospitals face federal cuts in charity care funds intended to serve the uninsured. The national federal cut will be $22 billion over the next eight years, as part of the Affordable Care Act. New York hospitals anticipate a $400 million cut within the next two years. These disproportionate share payments have been key to safety net hospital operations and this upcoming loss may compound the current stressed network of hospitals serving the poor. Since 2003, 14 hospitals have closed in New York City.
California has enrolled nearly 80,000 people into its health exchange as of November 19, according to Kaiser Health News. Those enrolling in droves include older and younger people. The enrollment of young people is considered necessary to help keep premium costs lower, since this group is generally healthier and have less need to access health care services. California has approximately seven million uninsured residents.
The new cholesterol risk calculator released by the American Heart Association and the American College of Cardiology continues to come under fire and is presenting a challenge to cardiologists in treating patients. Critics contend that the calculator exaggerates the risk of heart disease and stroke and that the data used is two decades old. The two groups who released the calculator have so far decided not to withdraw it. Some practitioners believe that the new guidelines exaggerate the risk less than previous guidelines. Others view it as one tool among many that practitioners use in making medical judgments on treating cholesterol levels.
This week, the U.S. Senate passed a bill to regulate drug compounding pharmacies. The bill also establishes a ‘track and trace’ system for prescription drugs through the use of a national system of serial numbers and electronic drug tracing technology. The compounding section of the bill gives the Food and Drug Administration regulatory authority over compounding pharmacies, which tailor mix drugs for individual patients. This comes after last year’s meningitis outbreak resulting from tainted drugs obtained from a Massachusetts compounding pharmacy, which killed 64 people.
-Jaime Venditti, 11/22/13