195 Congress Members Call for Extension of Enhanced Premium Tax Credits

By Marissa Plescia - In a pair of letters, 195 members of Congress recently urged leadership to extend the enhanced premium tax credits that will expire in 2025. The enhanced premium tax credits — which were introduced in 2021 — lowered health insurance premium costs for millions of people purchasing coverage on the marketplace. Read Full Article… 

HVBA Article Summary

1. Broad Congressional Support and Advocacy: A significant number of U.S. legislators, including 41 Senators and 154 Representatives, expressed strong support for the continuation and permanent adoption of enhanced premium tax credits (PTCs) in healthcare. These letters, directed at key congressional leaders such as Chuck Schumer and Mitch McConnell, highlight the urgency and bipartisan backing for policies aimed at reducing healthcare costs and improving accessibility.

2. Impact on Health Equity and Insurance Coverage: The legislators pointed out the tangible benefits of enhanced PTCs, noting a reduction in average monthly premiums by $59 per person and record enrollments in Marketplace plans, which reached 21.4 million during the 2024 Open Enrollment Period. Particularly noteworthy were the substantial increases in enrollment among Black and Hispanic Americans, which doubled or nearly doubled since 2020, underscoring the role of these credits in advancing health equity.

3. Consequences of Failing to Extend the PTCs: The correspondence warned of severe repercussions if the enhanced PTCs are allowed to expire. More than 20 million Americans could face increased health insurance costs, and approximately 3 million might lose their insurance coverage entirely. The letters emphasize the disproportionate impact on vulnerable groups, including those in rural areas and older adults, and stressed the importance of making these tax credits permanent to avoid exacerbating existing disparities in healthcare access and affordability.

FTC formally sues PBMs over insulin prices and warns manufacturers

By Noah Tong - The Federal Trade Commission is suing the titans of the pharmacy benefit manager industry for anticompetitive practices and artificially raising the price of insulin drug prices, the agency announced Friday. Read Full Article…

HVBA Article Summary

1. Allegations Against PBMs: The FTC's complaint claims that Optum Rx, Express Scripts, and Caremark, all affiliated with major health insurers, manipulated the pharmaceutical supply chain to inflate drug prices, particularly insulin, leading to higher out-of-pocket costs for patients. The PBMs allegedly encourage drug manufacturers to raise list prices to secure higher rebates, resulting in billions for the companies while harming vulnerable patients.

2. Impact on Drug Pricing: The lawsuit targets not only PBMs but also group purchasing organizations linked to UnitedHealth, Cigna, and CVS. The FTC asserts that these entities favor high-rebate drugs and exclude lower-cost options, exacerbating patient costs. The agency's investigation suggests that insulin prices have escalated since 2012, coinciding with these PBM practices.

3. Future Implications and Reactions: The lawsuit aims to lower drug list prices and reform rebate practices, with potential broader implications for other medications. While the Biden administration has not commented directly on the lawsuit, the FTC has signaled that it may pursue further actions against insulin manufacturers involved in price inflation. Critics, including some lawmakers, call for stronger regulation of PBMs, while PBM representatives argue that their practices help make insulin more affordable.

House, Senate Democrats press leadership to quickly extend ObamaCare subsidies

By Nathaniel Weixel - House and Senate Democrats are pressing leadership to quickly pass legislation extending ObamaCare’s enhanced subsidies before they expire at the end of 2025. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Legislative Urgency: Sen. Jeanne Shaheen and Rep. Lauren Underwood, supported by 41 Senate Democrats and 154 House Democrats, have called for immediate legislative action to extend enhanced health insurance subsidies initially introduced during the pandemic, which have significantly increased enrollment and financial assistance for low-income individuals.

2. Potential Impact of Expiration: If the subsidies expire in 2025, the Congressional Budget Office predicts a sharp decline in health insurance enrollment from 22.8 million to 18.9 million, leading to a potential surge in out-of-pocket costs for millions of Americans, particularly in states that have not expanded Medicaid.

3. Political and Financial Challenges: While extending the subsidies would cost an estimated $335 billion over ten years, resulting in 3.4 million additional insured individuals, Republicans oppose the expense, citing concerns about taxpayer-funded insurance for high earners. The outcome will largely depend on the congressional control post-November elections.

Consolidation is eroding quality of U.S. health care, doctors say

By Richard Payerchin - Consolidation in the U.S. health care system is chipping away at quality of patient care, according to the doctors who treat patients daily. Read Full Article…

HVBA Article Summary

1. Impact of Consolidation on Care Quality: The survey revealed that 70% of physicians and medical students believe health care consolidation negatively affects patient access to quality care, with significant concerns about job satisfaction (50%), patient care quality (36%), and the ability to exercise independent medical judgment (35%).

2. Call for Safeguards and Autonomy: A strong majority (90%) of respondents advocate for safeguards to maintain physician autonomy, alongside calls for transparency (86%) and upholding patient care standards (87%). However, there is less support for increased regulatory oversight, with only 46% of physicians and 50% of residents in favor.

3. Rising Burnout and Need for Support: The survey highlights an ongoing crisis of physician burnout, with 60% reporting frequent feelings of burnout, a significant increase from pre-pandemic levels. Solutions proposed include reducing administrative burdens, which 79% of physicians and 87% of residents found helpful, as well as addressing stigmatization around seeking mental health care.

What Will It Take to Improve Healthcare Cybersecurity?

By Katie Adams - Healthcare leaders are finally starting to take cybersecurity off the back burner, with most provider and payer organizations ramping up their spending in this area in the midst of proliferating cyberattacks. Read Full Article…

HVBA Article Summary

1. Cultivating a Culture of Cybersecurity Awareness: Andrew Molosky emphasized that every employee, regardless of their role, must recognize cybersecurity as a critical component of healthcare operations. This cultural shift requires integrating cybersecurity training into daily activities to prevent breaches that can occur from simple actions, like opening a phishing email.

2. Prioritizing Cybersecurity in New Technology Development: John Mowery highlighted the need for a security-first approach when adopting new technologies. As healthcare organizations rapidly increase their tech spending, they must ensure that cybersecurity measures are integrated from the outset and that cybersecurity leaders are informed about new tools before their implementation.

3. Encouraging Diverse Leadership in Cybersecurity: Ben Schwering recommended seeking cybersecurity leaders with varied experiences outside the healthcare sector. Such leaders can bring fresh perspectives and insights that may identify potential risks overlooked by those with extensive healthcare backgrounds, ultimately strengthening the organization's cybersecurity strategy.

FDA Clears First 1-Year Continuous Glucose Sensor

By Mariam E. Tucker - The US Food and Drug Administration (FDA) has cleared the Eversense 365 (Senseonics), an implanted continuous glucose monitoring (CGM) system that lasts a year. Read Full Article… 

HVBA Article Summary

1. Subcutaneous Insertion and Real-Time Monitoring: The Eversense system is inserted subcutaneously into the upper arm by a certified healthcare professional, with glucose data automatically transmitted to a mobile app every five minutes, providing real-time monitoring and alerts for high and low blood glucose levels.

2. Launch and Indications: The Eversense 365 is set to launch in late 2024, joining the 6-month Eversense E3 already available, both approved for adults with type 1 or type 2 diabetes as replacements for fingerstick measurements, though calibration testing is still required weekly or daily depending on the model.

3. Longevity and Integration Potential: With a 1-year lifespan compared to traditional CGM systems that last 10 to 14 days, Eversense 365 is also designed as an integrated system for potential compatibility with insulin pumps, although specific partnerships are still in development.

Young Americans Can’t Keep Funding Boomers and Beyond

By C. Eugene Steuerie and Glenn Kramon - You know the expression “OK, boomer”? Better said as “Boomer OK.” That’s because the social safety net in the United States is increasingly favoring the old over the young. And this affects our political views and the security of future generations. Read Full Article…

HVBA Article Summary

1. Wealth Disparity and Generational Discontent: Younger Americans are increasingly disenfranchised as significant portions of government spending have favored older generations, particularly through programs like Social Security and Medicare. This has resulted in a widening wealth gap, with younger generations facing higher student debt and housing costs.

2. Unsustainable Mandatory Spending: The current tax system primarily supports mandatory spending for older Americans, leaving little funding for essential services such as education, infrastructure, and poverty reduction. As the population ages and the birthrate declines, fewer workers are available to support the increasing costs of these programs, exacerbating financial pressures on younger generations.

3. Need for Systemic Reform: To address these imbalances, proposals include redefining retirement ages, adjusting benefits for wealthier retirees, and improving immigration policies to bolster the workforce. Without political engagement from younger generations, the trend of prioritizing older Americans may continue, further limiting opportunities for their children and grandchildren.