Is More ACA Confusion Possible? You Bet.

Is More ACA Confusion Possible You Bet

As if the ACA debate couldn’t get more complex – the U.S. Department of Justice (DOJ) has declined to defend an ACA challenge filed by Texas and several other Republican states, seeking to invalidate the pre-existing coverage mandate – and therefore the entire law.  The suit alleges that since the individual mandate was reduced to… [Read More]

Retiree Healthcare Back in Focus

A mixed race senior couple is kayaking down a river together. The image's focus is on the elderly woman smiling in the foreground. She is Pacific Islander and has graying hair. Her husband is seen in a kayak in the background. In the distance behind the couple you can see the shoreline and a bridge. The happy couple are wearing casual clothing. It is warm outside.

With the upturn in the economy, employers are again starting to look at improvements to benefit programs, especially for their key employees. Retiree healthcare is a topic where I am surprised that discussions have changed from “how do I eliminate this obligation” to “tell me what other employers are doing for their key staff for post-employment… [Read More]

“Right to Try” Is Compassionate Legislation, but Does It Make Sense?

research drug at science lab

President Trump signed the Right to Try Act yesterday, which cleared the House in late May, having been approved by the Senate in 2017. This legislation gives terminally ill patients the ability to access experimental drugs which have passed Phase 1 of the FDA approval process but are not yet officially approved. It is interesting to… [Read More]

Look to Automobile Insurance for Healthcare Answers

wrenches on garage wall, set of wrenches handy industrial tool,old wrenches in mechanic workshop,handy tool for motor vehicle mechanic use to fix motorcycle and car

We take care of our car. The oil, lights, brakes and steering are checked and in good shape, so we don’t expect anything mechanical to go wrong. Routine care costs are cheap and easy – besides, if the car is in bad shape the insurance company won’t cover it and it needs to pass a mechanical inspection… [Read More]

Trump Opts for a Baby Step in the Drug Cost War – Not the Expected Leap Forward

Also drug dealing, dealer or trade concept.

Last week President Trump released his long-awaited “American Patients First” blueprint on attacking out-of-control pharmacy costs. Unfortunately, it’s more of a whimper than a roar. If the regulations are effectively written to support my understanding of the President’s intent, the incremental steps forward were not horrible, they are just not bold enough. Drug manufacturers will have to… [Read More]

Politics and Healthcare – Nothing Is Easy

Pink cherry blossom and magnolia trees blooming at the White House in Washington, DC during the springtime

I had the pleasure of spending the day on Tuesday in Washington to discuss my favorite legislative topic – healthcare. First stop, the White House, where I met with the Special Assistant to the President for Health Policy. This was a lively discussion which covered rising drug prices, the opioid crisis, mental health parity and… [Read More]

Warning – The Healthcare Status Quo Is at Risk

5-2-16 An Exciting Day in Washington

Whether the Affordable Care Act (ACA) was ever an effective way to combat the issues facing our healthcare system is arguable – but it is clear that our political process has not helped. The Commonwealth Fund recently reported that the uninsured rate for working-aged Americans (between 19 and 64) has increased from 12.7% in 2016 to… [Read More]

Reference-Based Pricing – Coming to a Health Plan Near You?

Man paying bill. Hand black line, holding receipt. Payment of utility, bank, restaurant. Concept business finance. Vector illustration flat minimal design. Report finance, invoice, expenses.

I think you are going to hear more about reference-based pricing. Some history: What stops a provider from charging whatever they want for care? Let’s say a doctor charges $200 to remove a splinter. If the patient were paying, she/he might try to negotiate the charge or get care elsewhere. But they are most often not. The… [Read More]

More Pharmacy Fixes

hundreds of colorful pills on black background for medicine themes

The collateral effect of writing these blogs is that insurance companies (I am happy to say many of them follow me) and third parties are quick to provide additional information or clarification to the issue at hand. There was quite a bit of follow up about my pharmacy blog last week. UnitedHealthcare let me know… [Read More]

New Valuable Pharmacy App Solves a Big Problem

Pills on US dollars.

Why does pharmacy have to be so difficult? There seems to be a huge disconnect and a lot of finger pointing when it comes to prescribing drugs. A patient goes to the doctor and at the end of the visit gets prescribed medication to address the issue. Patients accustomed to the drill start to sweat… [Read More]