News for Insurers
Top stories summarized by our editors
9/22/2017

About 10% of babies born in the US are premature, facing lower odds of survival and possible quality of life issues, and the cost of their care is also higher, according to a report in Pediatrics. Preterm births accounted for at least $6 billion in additional spending by employer-sponsored health plans in 2013, with major birth defects accounting for fewer than 6% of cases but 25% of the expenditures.

9/22/2017

A Kaiser Family Foundation analysis estimated that states that expanded Medicaid under the Affordable Care Act would lose $180 billion in funding from 2020 to 2026 if the Graham-Cassidy health care repeal bill becomes law, while non-expansion states would gain $73 billion during the same period, with California losing the most at $56 billion and Texas gaining the most with a $34 billion increase. The bill, which would replace the Affordable Care Act funding structure with state block grants, would also increase the number of uninsured by more than 30 million, according to estimates from the Center on Budget and Policy Priorities.

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Kaiser Family Foundation
9/22/2017

Senate Republicans' decision to halt bipartisan talks and move forward with new repeal legislation is further increasing uncertainty in the individual health insurance market ahead of the 2018 enrollment season, which starts Nov. 1. Questions about whether the federal government will continue funding cost-sharing reduction payments after this month and how consumers will respond to rising premiums could prompt some insurers to leave public exchanges.

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The Hill
9/22/2017

The National Association of Medicaid Directors, the latest organization to oppose the GOP's newest attempt to repeal portions of the Affordable Care Act, said the Graham-Cassidy bill would put a massive financial burden on states on a timeline that is too short for setting up programs. The group also criticized the push to vote quickly, before a Congressional Budget Office score is available, arguing that the score "should be the bare minimum required for beginning consideration."

9/22/2017

Employee abuse or misuse of opioids and other drugs is an increasing problem for US companies, raising safety risks and health care costs and making it more difficult to hire and retain employees. Some companies require drug testing, create drug abuse policies and pay for employees to go through treatment programs.

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drug abuse
9/22/2017

EBay focuses on building employee relationships and forming a corporate community, and Global Benefits & Wellness Senior Director Becky Bailey told Employee Benefit Adviser's 2017 Workplace Benefits Summit that starting a wellness program should begin with getting to know the workforce and implementing small changes. Bailey said she promotes wellness as an investment in people instead of focusing on return-on-investment.

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eBay, EBA
9/22/2017

Novartis' new leukemia drug Kymriah is "dramatically" more expensive than many other drug therapies, and a new payment model is needed, says Express Scripts Chief Medical Officer Steve Miller.

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Bloomberg
9/22/2017

The Midwest Business Group on Health says employers should work closely with their pharmacy benefit managers, which typically reduce drug-benefit costs by 30%, according to the Pharmaceutical Care Management Association. "In an era of high drug prices and expensive specialty medicines, employers, unions, and government health programs rely on pharmacy benefit managers to restrain costs by, among other things, negotiating aggressive price concessions from drug companies," PCMA stated, also citing a recent survey of business owners showing a 95% satisfaction rate with the company they've hired to manage their prescription drug benefits.

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AIS Health
9/22/2017

The fate of state Medicaid waiver requests depends on whether Republican efforts to repeal parts of the Affordable Care Act succeed.

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Medicaid, ACA
9/22/2017

Drugmakers never began 20% of the post-approval safety studies required in 2009 and 2010, and 9% of those studies were delayed, researchers reported in The New England Journal of Medicine. Drugmakers and the FDA said the study's conclusions are inaccurate.

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Reuters
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FDA