HHS, States Move To Help Insurers Defray Costs Of Sickest Patients

As congressional Republicans’ efforts to repeal and replace the Affordable Care Act remain in limbo, the Trump administration and some states are taking steps to help insurers cover the cost of their sickest patients, a move that industry analysts say is critical to keeping premiums affordable for plans sold on the law’s online marketplaces in 2018.

This fix is a well-known insurance industry practice called reinsurance. Claims above a certain amount would be paid by the government, reducing insurers’ financial exposure and allowing them to set lower premiums.

CHIP Offers Families With Seriously Ill Kids More Financial Protection Than ACA Plans

Kids with chronic conditions are especially vulnerable to health insurance changes, relying as they often do on specialists and medications that may not be covered if they switch plans. A new study finds that these transitions can leave kids and their families financially vulnerable as well.

The research, which examines the spending impact of shifting chronically-ill kids from the Children’s Health Insurance Program (CHIP) to policies offered on the health law’s marketplaces, found that their families’ out-of-pocket costs would likely rise, in some cases dramatically, following a change to marketplace coverage.

Government costs could rise $2.3 billion without Obamacare payments: study

The U.S. government’s costs could increase by $2.3 billion in 2018 if Congress and President Donald Trump decide not to fund Obamacare-related payments to health insurers, according to a study released Tuesday by the Kaiser Family Foundation.

The payments amount to about $7 billion in fiscal year 2017 and help cover out-of-pocket medical costs for low-income Americans who purchase insurance on the individual insurance exchanges created by the Affordable Care Act, often called Obamacare.

Trump has threatened to withhold the payments to force Democrats to the negotiating table on a healthcare bill to replace Obamacare.

Health Care In America: An Employment Bonanza And A Runaway-Cost Crisis

In many ways, the health care industry has been a great friend to the U.S. economy. Its plentiful jobs helped lift the country out of the Great Recession and, partly due to the Affordable Care Act, it now employs 1 in 9 Americans — up from 1 in 12 in 2000.

As President Donald Trump seeks to fulfill his campaign pledge to create millions more jobs, the industry would seem a promising place to turn. But the business mogul also campaigned to repeal Obamacare and lower health care costs — a potentially serious job killer. It’s a dilemma: One promise could run headlong into the other.

Going For $1 An Ounce: The Burgeoning Trade In Mothers’ Milk

PALM SPRINGS, Calif. — Rebecca Soltes walked into a gaily decorated hospital meeting room, pushing her kids in a double stroller and carrying a soft-sided cooler filled with bags of frozen breast milk — 100 ounces of the stuff.

She dropped it on a table, and the roomful of lactation consultants and maternal health advocates from California’s Inland Empire erupted in applause.

She was donating the milk because she didn’t need it anymore. Her son, a young toddler, had recently graduated to solid food, but her freezer at home was still packed with pumped milk.

NASH: The next untapped pharma market gives investors many options

By Bill Berkrot

Large drugmakers with piles of cash are on the hunt for promising medicines being developed by small companies to treat NASH, a progressive fatty liver disease poised to become the leading cause of liver transplants by 2020.

The eventual market for the complex disease, formally known as Non-alcoholic Steatohepatitis, is forecast to be $20 billion to $35 billion as populations with fatty diets increasingly fall victim to a condition with no approved treatments.

Drugmakers Dramatically Boosted Lobbying Spending In Trump’s First Quarter

Eight pharmaceutical companies more than doubled their lobbying spending in the first three months of 2017, when the Affordable Care Act was on the chopping block and high drug prices were clearly in the crosshairs of Congress and President Donald Trump.

Congressional records show those eight, including Celgene and Mylan, kicked in an extra $4.42 million versus that quarter last year. Industry giant Teva Pharmaceutical Industries spent $2.67 million, up 115 percent from a year ago as several companies embroiled in controversies raised their outlays significantly.