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MEDICARE SIGN-UPS UNDERWAY: The open enrollment for seniors starts Tuesday as customers begin to choose between the regular plan that the government offers and a variety of plans that are administered by private health insurance, known as Medicare Advantage.
The sign-up season, which lasts until December 7, comes at a politically opportune time for the Trump administration. President Trump signed an executive order this month that lets Medicare Advantage offer even more benefits to customers that traditional Medicare doesn’t offer, but because the rulemaking actually was put out last year the effects of Trump’s announcements will become quickly apparent to shoppers.
They’ll see plans have lower premiums than last year and some of the plans will come with new benefits, such as acupuncture, nutrition services, or transportation to doctor’s appointments. About a third of seniors are on these private plans.
“The satisfaction rates have been and remain very high,” said Mark Hamelburg, senior vice president of federal programs at America’s Health Insurance Plans.
The timing comes as there’s a lot of attention on healthcare. A decision on the constitutionality of Obamacare could land any day and Democrats are preparing for the debate stage Tuesday night with promises to enroll more people in public plans.
Some things customers will need to consider. Problems in Medicare Advantage have been reported over the years, including overcharging the government. Plus, not all plans are going to have supplemental benefits, and some patients will have fewer doctors and hospitals to choose from under Medicare Advantage because private plans set up specific networks.
At the same time, the problem of surprise billing won’t be nearly as bad as it is for younger people on private plans because the prices for medical care are capped at Medicare rates. That’s one of the reasons why health insurers have been pushing so hard to benchmark prices during another debate in Congress, over surprise medical bills.
“It’s far more highly regulated than what you have seen in the commercial space,” Hamelburg said.
Good morning and welcome to the Washington Examiner’s Daily on Healthcare! This newsletter is written by senior healthcare reporter Kimberly Leonard (@LeonardKL) and healthcare reporter Cassidy Morrison (@CassMorrison94). You can reach us with tips, calendar items, or suggestions at [email protected]. If someone forwarded you this email and you’d like to receive it regularly, you can subscribe here.
AMERICANS FOR PROSPERITY WARNS MEDICARE NEGOTIATION WOULD ‘SAP INNOVATION AND COMPETITION’: Americans for Prosperity, a free-market political advocacy group, told Congress Tuesday that passing a bill to allow Medicare to negotiate drug prices with pharma companies would “result in delaying or denying Americans access to the next medication breakthroughs.”
The Lower Drug Costs Now Act of 2019, introduced by Democrat Frank Pallone and cosponsored by 49 other Democrats, would place price caps on certain prescription drugs in the Medicare part D programs, and place a tax on all pharmaceutical companies that decide not to come to the negotiating table. AFP members say the “crushing” excise tax would affect drug makers who don’t “acquiesce to top-down price-setting on a particular drug” and would “surrender to Washington nearly all revenue derived from its sales,” disincentivizing innovation and “put those life-saving medications further out of reach.”
THE LATEST ON HOW ‘MEDICARE FOR ALL’ IS PLAYING IN THE PRIMARY: Presidential hopeful Pete Buttigieg released a video Monday that argues the Medicare for All plan favored by Elizabeth Warren and Bernie Sanders would be less beneficial to Americans than his Medicare buy-in proposal.
Brown says backing M4A would be a ‘terrible mistake’: Ahead of the Ohio debates, progressive Ohio Democrat Sherrod Brown told CNN: “I think it’s a terrible mistake if the Democratic nominee would publicly support ‘Medicare for All.’” Candidates, he said, should focus their energy on improving the Affordable Care Act and protections for pre-existing conditions, rather than telling Americans they could lose the coverage they already have.
New polling suggests primary voters are getting sick of hearing about it: Most Democratic and Democratic-leaning voters agree that presidential candidates should spend more time talking about women’s healthcare and the issue of healthcare costs in Tuesday’s primary debate, according to Kaiser Family Foundation polling.
SANDERS IS TASKED WITH PROVING HE’S FIT ENOUGH FOR OFFICE AT TUESDAY’S DEBATE: Monday polling showed that 42% of Democrats feel Sanders’ health is not good enough for office, after it was announced recently that he had suffered a heart attack. The HuffPost/YouGov survey also found that 26% of people surveyed believed his health was adequate to serve, while 19% of voters overall said Sanders was fit to hold the presidency for a full term.
CONGRESS’ ONLY FEMALE DOCTOR LOOKS TO SHAKE UP THE HEALTHCARE SYSTEM: Before joining Congress in 2018, Democrat Kim Schrier spent nearly 20 years counseling anxious parents and caring for sick children in her pediatric practice in Issaquah, Washington. Since her swearing in, she has allowed her career as a physician, as well as her experience monitoring her type 1 diabetes since age 16, to inform the legislation she introduces and supports. She has sponsored a bill aiming to boost vaccine confidence, having almost two decades of experience convincing parents that immunizations are both safe and effective. Schrier was happy in Washington treating patients in her private practice, but decided she needed to serve people on a larger scale. She told Cassidy: “A lot of this was really going to bat for my patients the way I’ve always gone to bat for my patients… Who better to talk about this than a pediatrician with a preexisting condition?”
NEWSOM ISSUES A BLOW TO DIALYSIS COMPANIES: California Governor Gavin Newsom signed a bill Monday to cap dialysis companies’ profits from private insurers to match what Medicare pays to cover the cost of treatments. Labor organizations have accused the American Kidney Fund, which helps cover the cost of insurance premiums for dialysis patients, of steering patients toward private insurance that would pay dialysis companies more than Medicare. The AKF has denied the accusations and said that if Newsom sides with labor organizations and signs the law, the fund will be forced to leave the state. Patients already receiving assistance to pay premiums on insurance plans that reimburse dialysis companies way more can continue with their current arrangement, but with the new law dialysis companies will be prohibited from pointing patients to accepting help from third-party payers. The law goes into effect in 2022.
The Rundown
Stat FDA bid to bolster generic competition and combat shortages isn’t working — yet
The Wall Street Journal A lot of women work in health care. But not at the top. Why is that?
NHPR As presidential hopefuls offer addiction solutions, N.H.’s experience is at the forefront
Los Angeles Times Elizabeth Warren, 70, flaunts her fitness as Democratic candidates’ health becomes a debate issue
The Hill Former top Trump health official says THC vaping should be banned
Calendar
TUESDAY | Oct. 15
Congress back in session.
Medicare open enrollment.
Noon. HVC-201A. American Hospital Association briefing on surprise medical billing.
8 p.m. Westerville, Ohio. Democratic debate on CNN.
WEDNESDAY | Oct. 16
9:30 a.m. 562 Dirksen. Senate Aging Committee hearing on “Falls Prevention: National, State, and Local Solutions to Better Support Seniors.” Details.
10 a.m. 2358-C Rayburn. House Appropriations Subcommittee on the Departments of Labor, Health and Human Services, Education, and Related Agencies hearing on “E-cigarettes: An Emerging Threat to Public Health.” Details.
10 a.m. 2141 Rayburn. House Judiciary Committee to mark up the Preventing Online Sales of E-Cigarettes to Children Act. Details.
10:30 a.m. 2322 Rayburn. House Energy and Commerce Committee’s Health Subcommittee hearing on “Legislation to Reverse the Youth Tobacco Epidemic.” Details.
THURSDAY | Oct. 17
2 p.m. 2154 Rayburn. House Committee on Oversight and Reform hearing on “The Administration’s Decision to Deport Critically Ill Children and Their Families.” Details.
