Azar faces early test on Idaho’s plan to upend Obamacare market in the state. A top-ranking Democrat has asked Health and Human Services Secretary Alex Azar to tell him within the next 30 days how he will go about intervening with Idaho’s plan to upend its Obamacare marketplace. During a Senate Finance Committee hearing aimed at discussing President Trump’s budget, Sen. Ron Wyden, D-Ore., this morning slammed Idaho’s proposal to offer health insurance plans that don’t comply with the mandates and protections required under Obamacare. State officials have announced insurers will be allowed to sell plans that exclude certain services, such as maternity coverage, and they can charge enrollees more based on medical status. Obamacare does not allow for these types of plans to be sold, so it’s not clear how Idaho is proceeding and whether what the state is proposing will pass legal scrutiny. The case is being closely watched by other states because the prices of premiums are expected to continue to climb. Idaho Blue Cross has announced its intention to sell the types of plans the state would allow, according to media reports. Azar said he had not seen any formal applications and had only read about the move in the news. “I don’t want to be prematurely involved until there is a matter of controversy at the state level,” he said. “All we’ve seen is a press report. I don’t know whether it would even be approved by Idaho or certified by [Obamacare].”

Growth of health spending projected to accelerate in coming decade. Spending on healthcare is expected to quicken over the next decade, driven by people spending more of their disposable income on medical care, an aging population, and increases in the cost of care, according to an analysis by government economists. The annual analysis released Wednesday by the nonpartisan Office of the Actuary within the Centers for Medicare and Medicaid Services projects that spending will grow by an average of 5.5 percent each year during the period up to 2026, reaching $5.7 trillion. The analysis assumes the absence of a recession and that no new healthcare laws will be passed. It also takes into account the tax legislation that Trump signed into law late last year. It projects that the growth in healthcare spending will continue to be faster than gross domestic product, which is expected to rise at a rate of 4.5 percent. The GDP grew at an annual rate of 2.6 percent in the fourth quarter of 2017, according to the Bureau of Economic Analysis. Though healthcare spending is expected to quicken, it is not expected to reach pre-recession levels of 7.3 percent growth per year.

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Actuaries attribute 2008-2013 slowdown in health spending to recession. Healthcare spending had experienced a historically low deceleration from 2008 to 2013, primarily because of the effects of the recession, including people being more cautious about where their money goes and spending less on various parts of their lives, including healthcare. “Our models consistently suggest that income is a most substantial driver of health spending growth, that’s particularly the case for private health insurance and for out-of-pocket spending,” said Gigi Cuckler, an economist in the Office of the Actuary. “During the recession we really saw a substantial response from the health sector to changes in income growth and to changes in economic growth.” She acknowledged as well that actuaries believe that certain payment provisions in Obamacare, which aimed to change the growth of spending for some providers, contributed slightly to some slowing. Officials in the Obama administration often took credit for the deceleration, but actuaries have said that the economy carried more weight.

Government is projected to be a larger payer in healthcare. Spending on publicly funded healthcare programs such as Medicare and Medicaid are expected to grow faster than private health insurance spending, mainly because the aging Baby Boom generation will enroll in the programs. That will contribute to the government paying for 47 percent of healthcare by 2026, up from 45 percent in 2016. Medicaid spending per beneficiary is expected to increase as more people age, costing an average of $8,011 per person in 2017 and increasing to $12,247 per person by 2026. Medicare’s growth will slow slightly, from 5.4 percent in 2017 to 4.3 percent in 2026. This is because as baby boomers age into the program they will skew the Medicare population younger and have fewer medical needs, at least in the initial years. Medicaid, in contrast, can cover people who are on Medicare, but that typically happens when older adults in the program have additional medical needs that Medicare won’t cover, such as nursing home care.

FDA approves first blood test to help diagnose a concussion. The Food and Drug Administration on Wednesday approved a blood test that measures certain proteins to help evaluate whether someone has had an concussion after a head injury. The FDA predicted that the evaluation will help save money and prevent patients from undergoing unnecessary radiation because typically people undergo several imaging tests, such as a CT scan, so doctors can determine whether they have had a concussion. FDA Commissioner Scott Gottlieb said the device, the Banyan Brain Trauma Indicator, would help “ensure that each patient is getting the right imaging exam, at the right time, with the right radiation dose.”

Health price transparency gains steam in Congress. A top House lawmaker wants consumers to have as much information as possible on what health services such as MRIs, pharmaceuticals, or CT scans cost. Energy and Commerce Committee Chairman Greg Walden, R-Ore., said Wednesday that he is speaking with colleagues in the Senate on greater price transparency. The remarks come a few days after Sen. Bill Cassidy, R-La., said he is pursuing legislation to establish more transparency on healthcare prices for drugs and procedures. “There is a lack of transparency in pricing from one end to the other, in both pharmaceuticals and procedures,” Walden told reporters Wednesday. “I think we benefit as a country when consumers are empowered with information, and providers are competing for your business in a transparent way.” Cassidy told the Washington Examiner that he hopes to introduce legislation this week or next.

Veterans Affairs official who lied about Shulkin’s Europe trip hid healthcare scandal from Congress in 2014. A Department of Veterans Affairs official accused of altering an email to get a free trip to Europe for Secretary David Shulkin’s wife is the same official who tried to hide the VA waitlist scandal from Congress in 2014. But as of late Wednesday, the VA declined to comment on whether there was any effort within the department to fire her. The VA’s Office of Inspector General reported Wednesday that last year, VA chief of staff Vivieca Wright Simpson tried to arrange for Shulkin’s wife, Merle Bari, to travel with him to Europe on the taxpayers’ dime. Wright Simpson discovered that to get the taxpayer-funded trip, Shulkin would have to receive some kind of award while overseas, a condition that allows spouses to travel as part of the delegation. When Wright Simpson asked another staffer if Shulkin would be receiving an award, she was told, “Not that I’m aware of.” Wright Simpson was then told in an email there would be a “dinner” at the U.S. ambassador’s residence. Wright Simpson changed that email to read “special recognition dinner” and sent it along to another staffer to justify the VA paying for Shulkin’s wife’s trip, according to the IG.

RUNDOWN

Kaiser Health News Idaho Blue Cross jumps into controversial market for plans that bypass ACA rules

The Hill 172 Dems ask Trump official to reject Medicaid work requirements

Hartford Courant Aetna disputes report that medical director ignored patients’ records

Modern Healthcare Azar eyes relaxing restrictions on physician-owned hospitals

Wall Street Journal Republican foes of health law try a patch job ahead of midterms

New York Times New York will investigate reports of gay men denied insurance

The Associated Press Soda on children’s menus could fizz out in New Hampshire