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Tuesday, Oct 11 2016

Full Issue

Preventive Care Task Force Should Be Decoupled From Insurance, Experts Say

Under the Affordable Care Act, any preventive service that receives one of the USPSTF's top two ratings must be covered by insurance, but three doctors have spoken out against the rule, saying it breeds the possibility of manipulation within the system.

Three doctors who have led a task force that evaluates preventive medical services say the group's recommendations shouldn't be tied by law to insurance coverage. The former chairmen of the U.S. Preventive Services Task Force say the link between medical recommendations and insurance coverage leads to financial incentives that can corrupt the process and distort people's health care decisions. (Kodjak, 10/10)

The worst appears to be over for Mylan NV and its EpiPen controversy. It took a $465 million settlement with the U.S. Justice Department and a grilling from Congress for its chief executive officer to get there. The drugmaker鈥檚 shares rallied Monday following Friday鈥檚 settlement with the Justice Department, resolving claims by Medicaid that Mylan overcharged the government health program for the allergy shot. That helped erase some of the stock鈥檚 26 percent slide since August, when lawmakers began asking why Mylan had raised the聽EpiPen鈥檚 price sixfold since 2007, and whether it ripped off the government along the way. Meanwhile, the cost of the shots hasn鈥檛 changed. (Armstrong, 10/10)

In other news on costs and the health law聽鈥

Shela Bryan, 63, has been comparing prices for individual health insurance plans since May, and she can鈥檛 believe what she sees. 鈥淭hey cost a thousand, $1,200 [a month], and they have a deductible of $6,000,鈥 she said. 鈥淚 don鈥檛 know how they think anyone can afford that. (Anderson, 10/11)

The 12.7 million people who enrolled in coverage on Healthcare.gov last year make up a small portion of the population, but their insurance costs seem to be the most in flux. 鈥淭hat simply may be that health insurers don鈥檛 know how to price policies yet," said Sidney Watson, a health law specialist at St. Louis University. "They don鈥檛 really understand the risk pool; they are learning trial by error.鈥澛燞er research shows that the premium changes vary widely from city to city. In Missouri, last year pre-subsidy premiums for the benchmark plans rose by more than 20 percent in some areas, but declined in Hannibal, Mo. (Bouscaren, 10/10)

The 鈥減ublic option,鈥 which stoked fierce debate in the run-up to the Affordable Care Act, is making a comeback 鈥斅燼t least among Democratic politicians. The proposal to create a government-funded health plan, one that might look like Medicare or Medicaid but would be open to everyone, is being reconsidered at both the federal and state levels. (Bartolone, 10/11)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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