Last Week in Healthcare Reform: 25 July 2022

A new government analysis puts a price tag on proposed insulin legislation; drugmakers raise prices on more than 100 drugs already this month; the vast majority of Americans report being happy with their health plans; and, experts gather to discuss how to better capture data in order to advance health equity.

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Item of the Week

Week in Review

Insulin Bill Price Tag: According to the latest analysis from the nonpartisan Congressional Budget Office (CBO), a new bill targeted at addressing the rising cost of insulin would, in fact, actually drive up taxpayer spending by $23 billion over the next decade.  In responding to the CBO analysis, stakeholders pointed out that the legislation currently being considered would simply encourage pharmaceutical companies to continue doing what they’ve been doing, which is to game the system to maximize their profits, while simultaneously increasing costs to taxpayers and risking further inflation to healthcare premiums.  While making sure to acknowledge lawmakers’ intentions, they reinforce that, despite the proposed bill potentially providing some short-term relief, it does nothing to address the root cause of these out-of-control prices.  Instead of implementing artificial price caps, they continue, lawmakers should instead focus their efforts on pairing measures that offer relief to consumers at the pharmacy counter with market-based solutions that counter drugmakers’ egregious pricing and anti-competitive practices, such as those consumer-friendly tools currently being deployed by pharmacy benefit managers (PBMs) and which have been shown to help reduce out-of-pocket costs for patients who rely on insulin.

Rx Price Hikes: As they’ve done every year at this time, pharmaceutical companies have begun their second round of biannual price hikes on the prescription drugs that Americans depend on.  In fact, by the end of the first week of July, drugmakers had already raised prices on more than 100 brand name products.  Drilling further into those numbers, 57 drug manufacturers had increased prices on 108 pharmaceuticals by an average of 3.4 percent.  As mentioned, this latest round of hikes follows the price increases that drugmakers extracted from employers, consumers, and government programs earlier in the year, which saw pharmaceutical companies raise prices on nearly 800 drugs by an average of 5.1 percent.

Health Plan Survey: While consumers seem to still be a little confused when it comes to the terms surrounding their health insurance coverage, the vast majority of them report being happy with their health plans according to a new survey conducted by Forbes.  The data shows a persistent level of confusion on the part of respondents to medical bills and health insurance terminology in general, but fully 85 percent of them said that they were happy at some level with their insurance.  Unsurprisingly, costs ranked as among the top reasons survey participants said they weren’t happy with their coverage, a concern that health plans share with consumers as they work to lead the efforts to bring greater price transparency to our evolving healthcare delivery model.

Data & Health Equity: An integral component of our ongoing efforts to reduce health inequities is ensuring that collection of health plan enrollees’ race and ethnicity (R/E) data is consistent and complete in order to provide a more accurate reflection of the health status of diverse patient populations.  This was the focus of a panel discussion last week, highlighting the results of a collaborative study on the issue conducted by the Urban Institute, in coordination with the American Benefits Council, the Deloitte Health Equity Institute, and supported by Elevance Health.  Among the topics discussed were what stakeholders could be doing to enhance R/E data collection, how to better engage people from diverse backgrounds and identities in the discussion and development of solutions that could help reduce barriers to these efforts, and how we can collectively jumpstart these improvements.


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