The Weekly Insight – May 15

15th May 2017

This Week in Review

Last Week from Texas Insight

  • Health and Human Services Commission: Drug Utilization Review Board: The Texas Drug Utilization Review (DUR) Board meets quarterly to develop criteria and standards impacting Texas Medicaid. We provide a report on their most recent meeting.
  • Health and Human Services Commission: State Medicaid Managed Care Advisory Committee: The State Medicaid Managed Care Advisory Committee provides recommendations and ongoing input to HHSC on the statewide implementation and operation of Medicaid managed care. The committee looks at a range of issues, including program design and benefits, systemic concerns from consumers and providers, efficiency and quality of services delivered by Medicaid managed care organizations, contract requirements for Medicaid managed care, provider network adequacy, and trends in claims processing. We provide a report on their most recent meeting.

Health Policy News

  • While the news cycle has had a large shadow cast over it by the Comey firing, there has been significant developments with the AHCA in the Senate, as well as among constituents at town halls.
  • Representative Tom MacArthur (R-NJ) faced a particularly hostile town hall meeting this past Wednesday. Rep. MacArthur was responsible for the amendment allowing states to opt out of rules requiring insurers cover “pre-existing conditions.” While he has been celebrated in conservative circles for this contribution, many of his constituents did not echo that praise.

  • As GOP representatives return to town halls to defend the AHCA, it is good to understand the veracity of their claims. NPR provides a brief fact-check of those assertions.

  • The American Health Care Act is polling poorly nationwide. In a recent poll, POLITICO found that only 38 percent of voters approve of the GOP-drafted healthcare bill, and 44 percent of voters disapprove.

  • The healthcare debate continues at a time when research is once again highlighting the grave health disparities within our country. Recent research has demonstrated that the longevity gap is widening, and life expectancy can now vary by 20 years, depending on where you live. Racial and ethnic disparities also persist in sudden infant deaths.

  • As Senators begin work on their draft of the bill, they’ve drawn early criticism over the absence of women on the core working group. McConnell has claimed all 52 senators are involved in the revision, but the panel tasked with the AHCA remains all male.

  • The Congressional Budget Office is preparing to release its analysis of the House’s healthcare bill, AHCA, by the week of May 22. Senate rules require that the upper chamber have a CBO score before working on the healthcare bill, so it will be another week or so until the Senate Republicans do any substantive work.

  • The Senate voted on Tuesday to confirm Dr. Scott Gottlieb, a conservative health policy expert and venture capitalist, as commissioner of the Food and Drug Administration. Critics worry about Gottlieb’s ties to the pharmaceutical industry; Gottlieb has agreed to divest his holdings in approximately two dozen healthcare stocks.

  • Meanwhile, Aetna announced on Wednesday that it is exiting all of the Affordable Care Act’s insurance exchanges for 2018.