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Essentially, one commentator calculates that, with these changes, a family of four making $85,000 with $25,000 in health insurance coverage costs, will go from no federal support to a maximum payment for insurance of $7,000, or subsidies for such coverage will go from zero to $18,000. The American Rescue Plan provides various additional levels of support for all income levels, as shown in the table above.
2. Expands ACA cost-sharing support for the unemployed. The Senate legislation adds cost-sharing support for unemployed Americans enrolled in a qualified health plan. Currently, for those enrolled in such a plan who make between 100 and 400 percent of the FPL, the ACA mandates insurers reduce cost-sharing in phased amounts to make out-of-pocket expenses more affordable for lower-income Americans. The Senate legislation amends this provision for 2021 to deem that any person who received (or is approved to receive) unemployment compensation for any week during 2021 meets the req
In the early morning of Feb. 27, 2021, the U.S. House of Representatives narrowly passed H.R. 1319, the American Rescue Plan Act of 2021, by a 219-212 vote. Two Democrats joined with a.
HCPF report offers data-driven solutions to high Rx prices Eli Kirshbaum | Jan 13, 2021
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The Colorado Department of Healthcare Policy and Financing (HCPF) released a thorough report Monday detailing strategies for reducing prescription drug (Rx) costs in Colorado. The report looks at the main drivers of Rx costs in the state, which HCPF says are the fastest growing health care expense for consumers. Kim Bimestefer, the Executive Director of HCPF, discussed the report at HCPF’s Colorado Health Cabinet Health Policy Summit.
According to Bimestefer, total Rx expenditures in Colorado increased by over 50 percent between 2014 and 2019. She also said specialty drugs currently represent over 50 percent of state Medicaid spending on prescription drug expenditures.
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As my colleague Tom wrote about in a recent post, the Centers for Medicare & Medicaid Services (CMS) has finally responded to a growing chorus of stakeholders that government price reporting requirements, particularly Medicaid Best Price (BP), are stifling innovative value-based contracting arrangements (VBAs). As the proverbial wisdom goes, “nothing changes if nothing changes,” and CMS’ recently finalized proposal to allow manufacturers to report multiple BPs is meant to stimulate innovative changes in contracting for drugs and biologicals.
In this post, we want to take a closer look at the proposal and consider some potential implications in a bit more detail, especially as they relate to state Medicaid programs’ ability to leverage VBAs.
The Big Picture
Until late December, few if any Medicare policy changes were anticipated as part of a year-end healthcare package, barring extensions of funding for programs that otherwise would have expired. But after several days of closed-door negotiations, congressional leaders unveiled and very shortly thereafter Congress passed a legislative package containing an amalgam of Medicare policy changes.
The Consolidated Appropriations Act, 2021 (the Act) includes significant payment adjustments, rural health improvements, transparency requirements for certain manufacturers of drugs covered under Medicare Part B, and fixes to long-standing coverage and benefits issues such as eliminating beneficiary cost-sharing for colorectal cancer screenings. None of these changes, taken individually, represent a monumental shift in administration of the Medicare program. But as a whole, they represent an important body of policies that address long-standing concerns.