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Are Insurers Still Avoiding Sick Patients? - Health Care Edge

Health Care Edge - August 18, 2014

By Sam Baker

CHARGES OF DISCRIMINATION: The Affordable Care Act banned discrimination on the basis of pre-existing conditions. But patient advocates say that practice is still happening, citing the way insurers are pricing certain drugs as well as the difficulty consumers faced in trying to get comprehensive information about their plans. The biggest concern is over cost-sharing for prescription drugs; some plans are charging high out-of-pocket costs for especially expensive drugs, which advocates say is a subtler way to dissuade sick patients from choosing those plans.


Top Health Care News

DISCRIMINATION DEBATE: Washington state's Democratic insurance commissioner, Mike Kreidler, says there's "no question" insurers' practices are discriminatory. Insurers, meanwhile, note that consumers have a range of plans to choose from, including options with higher premiums and more generous coverage for prescription drugs. (Ricardo Alonso-Zaldivar, The Associated Press)

MEDICARE ADVANTAGE'S ADVANTAGES: Privately administered Medicare Advantage plans are more expensive than traditional Medicare, but maybe they're worth it. MA plans have gotten better lately and now appear to offer a higher quality of care -- without cherry=picking only the healthiest patients to begin with. Expect to hear a lot about this study from the insurance industry as it steps up its campaign against any more MA cuts. (Austin Frakt, The New York Times)

GOP TRIES TO OWN CONTRACEPTION ISSUE :A handful of Republicans in tough Senate races are trying to flip the script on contraception -- an issue that traditionally benefits Democrats. Starting with Rep. Cory Gardner, who's challenging Colorado Sen. Mark Udall, they've been endorsing proposals to make birth control available over the counter. It's an attempt to preempt any political fallout from the Hobby Lobby ruling, although Democrats say Garnder's voting record, on bills like the Life Begins at Conception Act, call his sincerity into question. (Elise Viebeck, The Hill)


PANTS ON FIRE: Five doomsday predictions about Obamacare that haven't come true. (Although, it certainly hasn't lived up to several of its pre-passage promises, either.) (Michael Tomasky, The Daily Beast)

SODIUM BINGE: The entire developed world is eating too much salt, which may be to blame for more than 1.5 million deaths. (Sarah Kliff, Vox)

Rx Drugs

ON THE HOOK: An Alabama court ruled that Pfizer is liable for damages caused by a generic version of one of its drugs. Generics' labels legally cannot be different from the labels from the brand-name drugs they copy, so they're largely insulated from tort suits, but some plaintiffs have said the duty to warn about side effects therefore falls to brands. (Ed Silverman, The Wall Street Journal)


EBOLA FIGHT GETS HARDER: The threat of Ebola is prompting many aid workers to leave West Africa -- which is making the Ebola threat even harder to combat. (Sheri Fink, The New York Times)


TREATMENT FACILITY ATTACKED: An Ebola treatment in Liberia was attacked over the weekend, causing infected patients to flee. (Ashley Fantz, CNN)

A LOT TO LEARN: Treating the two Americans who were infected with Ebola has given U.S. doctors a rare chance to study the virus up close, and to learn more about what seems to work even in the absence of an FDA-approved medication. (Denise Grady, The New York Times)


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