Payer Roundup—As midterms approach, pre-existing conditions are a top healthcare issue for voters

Voters name pre-existing conditions, ACA repeal as top healthcare issues

Voters will be paying close attention to what candidates say about protections for patients with pre-existing conditions this November.

According to the most recent installment of the Kaiser Family Foundation (KFF) Health Tracking Poll, 63% of voters say that's a "very important" or the "single most important" factor in their vote, including 74% of Democrats, 49% of Republicans and 61% of voters in battleground states.

The second-most important healthcare issue for respondents was the Affordable Care Act (ACA) repeal. When asked if they want the Supreme Court to overturn the law, 52% said no, and 41% said yes. However, when asked if they want the Supreme Court to overturn "the protections for people with pre-existing conditions established by [the ACA]," 64% said no—including 70% of Democrats and 49% of Republicans—and 27% said yes, possibly reflecting the public's continued misunderstanding of the law.

KFF also asked people who live in non-Medicaid expansion states if they want their state to expand Medicaid; just over half (51%) said yes. Among the 39% who said their state should keep the program as-is, 68% said they would be more likely to support expansion if their state instituted work requirements as well. (Poll)

House Democrats hold press conference on upcoming bill to reduce drug prices

Democratic Reps. Lloyd Doggett (Tex.), Peter Welch (Vt.), and Elijah Cummings (Md.) held a press conference on Wednesday to discuss The Medicare Negotiation and Competitive Licensing Act. The bill, Doggett explained, would allow Medicare to negotiate drug prices and authorize the use of competition to lower prices if negotiation is not successful. It would also create an interim price for drugs during the generic approval process based on prices in other OECD countries. It has more than 60 co-sponsors, he noted.

Pharmaceutical companies "get a government-granted monopoly, and then abuse it to impose punitive, relentless, exorbitant, gouging prices on consumers, and it's causing an immense amount of pain," Welch said. "And it's true that we need good drugs to alleviate suffering, to extend life, but that's not an excuse to kill people with the prices."

Cummings emphasized the need to take action on this topic, and criticized President Trump for his inaction, despite acknowledging the problem of high drug costs. He added that the House Oversight Committee would hold drug companies responsible for making drugs inaccessible to many Americans. (Video)

For lower out-of-pocket costs, Medicare beneficiaries can try generic drug discount programs

A new study in Annals of Internal Medicine suggests Medicare beneficiaries may be able to save money by obtaining their prescriptions through generic drug discount programs rather than their Part D plans.

The study compared the out-of-pocket costs of 27 cardiovascular drugs under 2,155 Part D plans to their prices under Walmart's generic drug program, which offers many drugs for $4. On average, 21% of plans required patients to pay more than $4 for a covered medication.

But this varies by plan type and drug tier. Standalone plans beat the Walmart price much more often than Medicare Advantage plans. Perhaps predictably, drugs in tier 1 and select care tiers charged $4 or less much less often than drugs in other tiers.

Still, the authors recommended addressing laws that prohibit pharmacists from notifying patients about lower out-of-pocket prices for medications. Beneficiaries are more likely to adhere to a medication regimen if they can afford their medications in the first place, the study noted. (Article)

Maine Medicaid expansion population enrolling in coverage as lawsuit continues

Mainers who may be newly eligible for Medicaid are signing up for coverage, despite Gov. Paul LePage's refusal to implement the policy.

Maine Equal Justice Partners, one of the advocacy organizations that sued the LePage administration in a case now pending before the state's Supreme Court, says it has helped about 25 people enroll so far. Hundreds more have used a tool on their website to check if they are eligible. No one has been denied coverage yet, a representative from Maine Equal Justice Partners said, though the state has 45 days to make that decision.

Under the expansion, an additional 70,000 residents of the Pine Tree State qualify for Medicaid. (Portland Press Herald)