Payer Roundup—Democrats unveil plan for Medicare buy-in

Democrats have officially revealed a plan to let people ages 50 and over buy in to Medicare, plus more insurance news. (Pixabay)

Democrats unveil plan for Medicare buy-in

House and Senate Democrats released a plan Wednesday that would allow people ages 50 and over to buy in to Medicare coverage.

The bill represents a more incremental step than those backed by some of the party’s more progressive members. Under the proposal, people between the ages of 50 and 65 could buy a Medicare plan and be eligible for subsidies and tax credits included in the Affordable Care Act’s exchanges.

The expanded Medicare enrollment would pay for itself through premiums and would be able to put more of that money toward care, as it doesn’t have the profit drive of a private plan. They also argue that moving more people in that age bracket out of the risk pool would lower costs for younger people.

“I have always supported universal healthcare, but we are not there yet,” Sen. Tammy Baldwin, D-Wis., one of the bill’s sponsors said. “Medicare at 50 is a very bold step in the right direction.” (Politico)

North Carolina’s Medicaid contracts face legal challenge

North Carolina officials awarded $6 billion in Medicaid managed care contracts, but a possible legal minefield awaits.

My Health by Health Providers, a group of 12 health systems in the state whose bid was rejected, said it plans to appeal that decision. A protracted legal fight could significantly delay the rollout of the state’s revamped Medicaid program.

Aetna Better Health and Optima Family Care were also rejected for contracts, and they’re weighing whether to challenge that decision. They must decide by March 6. (The News & Observer)

PCMA head ready to take on challenge of improving PBMs’ image

JC Scott just became the CEO of the Pharmaceutical Care Management Association in September, but he says he’s up to the task of mending PBMs’ public image.

That’s no small order, as pharmacy benefit managers are on the hot seat in the debate over rising drug prices. But Scott said he sees the opportunity in informing people about what PBMs do—and he expects to accomplish just that, he said, as Congress takes a greater look at the pharmacy supply chain.

“I’m not concerned about being called up to have those conversations with Congress, at all,” Scott said. “I frankly see it as an opportunity to explain how we work, what we do and the value we bring.” (STAT)