Health Care Delivery

The FDA is cracking down on a loophold drug companies use to avoid the requirement that they study products in children; a new study finds nearly 6 in 10 Hispanic adults cite a language or cultural barrier that makes it difficult for them to communicate with healthcare providers; a judge has ordered Wisconsin to pay for gender reassignment surgery for 2 Medicaid recipients.

Close to 200 organizations wrote to CMS and HHS this week to express concerns with the Trump administration’s plans to cut millions of dollars from the Affordable Care Act’s marketing and outreach budget, saying that they are “frustrated by CMS’ assertions that the need for these services has decreased as the number of uninsured or underinsured Americans continues to grow.”

Findings from the Foundation for Government Accountability did not net out those who would be eligible for exemptions under CMS rules.

If all states passed their own health insurance mandates similar to ones in New Jersey and Massachusetts, close to 4 million more Americans would have health insurance, and premium costs would drop an average of nearly 12%, according to a recent report from The Commonwealth Fund and the Urban Institute.

Senate Democrats are urging Republicans to agree to a resolution that would allow the Senate to intervene in a lawsuit challenging the legality of the Affordable Care Act; the after effects of Hurricane Maria are helping to fuel an exodus of physicians from Puerto Rico; a new congressional report suggests Anthem has effectively reversed a policy denying emergency department claims after the fact.

FDA Commissioner Scott Gottlieb, MD, announced the release of the agency’s Biosimilar Action Plan; Philadelphia’s tax on soda and other sweetened beverages has been upheld by the Pennsylvania Supreme Court; a federal judge dismissed a lawsuit by 19 states against the Trump administration over the decision to end cost-sharing subsidies under the Affordable Care Act.

Residents of the 20 Republican-led states that are challenging the Affordable Care Act (ACA)'s protections for people with preexisting medical conditions have the most to lose; House Ways and Means Committee Chairman Kevin Brady, R-Texas, is in talks with HHS about ways to restart ACA payments; Judge Brett M. Kavanaugh ruled in a case that paved the way for hospitals to seek more money from Medicare.

Here are 5 of Supreme Court nominee Judge Brett Kavanaugh’s opinions on heavily debated healthcare topics.

The FDA is planning a task force to find ways to combat drug shortages; a new Gallup poll finds nearly two-thirds of Americans support Roe v Wade 64% to 28%; the agency overseeing Oregon's legal medical marijuana industry conceded in a report it has not provided effective oversight of growers and others in the industry.

CMS cut the amount of money it is awarding to organizations that help individuals enroll in insurance for 2019 plans under the Affordable Care Act (ACA) by $26 million, and, for the first time, is encouraging the so-called “navigators” to also sign people up for health insurance that provides a narrower level of coverage than the plans under the ACA.

Blaming a recent decision by the US District Court for the District of New Mexico, CMS has announced that it has halted collections or payments under the risk adjustment program, including amounts for the 2017 benefit year, established by the Affordable Care Act for the 2014-2018 benefit period.

HHS Secretary Alex Azar appeared before the Senate Committee on Finance today to discuss the Trump administration’s efforts to drive drug innovation and affordability, answering a slew of questions revolving around the "American Patients First" blueprint, increasing generic and biosimilar competition, and value-based pricing.

How many uninsured people in the United States are eligible for coverage under the Affordable Care Act (ACA)? A new analysis from the Kaiser Family Foundation (KFF) found that 14.8 million people could gain coverage, either through Medicaid or by enrolling in a marketplace plan.

A conservative coalition is pushing a plan to repeal the Affordable Care Act (ACA), but centrist Republicans getting ready for the midterm elections have no interest in it; the World Health Organization has unveiled the 11th version of its International Classification of Diseases (ICD-11); doctors in Puerto Rico are seeing a stunning rise in the number and severity of asthma cases that they attribute to destruction caused by Hurricane Maria last September.

A look at telepsychiatry’s rapid expansion into nontraditional settings.

What seems like a straightforward idea—screen current and former heavy smokers for lung cancer—proves more challenging in practice, according to findings from a demonstration project at the Minneapolis Veterans Affairs Health Care System.

The Department of Justice (DOJ)’s legal brief in the Texas case against the Affordable Care Act (ACA) could have far-reaching ramifications besides ending protections for people with pre-existing conditions; 1 in 5 Medicare patients sent from the hospital to a nursing home boomerang back within 30 days, often for potentially preventable conditions; Anthem, Blue Cross Blue Shield of Texas, and UnitedHealth Group are among insurers scrutinizing the cost of emergency department (ED) visits.

Using data from 8 states, the Kaiser Family Foundation is tracking preliminary 2019 insurance premiums in the Affordable Care Act’s marketplaces as rate information is filed with state regulators. The 8 states are Maine, Maryland, New York, Oregon, Rhode Island, Vermont, Virginia, and Washington, plus the District of Columbia.

With few Americans receiving all the preventive services recommended for them, efforts across the full delivery system are needed to increase the use of preventive services, according to a paper published in Health Affairs.

A state judge in Maine ordered Goveror Paul LePage’s administration to stop stalling and implement a Medicaid expansion; the National Institutes of Health reported on a treatment that eradicated cancer from a patient who had untreatable, advanced breast cancer; citing changes to the Affordable Care Act, insurers are proposing double-digit rate hikes for 2019.

A new study published in Health Affairs hopes to provide an explanation of the evidence for the pros and cons of Medicaid expansion as part of the Affordable Care Act (ACA) with a systematic literature review, finding that expansion was associated with increases in coverage, service use, quality of care, and Medicaid spending.

A new study analyzed the burden of multiple myeloma around the world, as well as access to effective treatments. From 1990 to 2016, incident cases and deaths from the disease have grown substantially.

A new report from the Congressional Budget Office (CBO) and the Joint Committee on Taxation outlined health insurance coverage losses between 2018 and 2028 for people under age 65 as a result of changes to the Affordable Care Act (ACA) by the Trump administration, as the percentage of those who are uninsured will rise from 11% in 2018 to 13% by 2028.

Researchers based at the University of Michigan compared patients admitted to the intensive care unit (ICU) in Medicaid expansion states with those in nonexpansion states, focusing on 18 specific conditions identified as severe illnesses that could be avoided through better preventive care.

Terry Kohl, a real estate agent in New Jersey, battled what she thought was indigestion for 6 months and went repeatedly to a gastroenterologist for what she thought was a case of “grumbly gut.” Her "indigestion" led to a coronary artery bypass surgery soon after a trip to Rome left her breathless. Read about how women experience health and healthcare differently as National Women's Health Week draws to a close.