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What We're Reading: Relief From Medicaid Cuts; Amazon and PBMs; Safety Net Hospital Payments


Opting Out of Medicaid Cuts

Certain states may have the opportunity to opt out of Medicaid cuts under the Senate’s new bill to repeal the Affordable Care Act. According to Politico, Alaska, Wyoming, South Dakota, North Dakota, and Montana may be able to delay the new Medicaid financing system in the bill based on their low-density populations. The rest of the states would be moved to the bill’s block grant payment system. The opportunity to opt out would expire in 2026. Alaska’s governor has come out against the bill, while Senator Lisa Murkowski, who voted against previous repeal bills, is currently undecided.

Amazon Is in Talks With PBMs

There have been rumors for a while that Amazon might be looking to get into the pharmaceutical business. Now there are reports that the retail giant is in talks with mid-size pharmacy benefit managers (PBMs) to set up contracts, according to FiercePharma. Amazon could also decide to become an online pharmacy, an integrated PBM, or a distributor for pharmacies. Amazon’s entry into the field could take 18 to 24 months and would significantly shake up the drug business.

Safety Net Hospital Payments at Risk

Hospitals are currently reimbursed for some of the costs they incur from taking care of uninsured patients or those who cannot afford their medical bills through a federal program that is now at risk of expiring. The Disproportionate Share Hospitals payments offset some of the uncompensated care hospitals provide, but a payment cut is slated for October 1, reported STAT. If Congress doesn’t act, a total of $43 billion in payment cuts will start to take effect. Safety net hospitals, which care for some of the most vulnerable populations, will be hit the hardest.

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