Source Insights
Will Courts and States Prevent the Trump Administration from Playing Humpty-Dumpty with the ACA: Responses to the Association Health Plan Final Rule
Source Fellow April 29, 2019
By: Erin Sclar, Student Fellow In late March, U.S. District Judge John Bates rejected the Trump Administration’s policy promoting Association Health Plans (AHPs), holding its interpretation of the Employee Retirement Income Security Act (ERISA) violated the Administrative Procedure Act (APA) and undermined the Affordable Care Act (ACA). This post analyzes implications of the Trump Administration’s Final Rule on AHPs, looks at the U.S. District Court’s response to litigation challenging the rule, and considers state options for regulating AHPs. The AHP Final Rule: Implications for Consumers, Providers, and States As The …
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Affordable Care Act Hanging by a Thread in the Legal Tug of War
Source Fellow April 11, 2019
By: Katie Beyer, Student Fellow In 2018, the Trump Administration issued a number of new regulations that gutted the Affordable Care Act (ACA) by effectively eliminating the ACA’s safeguards and benefits. A multitude of lawsuits brought by cities, states and health plans challenging these administrative initiatives quickly followed suit. This post provides a litigation update on the prominent cases that highlight these challenges. There are three primary categories of lawsuits at issue: (1) state challenges on the constitutionality of the ACA’s Individual Mandate; (2) city challenges on the Trump Administration’s regulatory …
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Who’s Driving Healthcare Prices: A Look at Anticompetitive Conduct of Various Players in the Healthcare Market
Source Fellow and Amy Y. Gu, Managing Editor April 9, 2019
By: Megan O’Leary, Student Fellow and Amy Y. Gu, Managing Editor On Thursday, April 4, The Source attended the “Antitrust in the New Millennium Symposium” hosted by UC Hastings College of the Law. This blog focuses on the session “New Antitrust and Healthcare”, moderated by The Source Board member and UC Hastings Professor Thomas Greaney, and featuring the panel of, notably all women, UC Hastings Professor Robin Feldman, California Senior Assistant Attorney General Kathleen Foote, and American Antitrust Institute (AAI) President Diana L. Moss. What drives rising healthcare prices? Perhaps it stems …
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The Issues with Prior Authorization and Why Reform Is Needed
Source Fellow February 25, 2019
By: Swaja Khanna, Student Fellow Late last year, in the middle of the holiday season, I needed a prescription medication urgently. My physician prescribed it on December 13th. I received the medication on December 20th. It took a whole week to get a medication that I should have long finished by the time I actually received it. I was deeply frustrated not only because I was physically ill, but also because I was dealing with a great deal of uncertainty. When I attempted to pick up my medication from the …
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Right-to-Shop Programs: Encouraging Patients to Shop for High-Value Health Care
Katie Gudiksen, Senior Health Policy Researcher February 11, 2019
With the share of Gross Domestic Product spent on health care reaching crisis levels,[1] experts on both sides of the political spectrum are demanding better value for the dollars spent on health care. Programs that give patients incentive to choose better value health care get widespread support from both political parties. In the past few years, many states considered enabling or implementing right-to-shop or savings reward programs, in which an insurer creates an incentive program that gives patients financial rewards for choosing providers with lower than average costs. How …
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Governor Newsom Makes Big Steps Towards Establishing California as the Nation’s Leader in Health Care Policy
Source Fellow February 5, 2019
By: Leah S. Gray, Student Fellow On his first day as the Governor of California, Gavin Newsom made his first steps towards carrying out his health care campaign promise of universal health care. Additionally, two parts of his plan look like a direct rebuke of the Trump administration, as Newsom hopes to ensure health coverage for undocumented young people and impose the individual mandate, which Congress attempted to repeal, in California. He also used his first executive orders to work towards lowering the cost of prescription drugs and to create California’s …
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Crystal Ball Predictions for 2019 – Amazon Prime Healthcare is Going to Change Everything
Source Fellow January 24, 2019
By: Jake Winton, Student Fellow The times of healthcare, as Nobel laureate Bob Dylan would say – are a changin’.[1] With annual U.S. health spending quickly approaching $4 trillion[2] and on track to be 20% of GDP[3] by 2026, we are in desperate need of change. While most of the recent chatter around healthcare spending focused on regulatory reforms or reducing benefits offered by health plans, these discussions neglect one of the most effective levers of change – technology innovation. Enter Amazon, a customer-centric delivery system that conquers industries by cutting …
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DMHC Releases First Annual Prescription Drug Cost Transparency Report
Katie Gudiksen, Senior Health Policy Researcher January 11, 2019
At the end of 2018, California’s Department of Managed Health Care (DMHC) released the first Prescription Drug Cost Transparency Report covering the cost of prescriptions in 2017. The legislature directed DMHC to write this report as part of the provisions of SB 17, which was passed by the legislature in 2017. For more information on SB-17, see The Source’s previous coverage when SB 17 passed, of regulations promulgated by DMHC, and of the lawsuit filed by PhRMA over the law. In this post, we review the report compiled by DMHC …
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CVS Health Finalizes Merger with Aetna
Katie Gudiksen, Senior Health Policy Researcher November 30, 2018
On November 28, 2018, CVS Health announced that it had completed its acquisition of the health insurer Aetna. The resulting entity will be a behemoth that includes the third largest health insurer,[1] the largest pharmacy benefit manager (PBM),[2] and the largest pharmacy in the country.[3] The combined, vertically integrated company will likely steer patients to use CVS pharmacies and encourage Aetna members to receive more of their routine care at CVS Minute Clinics. In addition, CVS and Aetna claim that, by merging, they can reduce drug prices by eliminating profits …
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How Safe Injection Facilities Could Save San Francisco Millions of Dollars in Healthcare Expenses
Source Fellow November 9, 2018
By: Katie Beyer, Student Fellow There are 22,500 estimated injecting drug users (“IDUs”) living in the city of San Francisco. In 2015, males accounted for 71.4% of IDUs[1] and in 2017, the city recorded 100 deaths due to injected drug overdose.[2] For those who live in San Francisco, this number may not be so alarming. The majority of San Francisco’s injecting drug users are homeless – meaning drug consumption often occurs in public spaces. The short walk from City Hall to the Civic Center Bart station is overwhelmed by people injecting …
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