Center For Health And Democracy: News Digest

Center For Health and Democracy, Wendell Potter, November 1, 2023

Dear LOOP Coalition members,

As we all know, there is just too much news to keep up with on a daily basis. Recently, I’ve been thinking about our coalition and how we might be able to help coalition members stay up to speed on news that is relevant to our fight to lower out-of-pocket costs. In service of that goal, I’ve put together a digest of recent news that relates to the LOOP Coalition. 

If this is helpful, please let me know, and we’ll work to make this a regular communication. 

See below for a digest of recent news: 

Judge Strikes Down Trump-Era Medicare Copay Assistance Rule

The Medicare agency must withdraw a Trump-era rule on copay assistance programs under a federal judge’s order following claims from drug industry-backed patient groups that the policy has allowed health plans to increase out-of-pocket prescription drug costs for consumers. 

New National Survey by Curative Reveals Astonishing Failures of Traditional Employer-Sponsored Health Insurance Plans

Curative Insurance Company recently unveiled the findings of a nationwide survey involving 2,500 Americans who are enrolled in employer-sponsored insurance plans. The findings highlight a concerning fact that a significant number of employed and insured Americans are not utilizing their health benefits due to worries about affordability. When forced to seek medical care, many are then burdened with overwhelming medical debt caused by deductibles, co-pays, and co-insurance.

Employer plans are unsuitable for many Americans, survey finds

Four in 10 people insured by employer-provided health plans find their out-of-pocket costs are so expensive they need to dip into savings and take on debt, according to a nationwide survey of 2,500 Americans enrolled in employer-sponsored coverage. Nearly half of the respondents said they would struggle to afford healthcare expenses should a medical emergency occur, or they were diagnosed with a chronic illness. 

92% of Americans Would Consider Delaying Dental Care Because of the Cost

An overwhelming majority of Americans say they’d consider putting off dental care for financial reasons as costs for dental services continue to rise. The August consumer price index report showed the cost of dental services is up 5.3% in the past year.

After Surviving Cervical Cancer at 26, She Had $80K in Out-of-Pocket Costs

Katerina Klawes was born with a rare blood disorder that caused her to be hospitalized multiple times while growing up in rural northern Wisconsin. Then, in 2019, she was diagnosed with cervical cancer, just three days after turning 26 years old, the age when young Americans can no longer use their parents’ health insurance.

Health Inflation Pushes Employers to Pass on Costs to Workers

Employer-sponsored health plans in 2024 may resort again to passing costs on to their workers as medical inflation heats up, aided by demand for weight-loss drugs such as Wegovy, employee benefit advisers say. 

CMS wants Part D plans to be on their best behavior

CMS will keep a close eye on Medicare Part D plans to ensure they don’t raise out-of-pocket costs for older adults on any of the 10 drugs chosen for price negotiations when negotiated rates come online in 2026. Plans in Medicare Part D, the program’s prescription drug benefit, must cover any drug chosen by CMS for price negotiation. 

Care Over Cost Rallies Hundreds Nationwide at Private Health Insurers, Demanding Corporations Reverse Claim Denials & Provide Care

Care Over Cost Members Exposed Industry Greed at Anthem BCBS/Elevance, United Healthcare, and Aetna Corporate Offices. People’s Action’s Care Over Cost campaign yesterday demanded an end to private health insurance industry greed so people can get the care they need, when they need it.

Yale New Haven, stop extra out-of-pocket medical fees

As a physician of over 40 years and a patient advocate who has spent many years working with the legislature to improve patient safety and fairness in insurance reimbursement, I am disgusted by a recent trend in health care billing that I believe the citizens and legislators of Connecticut should be made aware of. 

2023 average individual health care cost projections: $7,221 (employer pays 59%)

A recent report on the cost of health care for families and individuals reveals a bit of a spike compared to 2021… $31,065: That’s Milliman’s 2023 estimate for the cost of health care for its hypothetical U.S. family of four covered by an average employer-sponsored preferred provider organization (PPO) plan.

L.A. County wants to buy — and forgive — your medical debt

Saddled with medical debt? L.A. County is looking to take it off your hands. The county government on Tuesday became the latest municipality to consider wiping out residents’ long-lingering medical bills by buying up the debt at a steep discount. The Board of Supervisors unanimously voted to ask county executives to explore purchasing and forgiving the more than $2 billion constituents owe in unpaid medical expenses.

How barring medical debt from credit scores could impact borrowers

A White House proposal to bar medical bills from being used in credit reporting won’t get rid of the debt itself or prevent future debts from being accrued, but the move could be transformative for many. The Biden administration and debt advocates argue medical debt is not a good predictor of a person’s credit worthiness, hence why it should be excluded from the information creditors can use. And they say shielding the debt from credit reports could free up borrowers to make big purchases or cover basic expenses. Allison Sesso, CEO of the nonprofit RIP Medical Debt, said a person with good financial habits in every other aspect of their life can be stuck with an enormous bill they can’t pay off. — 
Wendell PotterPresident,  Center for Health & Democracy President,  Business Leaders for Health Care TransformationAuthor of  Deadly Spin  and  Nation on the Take