Obamacare Premiums Drop; Short-Term Health Plans; Drug Pricing Gag Clause

October 15, 2018 by Chris Pirschel ONS Staff Writer/Producer, and Alec Stone MA, MPA, Former ONS Director of Government Affairs and Advocacy

Some Obamacare Premiums Will Drop for First Time in 2019

Despite earlier failed GOP attempts to repeal the Affordable Care Act (ACA), the healthcare law is stabilizing and some premiums are dropping for mid-tier insurance plan holders (https://thehill.com/policy/healthcare/410932-obamacare-premiums-will-drop-next-year-for-first-time). The Trump administration pointed to its changes to the law (https://voice.ons.org/advocacy/trump-slashes-obamacare-outreach-funding) that made the reductions possible. However, as the article notes, experts suggest that prices are dropping because insurers overpriced their plans in 2018, coupled with the reality that ACA won’t be repealed after all.

Since April 2018, Congress had turned its attention away from repeal and replace efforts (https://voice.ons.org/advocacy/gop-steers-away-from-obamacare-repeal-replace-is-cigarette-prohibition-on-the-horizon), allowing the marketplace to stabilize and new insurers to enter. If not for the early uncertainty with ACA’s status, estimates suggest that premiums might’ve reduced further for 2019. With more competition on the horizon, prices could continue to drop in the future. 

Senate Democrats Fail to Block Trump's Short-Term Health Plans

As part of earlier efforts to overhaul the Affordable Care Act (ACA), the Trump administration expanded the use of short-term health plans that offer a cheaper alternative to the ACA marketplace. Democrats have warned against the short-term plans, citing insurers potentially denying coverage to patients with pre-existing conditions. Dems introduced a resolution to block the plans; however, it failed to collect the votes needed to pass (https://www.politico.com/story/2018/10/10/senate-health-resolution-fails-838133).  

Some speculate that it was a clear political move by the Democrats to force Republican senators in tight re-election races to make a vote that would be linked to repealing the pre-existing conditions clause in ACA. However, the White House threatened to veto the measure if it passed. The 50-50 tie reiterates the important point that health care is never a cut-and-dry issue among either party. As the midterm elections dominate the news cycle, health care remains a top priority for voters in 2018 (https://voice.ons.org/advocacy/candidates-position-will-matter-to-voters-especially-health-care)

Trump Signs Bills Banning Drug Pricing Gag Clauses

In October 2018, President Trump signed two bills banning prescription drug gag clauses (https://thehill.com/policy/healthcare/410813-trump-signs-bills-banning-drug-pricing-gag-clauses). Gag clauses work by limiting the information patients can use to save money on medications. As it stands, both parties are looking for ways to demonstrate transparency and demystify the complexity of health care, especially as it relates to patient costs, and this could be a boon for patients.

The president’s ban on drug pricing gag clauses is a bold move to put patients first, and it removes some of middlemen involved in the complicated buying process. However, plenty of hidden and visible costs remain associated with care, medication, and procedures. Oncology nurses are tackling financial toxicity (https://voice.ons.org/news-and-views/financial-toxicity-and-its-burden-on-cancer-care) as they help patients navigate the potentially expensive pitfalls of cancer care.


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