HealthCare Roundtable e-News – September 22, 2020

Thanks for Your Input.

Mark Your Calendars!

Your responses to our 2020 Annual Conference Questionnaire have encouraged us… thank you! 

Although we’d all like to be planning our annual trip to Alexandria, your feedback has convinced us that we’re on the right track regarding both the timing and content of our proposed annual conference agenda. We are now in the process of finalizing the registration process and will be announcing that by the end of the month.

In the meantime, please reserve the dates and times for our agenda segments on your calendar. We are planning late morning and afternoon segments on Monday, November 9th through Thursday, November 12th. Additional details on each segment will be available with the registration announcement. 

Here’s the Preliminary Schedule/Agenda for your planning purposes.

Should you have any questions or suggestions as we move forward, please don’t hesitate to contact me at

Ginsburg Death Places Obamacare SCOTUS Case Back Into Election Spotlight

The death of Supreme Court Justice Ruth Bader Ginsburg, and President Donald Trump’s pledge to nominate a replacement as early as this week, thrusts the constitutional challenge to the Affordable Care Act back into the spotlight less than two months before the election, giving Democrats a chance to highlight a key issue that had largely receded into the background as voters focused on COVID-19, the economy, racial justice and other concerns.

Ginsburg’s death Friday evening leaves a vacancy on the court just weeks before the next session is scheduled to start, and a little over a month before oral arguments in the ACA case, now called California v. Texas, are set for Nov. 10. Legal experts say the court is likely to hear the case with the eight justices unless the Senate quickly confirms a nominee. In the former scenario, if the three remaining liberal judges back the law and Chief Justice John Roberts sides with them, this would lead to a 4-4 ruling next year, throwing the case back to the district court that had already ruled the law to be unconstitutional. While it isn’t certain the three conservative judges would rule against the law, the vacancy increases the prospect the ACA will be axed, and even more so if a Trump nominee is quickly confirmed and participates in the case.

Democratic presidential candidate Joe Biden is already using the vacancy to highlight Trump’s call for the high court to repeal the law, putting Republicans in a difficult spot. A recent Kaiser Family Foundation poll shows only 5% of Republican voters now view repealing the ACA as a top issue, compared to 29% in 2016. Voters also said they trust Biden over Trump to address nearly all health care issues, including determining the future of the ACA, ensuring access to care and protecting people with preexisting conditions.

The president recently said he would soon unveil his ACA replacement plan, a plan he has promised repeatedly since taking office. But the White House has declined to provide any details. Trump has also repeatedly said he would take steps to protect people with preexisting conditions, but he hasn’t explained how those steps would differ from protections in the health law he is challenging. (InsideHealthPolicy)

2020 State Health System Performance Scorecard Emphasizes Pre-Pandemic Challenges

The Commonwealth Fund released its annual state health system performance scorecard last week, citing challenges from COVID-19 as having exposed existing weaknesses in health care networks across the country. According to the group, state and federal officials must partner and work to resolve some of the most challenging areas, including high costs and preventable deaths.

The scorecard offers insight into a system’s performance based on the criteria of access and affordability, prevention and treatment, avoidable hospital use and costs, and healthy lives. Researchers analyzed 2018 and some 2019 data for the 2020 scorecard, citing that health care prices continue to increase, premature deaths persist and the differences in state policies threaten to leave people living in the poorly performing states behind. Regarding state performance, Hawaii, Massachusetts, Minnesota, and Iowa received top rankings, while West Virginia, Missouri, Nevada, Oklahoma, and Mississippi were at the bottom.

The group released several policy recommendations for lawmakers to consider, including the expansion of Medicaid in all states or the development of a federal fallback program that would capture people in non-expansion states. The group has also recommends allowing more individuals with employer-sponsored health coverage into the exchanges.

“The gains made in health insurance coverage since the Affordable Care Act have either stalled or eroded, and racial and ethnic inequities in coverage are at risk of getting worse during the pandemic. States that passed and implemented Medicaid expansion have lower uninsured rates. Expanding Medicaid eligibility is one important step that states can take to ensure that people can get the care they need,” said Sara R. Collins, study co-author and Commonwealth Fund Vice President for Health Care Coverage and Access.

Trump Contradicts Redfield, CDC’s Timeline of When COVID-19 Vaccine Will Be Available to the Public

President Trump contradicted CDC Director Robert Redfield at a press conference last Wednesday (Sept. 16), confirming that the administration is anticipating a COVID-19 vaccine to be ready this fall. The president stated the administration has a rapid distribution set up and that “under no circumstance will it be as late as the doctor says.” (InsideHealthPolicy)

Redfield suggested to Sen. Lamar Alexander (R-Tenn.) and other senators during an Appropriations subcommittee hearing earlier that day that the center is more confident a vaccine will be accessible to the public by late second quarter-third quarter 2021. Redfield noted that if a vaccine were to be ready as early as November or December, it may be in limited supply and recipients would be prioritized.

The CDC released a memo earlier this month to state officials offering guidance on how they can prepare for distribution by early November, but health officials have been hesitant to support the president’s claims that a vaccine will be available to all come April of next year. The president told reporters last week that vaccines ” could even start to take place in October, but certainly during November-December would be the latest because based on what we’re hearing. I’m hearing the results are very good.”

CMS Considering Reimbursement Strategy For COVID-19 Tests, Telehealth

During a press conference last week, CMS Administrator Seema Verma announced that the agency is looking to create an outcomes-based reimbursement strategy for COVID-19 tests and will also consider which temporary rules and waivers that had been implemented over the course of the pandemic might remain permanent. Verma called on Congress to make temporary telehealth provisions available beyond rural areas, commenting that reimbursement is also being explored for telehealth. (InsideHealthPolicy)

“We’ll be continuing to review that in light of the fact that we know that there are new drugs coming out from FDA, and we want to make sure that the reimbursement is appropriate,” Verma said. The Administrator also said that exploring reimbursement opportunities is something they will continue to do, offering that CMS is looking to implement options for quick and accessible reimbursement into upcoming CMS policies.

President Trump called on CMS and other agencies earlier this year to re-evaluate the temporary waivers and rules that had been implemented during the pandemic to see what can be made permanent. In response, CMS had proposed making some telehealth provisions permanent in rural areas, which the administrator would like to see made permanent in other parts of the country.

Drug Prices Are Rising Faster Than Any Other Health Care Service, According to GoodRx

According to new research from GoodRx, drug prices continue to increase at a rising rate outpacing other health care services. According to the group, drug prices have increased by 33% and inpatient and outpatient hospital services have also seen significant price increases since 2014.

GoodRx cited that all medical services costs have increased by about 17% since 2014, more than any other industry compared in the analysis, including transportation, retail, and telecommunications. Tori Marsh, Director of Research at GoodRx, commented that the team wanted to dig further into how price increases compared to other sectors within health care, noting that the biggest takeaway “is obviously that prescription drugs are rising beyond any of the other healthcare services,” she said.

The group compared data from their own index to data from the Bureau of Labor Statistics (BLS), analyzing price changes since 2014. During the same period, in which drug prices increased 33%, other medical services, like inpatient hospital services, nursing home care, and dental services have increased by 30%, 23%, and 19%. (InsideHealthPolicy)