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U.S. healthcare costs to escalate over next decade: government agency

WASHINGTON (Reuters) – The cost of medical care in the United States is expected to grow at a faster clip over the next decade and overall health spending growth will outpace that of the gross domestic product, a U.S. government health agency said on Wednesday.

A report by the U.S. Centers for Medicare and Medicaid Services (CMS) cited the aging of the enormous baby boom generation and overall economic inflation as prime contributors to the projected increase in healthcare spending.

Overall healthcare spending will comprise 19.9 percent of the economy in 2025, up from 17.8 percent in 2015, the report forecast. The pace of growth in U.S. spending on health is expected to pick up in 2017, increasing 5.4 percent over 2016. That compares with an estimated 4.8 percent spending uptick in 2016. Spending for 2016 was estimated at $3.4 trillion.

When the final numbers are in, the growth in prescription drug spending for 2016 is expected to have slowed to 5 percent from 9 percent in 2015. However, CMS has forecast growth of 6.4 percent per year between 2017 and 2025, in part because of spending on expensive newer specialty drugs, such as for cancer and multiple sclerosis.

The projections for 2016 to 2025 were made assuming that the Affordable Care Act (ACA), former President Barack Obama’s signature healthcare law widely known as Obamacare, would remain intact. It does not take into account likely changes to the law.

The Republican-led Congress and President Donald Trump have vowed to repeal and replace the ACA, but a viable replacement plan has yet to emerge.

Trump signed an executive order on his first day in office last month to freeze regulations and enable government agencies to take other steps to weaken Obamacare.

The ACA expanded Medicaid, the government health insurance program for the poor, in more than 30 states and set up private healthcare exchanges that enabled previously uninsured people to buy health insurance. After high enrollment between 2014 and 2015, Medicaid and private health insurance spending were expected to have slowed in 2016.

But spending on Medicare, the government health insurance program for the elderly, is expected to grow between 2017 and 2025 as a larger elderly population requires more medical services.

The overall insured rate of the population is expected to reach 91.5 percent in 2025, up from 90.9 percent in 2015, the report said.

(Reporting By Yasmeen Abutaleb; Editing by Tom Brown)

With eye on Obamacare, Price takes helm as U.S. health secretary

By Susan Cornwell

WASHINGTON (Reuters) – Tom Price was sworn in as U.S. secretary of health on Friday, putting in place a determined opponent of Obamacare to help President Donald Trump fulfill his pledge to dismantle his predecessor’s law and reshape the country’s healthcare system.

As head of the Department of Health and Human Services (HHS) Price has the authority to rewrite rules implementing the 2010 Affordable Care Act, also known as Obamacare. He could move quickly to rework the regulations while waiting for Republicans in Congress to keep their pledge to scrap the law entirely.

The Republican president signed an order on Jan. 20, his first day in office, to freeze regulations and take other steps to weaken the law enacted by former Democratic President Barack Obama, a directive that will fall largely on Price. But Trump said in a recent Fox News interview that a replacement for the law may not come until next year.

Trump said on Friday the effort was a “difficult process” but could now get going with Price in place.

“Now we get down to the final strokes,” he told reporters at a separate news conference at the White House alongside visiting Japanese Prime Minister Shinzo Abe. He did not offer more details but said the country would end up with “tremendous healthcare at a lower price.”

Republicans, who have long viewed Obamacare as federal overreach and who have the majority in Congress, are trying to craft a replacement but have not agreed on one. Twenty million Americans gained health insurance under the law.

“Having Dr. Tom Price at the helm of HHS gives us a committed ally in our work to repeal and replace Obamacare,” said U.S. House of Representatives Speaker Paul Ryan, who has vowed to pass a new plan this year.

Price, a member of the House since 2005 who chaired the budget committee, offered legislation in 2015 to repeal Obamacare and replace it with age-adjusted tax credits for the purchase of health insurance.

While Price’s fellow Republicans have controlled the House since 2011, they did not advance his bill and it was not considered by the full chamber.

The Senate voted 52-47 earlier on Friday to approve Price, a former orthopedic surgeon, to oversee the HHS, which has an annual budget of more than $1 trillion.

Price’s nomination was dogged by questions about his trading in hundreds of thousands of dollars in health company stocks while working on healthcare legislation. Democrats accused him of making misleading statements. Price defended his actions.

Democrats also criticized Price for his opposition to Obamacare, his ideas about restructuring the Medicare program for the elderly and disabled, and his opposition to Planned Parenthood, an organization that provides abortions and other affordable healthcare and education services.

With Price confirmed, the Senate is expected to vote on Monday on Trump’s U.S. Treasury secretary designate, Steven Mnuchin.

(Additional reporting by Susan Heavey and Steve Holland in Washington, and Brendan O’Brien in Milwaukee; Editing by Bernadette Baum and Frances Kerry)

Medical students, faculty rally to try to save Obamacare

Medical students protesting for obamacare

By Bob Chiarito

CHICAGO (Reuters) – Hundreds of medical students and faculty members gathered at Northwestern University’s school of medicine in Chicago on Monday to voice their opposition to the dismantling of Obamacare.

The demonstration was part of a larger White Coats for Coverage effort organized by medical students across the country and came a day before the annual deadline to enroll in the Affordable Care Act (ACA), former President Barack Obama’s healthcare law.

“The ACA is not perfect, but pulling the rug out from under the feet of our most vulnerable patients is not the answer,” Dr. Bruce Henshaw, a faculty member at Northwestern’s Feinberg School of Medicine, told the group of around 600 people.

“We will not stand idly by as our patients lose their rights. We will not stop today. We will write and call our representatives to ensure this doesn’t happen.”

Students organized the event. Northwestern University spokeswoman Marla Paul said the school had no official position on the issue.

Photos on social media showed students rallying at numerous universities and cities.

“Proud to join my Yale colleagues to collectively say #protectourpatients. Improve the ACA, DON’T repeal it,” Ryan Murphy, who shared photos of a rally at Yale University, said on Twitter.

Republican President Donald Trump’s first executive order, signed hours after taking office, directed the federal government to scale back regulations, taxes and penalties under the ACA.

Republican Representative Tom Price, Trump’s nominee to lead the Department of Health and Human Services, has said an overhaul of Obamacare will initially focus on individual health plans sold through online exchanges and the Medicaid health insurance program for low-income Americans.

Trump has said he wants to keep some elements of the program, such as allowing young adults to be covered under their parents’ insurance. He favors plans that use health savings accounts and sale of insurance across state lines.

More than 8.8 million Americans were signed up for 2017 coverage under the ACA through HealthCare.gov as of Jan. 14, according to the site, up from around 8.7 million sign-ups as of Jan. 14 last year.

Arturo Salow, a second year student at Northwestern from Miami, Florida, urged people to sign up for ACA coverage before Tuesday’s deadline, saying more enrollees would make a rollback more challenging for Republicans.

“I’d advise any patient to sign up immediately,” Salow said. “If they are going to take away coverage, let’s make it as difficult as possible.”

(Editing by David Gregorio)

Trump vows ‘insurance for everybody’ in replacing Obamacare

Donald Trump at conference disucssing Obamacare

WASHINGTON (Reuters) – U.S. President-elect Donald Trump aims to replace Obamacare with a plan that would envisage “insurance for everybody,” he said in an interview with the Washington Post published on Sunday night.

Trump did not give the newspaper specifics about his proposals to replace Democratic President Barack Obama’s signature health insurance law, but said the plan was nearly finished and he was ready to unveil it alongside the leaders of the Republican-controlled Congress. The Republican president-elect takes office on Friday.

“It’s very much formulated down to the final strokes. We haven’t put it in quite yet but we’re going to be doing it soon,” Trump told the Post, adding he was waiting for his nominee for health and human services secretary, Tom Price, to be confirmed.

The plan, he said, would include “lower numbers, much lower deductibles,” without elaborating.

“We’re going to have insurance for everybody,” Trump said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”

Trump was also quoted as saying in the interview that he would target pharmaceutical companies over drug pricing and insist they negotiate directly with the Medicare and Medicaid government health plans for the elderly and poor.

U.S. House Republicans won passage on Friday of a measure starting the process of dismantling the Affordable Care Act, popularly known as Obamacare, despite concerns about not having a ready replacement and the potential financial cost of repealing the law.

With the vote, Republicans began delivering on their promise to end Obamacare, also a campaign pledge of Trump, who has called the program a “disaster.”

The law, which expanded health coverage to some 20 million people, has been plagued by increases in insurance premiums and deductibles and by some large insurers leaving the system.

Republicans have called Obamacare federal government overreach and have sought to undermine it in Congress and the courts since it was passed by Democratic majorities in the House and Senate in 2010.

Democrats say Obamacare has allowed growing numbers of Americans to get medical insurance and helped slow the rise in healthcare spending.

(Writing by Mary Milliken; Editing by Will Dunham and Peter Cooney)

U.S. court puts Obamacare case on hold until Trump takes office

By Lawrence Hurley

WASHINGTON (Reuters) – A federal appeals court on Monday brought to an end President Barack Obama’s bid to overturn a ruling that threatens to gut his signature healthcare law by putting the case on hold until after President-elect Donald Trump, who aims to repeal Obamacare, takes office.

The Obama administration had appealed a judge’s May ruling favoring the challenge filed by Republicans in the U.S. House of Representatives against a key part of the 2010 law. But the U.S. Court of Appeals for the District of Columbia Circuit agreed to a request by the Republicans to delay its consideration of the government’s appeal until after Trump takes office on Jan. 20.

The Obama administration opposed the move.

If the law is repealed by Congress, the case would be moot. The court’s decision to put the case on hold will not have an immediate effect on the law, as the lower court ruling was put on hold pending the appeal. The court said both sides should provide an update on the status of the case by Feb. 21.

The challenge targeted government reimbursements to insurance companies to compensate them for reductions that the law required them to make to customers’ out-of-pocket medical payments.

Trump has said he favors repealing and replacing Obamacare but would consider retaining certain elements.

The law has enabled millions of previously uninsured Americans to obtain health insurance, but Republicans condemn Obamacare as a government overreach and have mounted a series of legal challenges.

The Obama administration appealed U.S. District Judge Rosemary Collyer’s ruling that the government cannot spend billions of dollars in federal funds without congressional approval to provide subsidies under the healthcare law to private insurers to help people afford medical coverage.

The House Republicans argued that the administration violated the U.S. Constitution because it is the legislative branch, not the executive branch, that authorizes government spending.

The Obama administration has interpreted the provision as a type of federal spending that does not need to be explicitly authorized by Congress.

The U.S. Supreme Court in 2012 and 2015 issued major rulings authored by conservative Chief Justice John Roberts that preserved Obamacare and rejected conservative challenges.

(Reporting by Lawrence Hurley; Editing by Will Dunham)

U.S. completes ‘takedown’ of Medicare fraud: officials

By Sarah N. Lynch

WASHINGTON (Reuters) – U.S. law enforcement officials have charged 301 suspects with trying to defraud Medicare and other federal insurance programs in 2016, marking the “largest takedown” involving health care fraud allegations, the Justice Department said on Wednesday.

The national sweep resulted in charges against doctors, nurses, pharmacists and physical therapists accused of fraud that cost the government $900 million, the department said.

The cases involved an array of charges, including conspiracy to commit health care fraud, money laundering and violations of an anti-kickback law.

This year’s sweep exceeded last year’s record in which 243 defendants faced charges in a combined $712 million in government losses. Officials said it was the largest takedown in the nine-year history of the Medicare Fraud Strike Force, a joint initiative between federal, state and local law enforcement.

Attorney General Loretta Lynch said some of the cases reflect new, troublesome trends, including instances of identity theft in order to prepare fake prescriptions and a growing number of cases involving compounding, or the mixing of medications tailored to meet a patient’s needs.

Compounded medications are typically very expensive. From 2012 to 2014, the quarterly Medicare spending on these prescriptions skyrocketed from $28 million to $171 million.

“As this takedown should make clear, health care fraud is not an abstract violation or benign offense,” Lynch said. “It is a serious crime.”

In one case, two owners of a group of outpatient clinics and a patient recruiter stand accused of filing $36 million in fraudulent claims for physical therapy and other services that were not medically necessary.

The Justice Department said that to find patients, the clinic operators and the recruiter targeted poor drug addicts and offered them narcotics so they could bill them for services that were never provided.

Another case was filed against the operator of a marketing business that received referral fees from pharmacies that filled and billed Tricare, the U.S. military’s government insurance program, for compounded medicines.

The prescriptions were submitted via “telemedicine” sites, and doctors were given blank prescription forms to fill out, regardless of medical necessity, according to the complaint.

One doctor told the FBI her identity and medical credentials were used without her permission to fill thousands of dollars worth of prescriptions.

Supreme Court Upholds ACA Subsidies

The Supreme Court has upheld by a 6-3 decision a key provision of President Obama’s signature healthcare law by saying that tax subsidies are Constitutional even though the law does not specifically say that federal subsidies can be issued in states with no state healthcare exchanges.

“After more than 50 votes in Congress to repeal or weaken this law, after a presidential election based in part on preserving or repealing this law, after multiple challenges to this law before the Supreme Court, the Affordable Care Act is here to stay,” Obama said in the White House Rose Garden.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Roberts wrote in the court’s decision, adding that nationwide availability of the credits is required to “avoid the type of calamitous result that Congress plainly meant to avoid.”

“In this instance,” he wrote, “the context and structure of the act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”

The decision was the second time in three years that the Supreme Court has ruled against major challenges to the Affordable Care Act.

Justice Antonin Scalia said: “We really should start calling the law SCOTUScare,” Scalia said. SCOTUS is the acronym for the Supreme Court of the United States. “This court has no free-floating power to rescue Congress from its drafting mistakes.”

Nepal Quake Devastated Nation’s Healthcare System

The massive 7.8 earthquake that rocked Nepal and left hundreds dead still hasn’t been fully noted by the government but a report on the state of the healthcare system shows the country is in serious trouble.

A new report given to the Nepal planning commission shows that one third of the nation’s healthcare system has been destroyed or severely damaged to the point it is currently inoperable. Almost 450 public health facilities in the nation were completely destroyed by the quake and its aftershocks.

Over 700 public health facilities have been reported with significant damage although they are still able to provide some services.

The total value of the damage is estimated to be around $58 million and the estimate cost to rebuild is close to $110 million over the next five years.

The situation is being complicated by the monsoon season with landslides threatening some of the remaining damaged healthcare structures.

The WHO said Nepal was one of the worst nations in the world for healthcare before the quake, with only 2.1 doctors per 10,000 residents of the population. The WHO says native doctors head for more industrialized nations in search of better pay and working conditions.

“Health services must be rebuilt and made accessible to all, while risk-reduction programmes must be implemented at the sub-national level,” Poonam Khetrapal Singh, the WHO regional director for Southeast Asia, wrote last week. “Soil testing, the enforcement of health facility-related building codes, and investment in design of quake-proof facilities and homes must be encouraged across the country.”

Michigan House Approves Religious Freedom Restoration Act

The Michigan House of Representatives has passed a state version of the federal Religious Freedom Restoration Act despite outcry from anti-Christian groups in the state.

The bill, HB5958, cleared the House Judiciary Committee 7-4 and passed the full House 59-50. The Senate now picks up the bill for consideration.

The bill was introduced in the state house because the federal law, signed into law in 1993 by President Bill Clinton, only applies to federal issues. Legislators in Michigan wanted to make sure Christians and other people of faith had their rights protected from state groups and organizations.

The statute reads: “The free exercise of religion is an inherent, fundamental, and unalienable right secured by Article 1 of the state Constitution of 1963 and the First Amendment to the United States Constitution.”

The bill is in response to anti-Christian groups that want to eliminate Christians and people of faith from being able to exercise their rights in society.

“I support individual liberty and I support religious freedom,” House Speaker Jase Bolger (R) declared Thursday to the Judiciary Committee. “I have been horrified as some have claimed that a person’s faith should only be practiced while hiding in their home or in their church.”

District of Columbia Delays Abortion Coverage Vote

A bill to force all business owners in the District of Columbia to provide abortion coverage to employees regardless of their faith beliefs has been delayed.

The “Reproductive Health Non-Discrimination Amendment Act of 2014” was pulled on Tuesday afternoon. The bill was introduced in the wake of the Hobby Lobby Supreme Court decision that said the government could not force business owners to pay for abortion coverage.

“The council seems to have heard the voices warning them not to waste D.C. taxpayer dollars promoting the abortion lobby’s interests,” said Casey Mattox of the Alliance Defending Freedom. “There is simply no prospect that a court would uphold a bill forcing D.C. prolife non-profits to pay for abortions. The D.C. Council has wisely stepped back from the ledge and – for now – respected fundamental freedoms and avoided raiding taxpayers’ paychecks.”

Pro-abortion organizations had hailed the bill and the infringement on the religious freedom of business owners to advance abortion including NARAL Pro-Choice America.

Pro-life groups contacted the members of the city government to inform them that the bill would be a violation of the Religious Freedom Restoration Act.

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