The Daily Rise: Monday, April 18

Congress considers employer-sponsored health plans

Morning Consult says that there’s movement in Congress from both parties in discussions on how to tax employer-sponsored health plans.

Although temporarily on hold, the most generous employer-sponsored health plans were scheduled to be hit with a 40 percent excise tax as part of the Affordable Care Act. Last December, the excise tax was delayed until 2020 as part of a year-end government funding package.

“The employer-sponsored health insurance market is a vital one. The question we must wrestle with is how we can sustain this option while advancing reforms that make the tax code fairer and health care more affordable for all Americans,” House Ways and Means Committee Chairman Kevin Brady said last week, according to Morning Consult. “We need bold solutions to tackle this challenge, not Obamacare’s punitive tax on high cost health insurance plans that the law itself has made even more expensive.”

The debate over the so-called “Cadillac Tax” cuts to the very heart of how we tax health care. Right now, health care premiums are considered pre-tax, and as such, offer employers a way to provide better benefits to their employees without increasing either parties’ tax bill. According to the Congressional Budget Office, a tax on health care premiums would raise taxes by $250 billion per year.

Coming Soon: Higher Premiums

Your health insurance premiums are expected to go up next year. Caitlin Owens of Morning Consult reports that the transition of health care plans as part of the Affordable Care Act is the primary culprit.

After several extensions “grandmothered plans,” which were intended to act as transitional plans, will be phased out completely by the end of 2017. Additionally, insurance companies bid lower than the Congressional Budget Office expected on the initial premium rates set in 2015.

“I think we’d be looking at a very different picture right now if premiums had come in as expected rather than 15 percent below what CBO projected,” said Larry Levitt, a senior vice president at the Kaiser Family Foundation. “But it’s easy to say that now looking through the rear view mirror.”

We’re a long way from the days of “If you like your healthcare plan, you can keep it.”

Tough Talk

Kaiser Health News Barbara Feder Ostrov writes that many doctors are struggling in talking with their patients about end-of-life care. That’s according to a new survey commissioned by The John A. Hartford Foundation, the California Health Care Foundation and Cambia Health Foundation.

Among the findings from the survey of 736 primary care doctors and specialists:

  • Only 14 percent of doctors billed Medicare for advance care planning discussions.
  • 75 percent of doctors believe they should initiate end-of-life conversations.
  • Fewer than one-third reported any formal training on end-of-life discussions with patients and their families.
  • More than half said they had not discussed end-of-life care with their own physicians.

Doctors can be reimbursed $86 from Medicare for end-of-life care discussions, which explain hospice, living wills and do-not-resuscitate orders. In the next fifteen years, one-fifth of the U.S. population will be over the age of 65 — increasing the importance of end-of-life care decisions.

Hospital Collusion

Two West Virginia hospitals have agreed to a tentative settlement with the U.S. Justice Department over claims that the entities colluded in illegal marketing campaigns.

St. Mary’s Medical Center and Charleston Area Medical Center agreed not to advertise in each other’s territory, according to

“These hospitals limited competition by agreeing on how and where each would advertise competing healthcare services,” Assistant Attorney General Bill Baer of the Justice Department’s Antitrust Division said a press announcement. “Marketing is an important tool that hospitals use to compete for patients. Today’s action will end the hospitals’ anticompetitive agreement and promote competition.”

Under the terms of the proposed agreement, the two hospitals would be banned from communicating or coordinating their marketing efforts. They’ll also be subject to antitrust compliance officers and occasional compliance inspections.

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