The Daily Rise: Wednesday, July 6

If You Like Your Plan, Can You Keep It?

It’s easily the biggest broken promise of the Affordable Care Act: “If you like your health care plan, you can keep it.”

Even now, three years after PolitiFact named it the “Lie of the Year,” patients are still feeling the effects – and disruption – of that broken promise.

The Advocate reports that tens of thousands of patients in Louisiana could lose their current health care plan purchased through the federal marketplace as a result of the state’s Medicaid expansion. Approximately 375,000 patients in Louisiana are expected to receive free health insurance this year after Louisiana became the 31st state to expand Medicaid coverage under the Affordable Care Act.

Ruth Kennedy, the Louisiana Medicaid expansion project director, says that patients that purchased individual policies but now qualify for Medicaid will not be forced to switch — as long as they make their premiums.

Insurance companies disagree and are working to force patients to drop their plans.

“But Blue Cross and Blue Shield of Louisiana, the state’s largest health insurer and carrier for the bulk of Obamacare policies, says that’s not allowed under federal regulations,” the Advocate reports. “Once Obamacare plan members become eligible for Medicaid, they are no longer eligible for the federal subsidies that help them pay for the federal marketplace coverage, said Blue Cross spokesman John Maginnis.

And if that was confusing enough, another health expert says patients can keep their current plan for the remainder of this year, but lose it next year.

No one is clear on whether patients can keep their plan or must enroll in the state’s Medicaid coverage. When the state’s Medicaid expansion project director tried to get an answer, “She said she hadn’t been able to nail down the federal agency on what would be required of the newly Medicaid-eligible after Dec. 1…The Centers for Medicare and Medicaid Services declined comment on the Blue Cross assertions.”

What are patients supposed to do? How can patients be expected to make informed decisions when the state’s Medicaid director disagrees with insurance companies and can’t get an answer from the Centers for Medicare and Medicaid Services?

Olympic Zika Study

American athletes won’t just be working to bring home the gold next month. They’ll also be helping researchers gain a greater understanding of Zika virus.

The National Institutes of Health announced this week that researchers will study a group of the U.S. Olympic team for Zika virus.

“For those infected, the study hopes to shed light on where the virus remains in the body, how long it remains in the fluids and how it affects reproduction for participants for up to one year after the games conclude,” Morning Consult reports.

“We partnered with the USOC to improve knowledge of the dynamics of Zika infection, so that we can better protect the health of athletes and staff who will participate in the 2016 Games,” said Carrie Byington, the lead researcher and chair of the U.S. Olympic Committee’s Infectious Disease Advisory Group. “This ongoing relationship also opens avenues for long-term research that promises to benefit not only the Americas, but also other regions facing the emergence of the virus.”

State Spotlight: Patients Oppose CA Price Controls

Patients are speaking out against California’s misguided effort to impose price controls.

The New York Times reports that California’s drug price plan is being strongly criticized by patient advocates, who are worried it could jeopardize patients’ access to life-saving treatments and increase costs for prescription drugs.

“We agree with the proponents that we need to do something, but we just don’t think this is it,” Anne Donnelly, director of health care policy at Project Inform, an advocacy group based in California for people with H.I.V. and hepatitis C, told the New York Times. “It doesn’t appear to save the State of California perhaps any money, and it could have some negative effects.”

Proposition 61 would prohibit the state from paying more for a prescription drug than the lowest price paid by the U.S. Department of Veterans Affairs. But, the California Legislative Analyst’s Office, an independent panel of experts that provides impartial analyses of proposed legislation, is warning that the measure might not save patients one penny.

In addition to policy analysts and patients, the California Medical Association has called it “deeply flawed and unworkable.”

Campaign 2016: Democratic Party Platform

Earlier this summer, we reported on the efforts to influence the party platforms that will be adopted at each party’s convention. The party platforms set the agenda not just for the presidential candidates, but congressional, state and local leaders.

Now, it looks like Democrats are closer to adopting new language related to the party’s position on health care.

“Democrats will never falter in our generations-long fight to guarantee health coverage as a fundamental right for every American. As part of that guarantee, Americans should be able to access public coverage through Medicare or a public option,” the draft platform reads. “By contrast, Donald Trump wants to repeal the ACA, leaving tens of millions of Americans without coverage.”

We’re disappointed. Coverage is a means to an end. What good is coverage if that coverage doesn’t provide the right treatment to the right patient at the right time?

Let’s hope that the final version incorporates language that understands what’s truly important: getting the right treatment to the right patient, right when they need it.

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