The Daily Rise: Tuesday, July 12

Spotlight on the Marketplace Access Project

Should patients be legally banned from receiving financial assistance to pay their insurance premiums?

As further evidence of how convoluted our health care policies have become, federal regulations currently ban non-profits from supporting premium assistance programs. In March 2014, the Centers for Medicare & Medicaid Services’ federal guidance on third-party insurance payments excluded non-profits from the list of acceptable premium assistance.

Enter the Marketplace Access Project — a patient advocacy movement working to correct this absurd ruling.

“Individuals living with chronic and life-threatening illnesses, such as cancer, autoimmune diseases, and bleeding conditions, rely on patient assistance programs to help cover the high costs of managing their conditions,” the Marketplace Access Project explains on its website. “For the chronically ill and patients suffering from rare diseases, the costs to simply maintain their health insurance can be prohibitive. Premium assistance programs provide a critical service that can mean the difference between life and death for many of these patients – and at no added cost to the public.”

Patients in 37 states are now battling insurance companies. Insurers are citing this rule as they deny coverage to patients. Rather than wait for the issue to make its way through the courts, the best solution is to pass HR 3742 — the Access to Marketplace Insurance Act. If approved by Congress, the law “would override the CMS guidance on third-party payments and require health insurance companies to accept payments from non-profit organizations that operate in compliance with the False Claims Act.”

If you want to help ensure that patients have access to vital premium assistance, check out the Marketplace Access Project.

Patient Education: Mixing Medications

The American Heart Association is reminding patients and doctors to keep track of their medications.

Kaiser Health News reports that heart failure patients “take an average of nearly seven prescription medicines a day and 40 percent of Medicare patients with heart failure also have five or more other chronic diseases.” Some patients – such as Mike O’Meara — take 16 medicines — 26 pills a day — to manage their health.

“Taking a variety of pills is not unusual for older patients, but the American Heart Association Monday warned heart failure patients and their doctors that they need to monitor the variety of drugs because of the possibility of unintended consequences.”

So what should the roughly 5.7 million Americans who live with heart failure being do?

  • Talk with your doctor about a comprehensive review of your medicines, including dosage and frequency.
  • Ask your doctor to verify all information with your pharmacy.
  • Show each of your healthcare providers a complete list of your medications, including over-the-counter drugs and natural supplements.
  • Always consult with a health professional before starting or stopping any medication.

Quote of the Day: “It’s not apocalyptic until it is”

“It’s not apocalyptic until it is. Shame on us if we wait till bodies are in the street.” — Peter Pitts, president of the Center for Medicine in the Public Interest on the lack of innovation in antibiotics research.

Innovation isn’t just about advancing the quality of care. In some cases, innovation is vital to preserving the status quo. That’s especially true when it comes to antibiotics. Drug-resistance bacteria are evolving into superbugs. There hasn’t been “a new class of antibiotic medication since 1987. As a result, while bacteria have continuously evolved new ways to thwart antibiotics, the medicines have not gained new mechanisms to fight back.”

We need a major investment in antibiotics research to avoid the apocalyptic scenario described by Pitts. Check out the entire LA Times piece.

White House 2016: Trump’s Health Care Plan

Eighteen million Americans could lose health insurance under Donald Trump’s health care plan, a new independent analysis concludes.

News outlets report on a newly-released analysis by the Center for Health and Economy of Trump’s plan. Although millions would lose coverage, Trump’s proposal would “lower premiums significantly for policies purchased directly by consumers,” while having minimal impact on employer-sponsored plans.

“You are going to get a lot thinner coverage both in terms of higher deductibles and fewer benefits,” said John Holahan of the Urban Institute. “The policy is bad for people with high risk, and good for people with low risk.”

The biggest unanswered question regarding Trump’s health care plan is: what are the effects of allowing insurers to sell policies across state lines?

“The biggest wild card is (Trump’s) approach to allowing people to buy across state lines,” said Douglas Holtz-Eakin, a Republican economist and a board member of the Center for Health and Economy, which conducted the study.

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