Word from Washington: August 2023
Advocates are responding to yet another payer-side, cost-saving scheme that harms patient access to medicine. The latest version, the so-called “alternative funding program” (AFP), is a shady strategy pitched to employers that promises to lower health plan spending on specialty drugs such as bleeding disorder products and other expensive medicines. AFP vendors advise employer health […]
Word from Washington: July 2023
July saw mounting coverage losses from the national Medicaid unwinding. As of July 28, nearly four million people have been disenrolled from Medicaid since redeterminations began in April 2023. Three-quarters of that total lost coverage for procedural reasons, i.e., paperwork, and may still be eligible for Medicaid. In response to this dismaying track record: Also […]
Word from Washington: June 2023
Medicaid disenrollments are now underway in about 40 states, as part of the Medicaid “unwinding.” Medicaid unwinding, recall, is shorthand for the resumption of regular Medicaid eligibility reviews and terminations, following a three-year pause during the COVID public health emergency. Unfortunately, early reports from 26 states show that at more than 1.5 million Medicaid […]
Word from Washington: May 2023
Lawmakers in May devoted close attention to the role that pharmacy benefits managers (PBMs) play in our health care system. PBMs are middlemen that create and administer drug formularies on behalf of health insurers, self-insured employers, Medicaid, and other payers. PBMs choose which drugs a plan will cover, negotiate drug prices on behalf of payers, […]
The HELP Copays Act moves forward – now in the Senate as well as in the House
Protections for people who rely on copay assistance have been a top priority for HFA and many other patient groups for several years. That effort took a big step forward in April with the introduction of a first-ever Senate version (S. 1375) of the HELP Copays Act. Sponsored by Sens. Kaine, Marshall, Markey, and Ernst, […]
The Importance of Copay Assistance Protections: Awareness Grows
For over three decades, March has been designated “Bleeding Disorders Awareness Month.” HFA and member organizations across the country mark the occasion with monthlong education and advocacy activities – social media outreach, state and local proclamations and resolutions, Hill Days, and more. In March 2023, as in past years, HFA was pleased to take part […]
The Complexity of Unwinding Medicaid
The long-heralded Medicaid “unwinding” has begun. As previously reported, state Medicaid programs have, since the start of the COVID-19 pandemic, operated under a law that prohibited them from disenrolling Medicaid enrollees for the duration of the public health emergency (PHE). Congress changed that requirement in December 2022, delinking the Medicaid continuous enrollment obligation from the PHE. […]
Word from Washington: January 2023
HFA reports on a particularly concerning insurance problem unfolding in Tennessee, and how HFA is responding; news on Medicaid eligibility reviews; changes in blood donation policy; and much more.
Word from Washington: December 2022
On December 23rd, Congress passed a $1.7 trillion year-end spending package that averts a government shutdown and funds the government through September 2023. The 4,000+ page omnibus bill contains numerous important health provisions affecting Medicaid, telehealth, the accelerated approval pathway for new drugs, and more. The legislation sets a date (April 1, 2023) for the […]
Word from Washington: November 2022
Midterm elections are mostly wrapped up as November draws to a close. The race between Sen. Raphael Warnock and Herschel Walker heads to a runoff in early December, but regardless of the outcome in that contest, control of the U.S. Senate remains – narrowly – with the Democrats. Control of the House of Representatives, by […]
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