Checking Up On Health: July 21, 2015

Health Policy News and Views
Compiled By Benita M. Dodd



The Internal Revenue Service’s tax subsidies for individuals in federally run exchanges are now allowable, thanks to U.S. Supreme Court justices who have now become adept at reading minds and can divine the intent of politicians and bureaucrats despite what laws declare in black and white.

What happens next in ObamaCare? As long as President Obama is in the White House, little will change. He’s vowed to veto any effort to repeal the Affordable Care Act. The high court’s ruling is not the last word. It can’t be: Problems with the legislation abound.

Responsibly run government program is a pipe dream. Government exists to perpetuate itself, and its ability to stick its hand in the pockets of taxpayers perpetuates its irresponsibility.

It’s up to Congress to craft bipartisan solutions around and beyond the Obama administration. It’s up to the states to ensure that the most cost-effective, patient-centered solutions are investigated, promoted and adopted. As Calvin Coolidge said, “The encouraging feature of our country is not that it has reached our destination, but that it has overwhelmingly expressed its determination to proceed in the right direction.”

Read John Goodman’s article on the six problems with the Affordable Care Act that aren’t going away.


By the numbers, from Accounting Today:

710,000: The number of taxpayers who received the Advanced Premium Tax Credit for buying health insurance under the Affordable Care Act last year and have not filed their tax returns or filed for an extension.

$2.4 billion: The estimated amount those 710,000 received in Advanced Premium Tax Credit payments, according to Senate Finance Chairman Orrin Hatch.

11: The number of fake applicants – out of 12 – who were approved for Advance Premium Tax Credits for health insurance after setting up fictitious accounts. The applications by andercover investigators working for the Government Accountability Office (GAO) were approved, the GAO reports, even after an earlier report last year by the GAO about the fake accounts.

300,000: The estimated number of taxpayers who overpaid the Individual Shared Responsibility Payment (individual mandate) for health insurance on their tax returns processed through the end of April, according to the National Taxpayer Advocate. Most taxpayers use paid tax preparers, meaning most would probably spend more than the roughly $110 average overpayment amount in preparer fees if amended returns are required.

178: The number of employers and trade associations in the nationwide E-Flex Coalition that are asking Congress to clarify the rules for determining employee eligibility for tax credits for health insurance and allow online filing of information.

The operation was a success but … Did you hear about the $153,000 hospital bill for snakebite treatment? The Washington Post reported on the bill said one reason was the pharmacy costs for antivenin for the rattlesnake bit victim, Todd Fassler. (His treatment used up supplies from two hospitals.) “But the other reason hospitals charge so much is the byzantine negotiating process that happens between hospitals and insurance companies to determine the final payout amount.”

After five months of treatment, the patient's hands show significant repigmentation. (Photos by Dr. Brett King)

After five months of treatment, the patient’s hands show significant repigmentation of vitiligo spots. (Photos by Dr. Brett King)

You’d better shop around: Which hospital parents pick to deliver their baby can have serious cost consequences, according to a new study in the journal Health Affairs. Hospital costs alone for women without risk factors to complicate childbirth ranged from less than $2,000 to nearly $12,000. The significantly higher costs were found in hospitals having government or nonprofit ownership; rural hospitals; those with relatively low volumes of childbirths, low proportions of childbirths covered by Medicaid, and long stays.

Fox, meet henhouse: America’s Health Insurance Plans, the industry’s biggest lobbying and PR group, announced Wednesday that its new president, starting next month, will be none other than Marilyn Tavenner, who served as the chief administrator of the Centers for Medicare and Medicare Services from 2013 until she stepped down in February.

Overdoing it? In 2014, usage of the most common fetal-ultrasound procedures in the United States averaged 5.2 per delivery, up 92 percent from 2004, according to Kevin Helliker, writing in The Wall Street Journal. “But medical experts are now warning that frequent scans in low-risk pregnancies aren’t medically justified. A joint statement in May 2014 from several medical societies, including the American College of Obstetricians and Gynecologists, calls for one or two ultrasounds in low-risk, complication-free pregnancies.”

Clearing vitiligo: Vitiligo and alopecia are both caused when the body’s immune system becomes confused and attacks itself. In vitiligo, the body destroys pigment-forming cells; in alopecia, it attacks its own hair follicles. Yale researcher Dr. Brett King discovered that tofacitinib, a drug used to treat rheumatoid arthritis – another immune response – could treat alopecia. It stopped the chemical pathway that triggered the response and allowed hair to grow back. He and his colleagues wondered whether it could also treat vitiligo and restore color. It’s worked in a 53-year-old woman; now they’re hoping to begin a wider clinical trial using tofacitinib or a similar medicine, ruxolitinib, for the treatment of vitiligo.

CON lawsuit: The Goldwater Institute of Arizona is representing two Georgia surgeons who have filed suit over Georgia’s Certificate of Need law after the state denied them permission to expand their practice in Cartersville, Ga. Hugo Ribot and Malcolm Barfield sought to add an operating room at their Georgia Advanced Surgery Center for Women and allow other surgeons to use their facility. Read more about Georgia’s CON laws here; read about the lawsuit here.

In other unsurprising news:

Quotes of note

“The main takeaway from CBO is ‘repealing the ACA would increase Gross Domestic Product (GDP) by about 0.7 percent in the 2021–2025 period, mostly because provisions of the law that are expected to reduce the supply of labor would be repealed.’” – John R. Graham

“If people won’t use the technology because of data breaches, we run the risk of losing the benefits of these technologies. Privacy is probably the single biggest issue of our time.” – Robert B. McCray, president and CEO of the Wireless-Life Sciences Alliance

Benita Dodd is vice president of the Georgia Public Policy Foundation.