Aetna’s Proposed Merger with Humana Prompts Concerns of Reducing Competition in the Marketplace

U.S. District Judge John Bates intercepted Aetna’s proposed acquisition of Humana, a deal the judge declared was “presumptively unlawful” in the private marketplace. The proposed $37 billion acquisition, which was focused on Medicare Advantage plans, a market in which Humana is particularly strong, was blocked because it was thought that it would lessen competition for Medicare Advantage plans in the marketplace. The judge declared the merger would not be in the best interest of the companies’ consumers, especially in other markets where the merger would have a large share of business.

Judge Bates commented, “The court is unpersuaded that the efficiencies generated by the merger will be sufficient to mitigate the anticompetitive effects for consumers in the challenged markets.”

This interception came just 6 months after a proposed merger between Anthem and Cigna was blocked by the Justice Department.


This is a developing story. Stay tuned for more information regarding the Aetna-Humana merger proposal.

Resources

Judge Blocks Aetna’s $37 Billion Deal for Humana, The New York Times

Judge Cites ‘Serious Concerns,’ Blocks Aetna’s $37B Merger with Humana, BenefitsPro

President Trump Signs Executive Order to Minimize Burdens Caused by ACA

According to the executive order, the secretary of the U.S. Department of Health and Human Services and other executive departments have the authority to “minimize ACA-related burdens” that would be fiscally or regulatorily burdensome on “individuals, families, health care providers, health insurers, patients, recipients of health care services, purchasers of health insurance, or makers of medical devices, products or medications.”

Read the full story here.

Rand Paul Brings His Own ACA Replacement Plan to the Table

BenefitsPro reports that Republican Senator Rand Paul is drafting his own solution for an ACA replacement that would endorse the sale of inexpensive abbreviated coverage. Paul’s plan would allow users to pay health care costs through tax credits or HSAs.

Paul commented on CNN: “It’s incredibly important that we do replacement on the same day as we do repeal. Our goal is to give access to the most amount of people at the least amount of cost.”

Read the full article here.

Worry Over Effects of Repealing ACA Drives Need for Republicans to Find Replacement Policy

The New York Times reports that, according to the non-partisan Congressional Budget Office, nearly 18 million Americans could lose their insurance in the first year after the Affordable Care Act is repealed. The number of uninsured Americans and the cost of premiums would continue to climb over the next 10 years.

For the full article, click here.

Health Care Changes: What to Expect at the End of January

With the new administration in the beginning stages of attempting to repeal the Affordable Care Act, the Transamerica Center for Health Studies has assembled a list of the four most prominent reforms or statements from the administration. BenefitsPro has broken down that list into 10 possible changes for which health care workers should prepare for January 20, 2017.

Read through the full list here.

Senate Republicans Take Action with Repealing Obamacare; Prevent Democratic Filibuster

According to The New York Times, with a vote of 51 to 48, Senate Republicans approved a budget blueprint for the repeal of Obamacare without a Democratic filibuster. President-elect Donald Trump says he has a plan for simultaneously repealing and replacing the policy, but will not expose the plan until Tom Price, his nominee for secretary of health and human services, is confirmed.

Read the full article here.

HHS Provides Commentary on the ACA in the Individual Market

According to BenefitsPro, the number of individuals enrolled in health care under the ACA has increased from 7.9 million in 2010 to 10.9 million in 2014. These figures came from officials at the U.S. Department of Health and Human Services who wanted to illustrate how the ACA has helped individuals with pre-existing conditions and conditions that would keep them from obtaining ordinary medical coverage in states that allowed medical underwriting in the individual market before January 1, 2014.

Read the original article here.

House Republicans Draft AHCRA with Intent to Replace the Affordable Care Act

According to LifeHealthPro, the House Republican Study Commission submitted a draft of the American Health Care Reform Act of 2017 (AHCRA), a bill designed to replace the ACA that would create an inflation-adjusted, above-the-line “standard deduction for health insurance.”

As stated in the bill summary, the AHCRA is designed to let consumers use more types of coverage to maintain continuous coverage and let sick group health plan enrollees show they had maintained continuous coverage and buy health coverage using the HIPPA access guarantee without exhausting COBRA benefits.

 

Click here to read the full article.

President-Elect Trump Considers New Plan for Veteran Medical Care

“We’re working on something to make it great for the veterans,” the president-elect commented. “People are dying. We’re going to fix it properly.”

 

Read the full article here.

Certain Health Conditions Causing Rise in U.S. Health Care Expenses

A study by Dr. Joseph L. Dieleman, PhD from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington reveals that health conditions like heart disease, back pain, and diabetes are leading to an increase in U.S. health care expenses. The study, which estimates U.S. spending on personal health care and public health according to condition, revealed that, of the 155 conditions studied, diabetes had the highest health care spending in 2013 at nearly $101.4 billion. Heart disease and low back and neck pain followed at $88.1 billion and $87.6 billion, respectively.

A press release from the IHME notes that diabetes, heart disease, and back pain, as well as hypertension and injuries from falls, comprise 18% of personal health spending in the U.S., totaling nearly $437 billion in 2013.

“While it is well known that the U.S. spends more than any other nation on health care, very little is known about what diseases drive that spending,” said Dieleman in the press release. “IHME is trying to fill the information gap so that decision-makers in the public and private sectors can understand the spending landscape, and plan and allocate health resources more effectively.”

According to the study, the top ten most costly health expenses in 2013 are as follows:

  1. Diabetes – $101.4 billion
  2. Ischemic heart disease – $88.1 billion
  3. Low back and neck pain – $87.6 billion
  4. Hypertension – $83.9 billion
  5. Injuries from falls – $76.3 billion
  6. Depressive disorders – $71.1 billion
  7. Oral-related problems – $66.4 billion
  8. Vision and hearing problems – $59 billion
  9. Skin-related problems, such as cellulitis and acne – $55.7 billion
  10. Pregnancy and postpartum care – $55.6 billion

 

Resources:

U.S. Spending on Personal Health Care and Public Health, 1996–2013

Diabetes, Heart Disease, and Back Pain Dominate U.S. Health Care Spending

Heart Disease, Diabetes Lead in U.S. Health Care Spending