Health Plan Weekly

In a year when a pandemic and a presidential election are already fueling high levels of uncertainty, the Sept. 18 death of Justice Ruth Bader Ginsburg — which could tip the scales in favor of striking down the Affordable Care Act (ACA) — was hardly welcome news for health insurers. However, industry analysts and legal experts say there are plenty of reasons not to hit the panic button just yet.

“This definitely increases the chance of the Supreme Court striking down the full ACA. But we’re going from a pretty low likelihood base,” says Chris Sloan, an associate principal at consulting firm Avalere Health. “The odds are still really stacked against anything materially changing for the ACA.”

✦ Anthem, Inc. is teaming up with the University of California, Irvine, Apple, Inc., and a company called CareEvolution to launch a study that examines whether devices like the Apple Watch and iPhone can help people with asthma manage their condition. As part of a two-year, randomized controlled study, Anthem-affiliated health plan members who have been diagnosed with asthma will get a digital tool that includes “daily symptom and trigger tracking to provide awareness of asthma control and personalized nudges based on changes in signals from their Apple Watch including activity, heart rate, the new Blood Oxygen feature and other health metrics.” Read more at https://bit.ly/2EgbZI4.

✦ Between 2018 and 2019, the number of uninsured Americans rose from 28.6 million (8.9% of the population) to 29.6 million (9.2%), according to new data from the U.S. Census Bureau. Notably, those findings do not capture insurance losses due to the current recession related to the COVID-19 pandemic. Among other findings, the report said Hispanic Americans experienced the largest year-over-year change in uninsured rates among racial/ethnic groups, with that rate growing from 17.9% in 2018 to 18.7% in 2019 — primarily driven by “a 1.4 percentage-point decrease in the percentage of Hispanics with public coverage.” To view the Census Bureau report, visit https://bit.ly/3mwj1ty.

In a Sept. 9 webinar hosted by the Brookings Institution and Robert Wood Johnson Foundation, leading health care economists debated the value of government intervention in prices — and got into an extended argument about what makes U.S. health care prices so high in the first place.

The event was held in honor of the late Princeton economist Uwe Reinhardt, who wrote the seminal 2003 health care economics paper “It’s the Prices, Stupid” and advocated for the U.S. to shift to an all-payer system along the lines of his native Germany, in which prices for health care services and products are subject to uniform schedules.

If there’s any upside to the COVID-19 pandemic, it’s that it has laid bare what both the country and health care organizations need to prioritize moving forward, suggested two keynote speakers during the America’s Health Insurance Plans (AHIP) National Conference on Medicare, Medicaid & Dual Eligibles, which was held online from Sept. 14-17.

“I really do hope that we don’t just look at this as a fire to be put out, but we look at it as a real opportunity to address some underlying kindling that was there,” VADM Jerome Adams, M.D., the U.S. Surgeon General, said during a Sept. 14 panel hosted by AHIP President and CEO Matt Eyles. A major part of that “kindling,” he said, are the stark disparities in social and economic conditions experienced by different racial and ethnic groups across the country.