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The Voice of John Gorman
The Wall Street Journal reported last night (Cigna Nears Deal to Buy Express Scripts) that Cigna is in final talks to acquire Pharmacy Benefit Manager (PBM) Express Scripts (ESRX) for a whopping $67 billion. ESRX was the last truly independent major PBM, and the deal signals the end of an era…and ushers in a new one, further blurring the lines between insurers, providers, and their primary vendor. The combined entity will reach over 250 million people and will have a ripple effect on many of their competitors.
The February 2018 Medicare Advantage (MA) enrollment report is out and includes the tail end of Annual Election Period (AEP) activity.
The Penceification of the US Department of Health and Human Services (HHS) continued today as Alex Azar, former CEO of Eli Lilly America and Pence selection, was easily confirmed by the Senate to be the next Secretary. A twice-confirmed veteran of W. Bush’s HHS, Azar has earned bipartisan respect and takes the reins of a battered agency after the Tom Price debacle.
As 2018 and Year 2 of the chaotic Trump Administration kick off, trying to predict what will happen in Medicare, Medicaid, and the Affordable Care Act is as challenging as ever. It’s a midterm election year with terrible headwinds for the GOP, so the legislative calendar is abbreviated, and partisan rancor will peak. That makes it less likely Republicans will get to do much damage but also more likely they will try to serve up red meat for their base, like a return to “repeal and replace.” Congressional leaders, fresh off their billionaire bailout tax bill, are already talking about taking up “reform” (aka cuts) of Medicare and Medicaid and other social welfare programs. The only thing that is certain is 2018 will be another battleground year for government health programs.
The 2018 “landscape files” for Medicare Advantage (MA) and Medicare Part D from The Centers for Medicare & Medicaid Services (CMS) are out, and they show the two programs as stronger than ever, and providing great value to beneficiaries. A closer look at the numbers also reveals the strategies of market leaders to get in front of two seismic events in government health programs.
Supporters of the Affordable Care Act (ACA) won another huge battle against TrumpCare this week, but the war rages on. The threat will continue to loom until Trump is removed from office, Democrats retake the House or Senate, or the Senate provides him a win with a bipartisan market stabilization bill in the wake of the stinging defeat of Graham-Cassidy, his third failure to repeal the ACA.
I worked on single-payer healthcare legislation for US Rep. John Conyers (D-MI), my hometown Congressman from Detroit and an early leader on the issue with Rep. Jim McDermott (D-WA) in the 90’s. It’s not surprising the idea has gone nowhere in the 26 years since. While my heart is in it as a means of universal coverage, Bernie’s “Medicare for All” proposal as dropped this week is a conversation piece, and that’s it. It’s DOA as legislation.