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January 2019
Schlein
Washington Watch

New Congress: Ambitious Health Care Agenda – But Can They Accomplish Anything?

Serious medical conditions like cancer, diabetes, heart disease, HIV/AIDS and asthma are often the kinds of illnesses that some health insurance companies try to avoid covering. More than 25 percent of Americans under age 65 – about 52 million people – have a pre-existing condition that would have prevented them from buying individual health insurance before the ACA became law in 2010. More than 75 percent of Americans, polls show, favor keeping these protections in place.

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Finding a workable solution to skyrocketing drug prices is where the issue really gets sticky. On this issue and the discussion of Medicare for All – the real purpose of most drug pricing legislation in the new Congress will be to set an agenda for the 2020 presidential elections, more than to actually fix the problem.

June 2018
Schlein
Washington Watch

Attempting to Lower Drug Prices – What’s Proposed, What’s Realistic?

Direct-to-consumer pharmaceutical advertising boosts drug costs both by directly increasing expenses to drugmakers that they then incorporate into the price of the drug and by increasing consumer demand for medication they may not need.

May 2018
Schlein
Washington Watch

Federal Budget Woes and Wins for Seniors

In the course of getting the budget approved, Trump upset liberals, conservatives, Democrats and Republicans and even members of his populist base.

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Congress rebuffed drug companies' appeals to reduce how much they have to pay for some seniors' prescription costs – a rare defeat for the industry after an intense lobbying campaign.

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Under the budget law, benefits targeting those with chronic diseases do not have to be primarily health related, and only have to provide a "reasonable expectation" of improving health.

April 2018
Schlein
Washington Watch

Electronic Health Records – Stuck in the 1990s?

Lack of patient health data access often leads to duplicate testing and unnecessary treatments, increasing costs for consumers, doctors, hospitals and health systems. Medicare continues to push forward on its efforts, but those efforts have so far, gone nowhere.

March 2018
Schlein
Washington Watch

Rewriting the Rules – Will Seniors Bear the Brunt of Deregulation and Rules Changes?

Under CMS's plan, the states could set minimum requirements, allowing insurers to scale back prescription drug coverage, for example, as long as it ramped up coverage in another category.
That allows them to make plans less appealing to someone they don't want to cover, such as someone with long-term conditions like diabetes or arthritis – in other words, older folks.

February 2018
Schlein
Washington Watch

Successful Tax Cut Bill Consequences Now Pointing Toward Cuts in Social Security, Medicare and Medicaid? Debates Will Definitely Ensue

Realistically, you can't reduce the costs of Medicare or Medicaid in big way unless you cut the costs of services or eliminate services altogether. So it's important to cut through the phony language when politicians lump Social Security and Medicare and Medicaid together in a fix-them-all-together solution. The policy solutions are different.

November 2017
Ambord
Dollar Sense

A Raise in Social Security for 2018 – Time to Rejoice or Regret?

Since 2000, SS beneficiaries have lost roughly 30% of buying power...Rising prices affect seniors differently than the general population, as housing, medical costs and prescription drugs represent such a large part of their spending. And the miniscule COLA received for 2017 of .03% only exacerbated the problem.

Ambord
Dollar Sense

It’s That Time Again – Medicare Open Enrollment: What’s New for 2018?

By 2020, the donut hole is scheduled to close entirely and go away… though this could change. Assuming the donut hole does close, enrollees will pay 25% of the cost of drugs, up to the catastrophic coverage limit.

Schlein
Washington Watch

Nursing Home Storms Come in Many Forms

In arbitration, the parties hire a private judge and use a different set of rules that can be more restrictive than civil court. A 2009 study found that awards to plaintiffs can be as much as 35 percent lower, using arbitration.

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“Investigators should observe nursing home staff demonstrating their actual emergency plans rather than just checking that these plans would have been written down.  If you have not implemented and exercised plans, they are paper tigers…"

October 2017
Schlein
Washington Watch

Nursing Home Abuse Vastly Under-reported; Emergency Rooms Coming to More Than Medical Rescue

The IG's report blamed Medicare for failing to enforce federal law which requires that nursing homes immediately notify the police in abuse cases.

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A 2011 New York state study found that as few as 1 in 24 cases of abuse against residents age 60 and older were reported to authorities...Because a visit to the emergency room may be the only time an older adult leaves the house, the staff of the ER can be the first line of defense.

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