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The House Oversight Committee is probing some of the largest health insurers and pharmacy benefit managers amid reports that they are not providing free birth control to beneficiaries.
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Programming note: Health Care will not publish Monday, May 30, in observance of Memorial Day. Enjoy the holiday weekend!
Panel presses insurers on free birth control
The House Oversight and Reform Committee is pressing major health insurers and pharmacy benefit managers on their coverage of contraceptives, saying they may not be fully complying with requirements to cover them at no cost to the patient.
Chair Carolyn Maloney (D-N.Y.) sent letters to nine companies requesting information on their birth control coverage, which they are required to cover fully under Affordable Care Act (ACA) rules.
“I am deeply troubled by reports that health plans and issuers may not be fully complying with the ACA’s requirement to cover contraceptives at no cost, potentially depriving patients of access to critically important reproductive health care,” Maloney said in a statement.
She wrote that insurers are sometimes not covering contraceptives that were recently approved by the Food and Drug Administration or were sometimes requiring payment for the surrounding services, such as an office visit.
“Public reporting and information obtained by the Committee indicates that some plans and issuers, including their pharmacy benefit managers (PBM), have not been in compliance with these requirements,” Maloney wrote.
An increased spotlight has also fallen on contraceptive access recently given the expected ruling from the Supreme Court overturning the right to an abortion in Roe v. Wade. That ruling is set to be issued sometime next month.
Medicare premium increase to be lowered next year
Medicare beneficiaries won’t see lower premiums this year, even though the cost of including a new Alzheimer’s medication into the program had been overestimated.
Health and Human Services Secretary Xavier Becerra on Friday said Medicare premiums would be adjusted for 2023, not for 2022, “to account for an overestimate in costs attributable to the inclusion of new Alzheimer’s drug Aduhelm within the Medicare program for reimbursement.”
HHS cited “legal and operational hurdles” as the reason premiums will not be adjusted this year. Becerra acknowledged that HHS had hoped to achieve this lowered premium sooner, but said it was not “feasible.”
FDA approved Aduhelm, created by Biogen, in June, making it the first Alzheimer’s medication approved in almost 20 years.
The drug has since faced scrutiny over its actual efficacy in treating Alzheimer’s disease as well as its sky-high cost. When the drug was approved, it initially cost $56,000 a year. However, Biogen announced in December that it was halving the cost down to $28,200 a year, or about $2,170 per monthly infusion for patients.
In January, Becerra ordered Medicare to “reassess” the proposed premium increase following Biogen’s announcement.
DEMS WANT TO BAN DATA MINING PEOPLE SEEKING ABORTIONS
A group of Senate Democrats asked Apple and Google to prohibit apps available in their app stores from using data mining practices to target people seeking abortion services in letters sent to the tech giants Friday.
The senators, led by Sen. Ed Markey (Mass.), asked the companies to review and update their app store policies and practices as necessary to address concerns around allowing apps to engage in “data practices that may victimize individuals who seek or have sought abortion services.”
The senators underscored the need for the updates following the leak of a draft majority opinion indicating the Supreme Court is poised to overturn Roe v. Wade, which could make abortion illegal in states across the country with restrictive laws.
The senators said information about app users’ fertility, browser histories indicating interest in contraception or location information showing a user visited a gynecologist could become a “data trove for actors who are intent on targeting, intimidating, and harming individuals who seek abortions or individuals who simply take steps to promote their reproductive health.”
AMERICANS GROWING CONCERNED OVER FORMULA SHORTAGE: POLL
The overwhelming majority of Americans appear to be worried about the ongoing baby formula shortage as top Food and Drug Administration (FDA) officials warn supplies will not return to normal until July.
A new poll from the progressive think tank Data for Progress found 84 percent of voters said they are either “very” or “somewhat” concerned about the lack of formula across the U.S. That includes 86 percent of Democrats, 84 percent of Republicans and 83 percent of independents.
Eighty-two percent said they favor importing baby formula from abroad, an operation President Biden kicked off this week in a scramble to get product on the shelves. The same share supports expanding the number of baby formula products made available to families participating in the government’s nutrition program for women, infants and children.
Currently, four companies make up 90 percent of the formula market.
Among the 6 percent of respondents who are parents of infants, more than half said they have struggled to find formula since the widespread shortage started in February.
What we know about monkeypox cases in the US
Nine likely cases of monkeypox have been identified in the U.S. so far as the virus continues to spread throughout Western countries, outside of the central and western African regions where it typically occurs.
Health authorities have been quick to advise against panic, with the Centers for Disease Control and Prevention (CDC) still considering monkeypox to pose a low risk to the general community.
Health experts have stressed that monkeypox is not another COVID-19.
“If people have COVID in their minds, they should cast that out. Because this is not COVID. It doesn’t transmit with the same facility,” Stanley Deresinski, a clinical professor of infectious diseases at Stanford University, told The Hill.
As Deresinski noted, monkeypox requires prolonged skin-to-skin contact for it to spread from person to person, unlike SARS-CoV-2, which spreads through respiratory droplets. The main method through which monkeypox spreads is through the characteristic lesions that develop on the skin.
One clear difference between the monkeypox outbreak and the coronavirus pandemic is that treatments and vaccines for monkeypox were immediately available through the U.S. national stockpile and have already been mobilized to states where cases have been detected.
WHAT WE'RE READING
- Key Senate committee proposes a council to ensure FDA better coordinates on accelerated approvals (Stat)
- Argentina confirms Latin America's first case of monkeypox (Reuters)
- On remote US territories, abortion hurdles mount without Roe (Associated Press)
STATE BY STATE
- Planned Parenthood plans to offer gender-affirming hormone therapy across Michigan (MLive.com)
- John Fetterman got a defibrillator after his stroke. But doctors say the campaign’s story ‘doesn’t make sense.’ (The Philadelphia Inquirer)
- Politics and pandemic fatigue doom California’s COVID vaccine mandates (Kaiser Health News)
THE HILL OP-ED
The formula crisis puts Black infants at risk for severe undernutrition
That's it for today, thanks for reading. Check out The Hill's Health Care page for the latest news and coverage. See you next week.
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