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The U.S. Senate released its proposed healthcare bill as an alternative to the Affordable Care Act, and it differs from the House version. The Kaiser Family Foundation has nicely summarized the differences between the Affordable Care Act and the two proposed replacements. Of note, the Senate's version of the bill removed the unpopular individual mandate, a tax designed to keep healthy people buying insurance. Vox reported that the Senate plans on announcing a six-month waiting period for individuals who wish to be insured, but have not had continuous insurance coverage.

The U.S. Senate released its proposed healthcare bill as an alternative to the Affordable Care Act, and it differs from the House version. The Kaiser Family Foundation has nicely summarized the differences between the Affordable Care Act and the two proposed replacements. Of note, the Senate's version of the bill removed the unpopular individual mandate, a tax designed to keep healthy people buying insurance. Vox reported that the Senate plans on announcing a six-month waiting period for individuals who wish to be insured, but have not had continuous insurance coverage.

Neither of the proposed replacements remove the requirement that insurers cover pre-existing conditions. Without a mechanism like the individual mandate or the waiting period, many individuals may wait until they are in need of insurance before paying for coverage.

As 2018 looms closer, people are watching for insurance companies' filings to get a sense of what will happen to next year's premiums. Some insurers have already announced that their premiums would be higher in anticipation of the White House not continuing certain subsidies. The Wall Street Journal reports large premium hikes, even without the uncertainty around those cost-sharing subsidies. Highmark Health, for example, is reported to have expected a premium increase of around 20% in Delaware without considering the loss of the cost-sharing subsidies.

As 2018 looms closer, people are watching for insurance companies' filings to get a sense of what will happen to next year's premiums. Some insurers have already announced that their premiums would be higher in anticipation of the White House not continuing certain subsidies. The Wall Street Journal reports large premium hikes, even without the uncertainty around those cost-sharing subsidies. Highmark Health, for example, is reported to have expected a premium increase of around 20% in Delaware without considering the loss of the cost-sharing subsidies.

These premium hikes -- with or without the subsidies -- are increasing faster than inflation.

We plan on installing some operating system updates this Friday, June 9th. This site is expected to be unavailable as early as 10 AM PST and as late as 6 AM, Saturday, June 10th.

We plan on installing some operating system updates this Friday, June 9th. This site is expected to be unavailable as early as 10 AM PST and as late as 6 AM, Saturday, June 10th.

Noted in several publications, the California Senate voted for the state government to become the single payer for healthcare in the state. The bill will go to the California Assembly for additional discussion. According to The Mercury News, even one of the bill's sponsors dubbed the bill "a work in progress." Significantly, the bill omits key details, including a way for paying for the system.

Noted in several publications, the California Senate voted for the state government to become the single payer for healthcare in the state. The bill will go to the California Assembly for additional discussion. According to The Mercury News, even one of the bill's sponsors dubbed the bill "a work in progress." Significantly, the bill omits key details, including a way for paying for the system. The California Nurses Association apparently commissioned a study that finds that the healthcare costs can be paid for with a payroll tax and a gross receipts tax.

It will be interesting to see how the details of the legislation gets filled in over time. Kaiser Health News previously reported that the system would largely rely on fee-for-service, a reimbursement system that rewards healthcare providers for volume and is widely blamed for at least part of the rapid growth in healthcare costs. The rest of the country has been moving away from fee-for-service.

Regardless of whether the legislation gains traction, that the bill has passed the California Senate (especially missing the key details that it did) signifies the general discontent with the current healthcare system. Other states that have seriously considered single-payer health include Vermont and Colorado.

Previously, FDA has generally taken the stance that its role has been to ensure safety and efficacy of medications. Sometimes, the FDA would address issues of availability (e.g. in the case of rare diseases), but it has eschewed drug pricing. The Wall Street Journal reports that the new FDA commissioner is changing tack by proposing policies that will encourage competition. Among the proposals is to accelerate the review of generics. It also sounds like the plan is to make it easier for a manufacturer to prove equivalence, including generic equivalents of Mylan's EpiPen.

Previously, FDA has generally taken the stance that its role has been to ensure safety and efficacy of medications. Sometimes, the FDA would address issues of availability (e.g. in the case of rare diseases), but it has eschewed drug pricing. The Wall Street Journal reports that the new FDA commissioner is changing tack by proposing policies that will encourage competition. Among the proposals is to accelerate the review of generics. It also sounds like the plan is to make it easier for a manufacturer to prove equivalence, including generic equivalents of Mylan's EpiPen.

These proposals sound promising, but as most other cases, the details matter a lot. It'll be interesting to see if, over time, people are still shocked at high prices of medications that have generic equivalents.