Before we get to the news, a brief personal note: I’ll be at the AcademyHealth Annual Research Meeting Sunday through Tuesday. If you see me there, do say hello—I promise “hi, I think I know you from the internet” is only weird the first two or three times (and yes, I speak from experience).
- How much trouble are the exchanges in? The Government Accountability Office released two reports on the status of state insurance exchanges—the online marketplaces in each state where people should be able to buy insurance plans starting October 1. I won’t direct you to the actual reports (they’re not for the faint of heart), though Tim Jost calls them “the best windows we have had so far into the frustratingly opaque process of CMS exchange implementation.” Jost finds that there are reasons to be concerned, especially on the consumer assistance front, and reminds us that glitches and disruptions are inherent to any major new program in either the public or private sector. HHS has been met with more resistance than expected (including the usurpation of valuable time for oversight testimonies). CMS maintains that the states will all have operational exchanges up in time.
- Diagnosis: obesity? The American Medical Association has officially recognized obesity as a disease, which is a huge development in the “medicalization” debate. What does the AMA’s decision mean? Well technically, not much—the association doesn’t possess the authority to “designate” diseases in any real capacity; nothing official magically appears upon press release. But culturally this could be a big deal, by encouraging insurers, clinicians, researchers, and patients to pursue public health efforts and other interventions more aggressively.
- Generically speaking. Folks have been tuning in to Supreme Court decisions, as some big ones are anticipated around gay marriage, affirmative action, and the Voting Rights Act. All of those are expected next week, but “pay-to-delay”, a lower-profile case with big implications for health care, was decided on Tuesday. In a triumph for consumers, SCOTUS ruled that the FTC can sue pharmaceutical companies when they pay off generic drug-makers to keep generics off the market. This is a practice that has been going on unchecked for years, and a recent FTC study suggests that it could cost consumers $3.5 billion annually in unnecessary drug costs.
- Kindly allow me to indulge in a home-state rant. On Thursday afternoon, Michigan’s Senate decided not to decide on Medicaid. Yep, you read that right; it’s not that they rejected expansion, they simply refused to take the bill up for vote before adjourning—even though Gov. Rick Snyder cut short a trip to Israel to attend to the matter and it’s believed that the chamber would’ve had the votes to pass the bill, had it been brought. Instead, the bill will move to committee and a workgroup, to be reconsidered after summer recess. Whatever your personal views of the expansion, it seems inevitable in Michigan: Snyder, a Republican, endorsed it months ago and the GOP-held House passed the bill with an overwhelming majority last week. Here’s the catch: the proposed bill requires a waiver from HHS, and waiver approvals take time. I worry that Senate conservatives shot themselves in the foot by refusing to take up the vote—if they put off the legislation, it will be much harder to get their desired version of the program approved by the feds in time for 2014, which could mean forfeiting a year of full federal expansion funding. Way to go, guys.
- The theme song Gotham deserves, but not the one it needs right now. A bunch of people who really, really like bats recorded their ultrasounds—normally not detectable to the human ear—reduced the frequencies to make them audible, and then used the sounds to reproduce the Batman theme song. Because why not?