President Donald Trump vowed Monday that his new health-care chief Alex Azar — a former top drug-company executive who raised prescription prices — is “going to get those prescription drug prices way down” as Azar was sworn in for his job.

“It’s doing to come rocketing down,” Trump said as Azar, 50, stood at his side in the White House before taking his oath as secretary of the U.S. Health and Human Services Department from Vice President Mike Pence.

“We have to get the prices of prescription drugs way down, and unravel the tangled web of special interests that are driving prices up for medicine, and are really hurting patients,” Trump said.

“And nobody knows that process better than Alex.”

A House committee voted Tuesday to impose work requirements on Medicaid recipients, something Republicans are seeking as a precondition to expanding the health-care program to more low-income, uninsured Virginians. It was not clear how many of the state’s 1 million Medicaid recipients would be affected if the bill becomes law because the majority are children, the elderly, pregnant women and people with disabilities, all of whom would be exempt under the plan because they are considered to face some barrier to work.

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  • HHS on Friday released a report touting its 2017 accomplishments, including regulatory rollbacks and cost savings.
  • The 37-page report highlighted some actions that are priorities for the Trump administration, but which have sharply divided the healthcare industry. It said 70 regulatory actions were withdrawn last year and more than $3 billion was recovered through efforts to stop waste, fraud and abuse.
  • It also pointed to a final rule that cuts hospital payments from the 340B Drug Pricing Program, saying it will save $3.2 billion. Hospitals fiercely oppose the cut and are challenging the rule in court.

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Using 2017 dataOut of 9,201,805 healthcare.gov enrollees, here’s how many would win and lose if the insurer subsidies were now funded:

  • Winners: 682,712 unsubsidized exchange enrollees enrolled in middle-of the-road “silver” plans
  • Losers: 1,621,325 enrollees who receive premium subsidies and don’t have silver plans
  • Likely losers: 1,706,780 enrollees with silver plans and incomes between 200%-400% of the federal poverty level.

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American workers have not seen their wages grow in tandem with the success of their employers.

Meanwhile, health spending has been growing faster than the broader economy. Health benefits consequently are getting more expensive for employers to offer, and companies are responding by making employees shoulder more of their own health care costs — either through higher premiums or higher out-of-pocket costs, like deductibles and copays.

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Across plans and states, the expansion population experienced high disenrollment rates, indicating that, as in other Medicaid eligibility groups, there is substantial churn in this population.

• Even after adjusting for age and gender, claims costs increased steadily over time, suggesting that expansion enrollees have complex and/or chronic conditions.
— For some enrollment cohorts, average claims costs decreased modestly in the second half of the first year of enrollment, suggesting some initial pent-up demand for services, though claims costs increased steadily from that point forward.
• Across enrollment groups, per member per month spending on prescription drugs increased with enrollment duration.
— Among enrollees who remained enrolled the longest, inpatient claims initially made up the largest share of claims costs, but were surpassed by prescription drug claims by month 8 of enrollment, on average.

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Health care dominated the news cycle in 2017. Yet, for all the legislative wrangling and rhetoric, little changed this past year.

It is my job to listen to health-care consumers. They entered 2017 worried about the cost of coverage. They find themselves at the start of this year in the same place they ended the last. People want to know: What happened to the “affordable” part of the Affordable Care Act?

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Public health-care entitlements in the U.S. have traditionally been designed to supplement rather than to supplant privately purchased health insurance. About 40% of the entitlement funds disbursed under the Affordable Care Act (ACA), however, have gone to individuals who already had private coverage. This displacement of private-sector spending by public-sector activity is called “crowd-out.” While the ACA has reduced the share of the American population without health insurance, its spending has been poorly-targeted to fill gaps in care, and 28 million remain uninsured.

This paper reviews estimates of ACA crowd-out and examines the potential for block grants to allow states to target assistance at individuals otherwise lacking coverage. Under such a reform, the same level of federal funding could do more to expand access to care and to provide protection from catastrophic medical costs for those who need help the most.

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Americans are familiar with the horrors of the opioid crisis, and government at every level has tried to respond with spending on treatment programs and more. But one area that deserves more scrutiny is how government programs may be contributing to the epidemic.

Wisconsin Senator Ron Johnson released a report this month from the Senate Homeland Security and Governmental Affairs Committee that connects the dots between Medicaid and the opioid epidemic. The report doesn’t claim too much, conceding that everything from too many prescriptions to drug marketing contributed to the epidemic.

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Republican leadership emerged from their Camp David policy retreat earlier this month announcing that significant healthcare reform is not on their 2018 agenda. That’s bad news for the one-quarter of Americans who put off or postpone getting the healthcare they need each year because of its costs, which have doubled since 2013.

To meaningfully address these skyrocketing healthcare costs, bold reforms are needed. Rather than simplistic assertions that blame doctors, legislators must tackle healthcare’s stultifying bureaucracy consisting of federal and state government agencies, big insurance companies, and, yes, the American Medical Association.

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