August 5, 2021
Newsletter | Tea Leaves

Access & Coverage:

  • CMS officials communicated to Montana state officials that the agency will likely reject the state’s request to include work requirements in its Medicaid expansion program. The decision has made the future of Montana’s program uncertain; previously state lawmakers only approved extending the 2015 program because it included work requirements. State lawmakers will have two legislative sessions to consider changes before the program ends in 2025. (Article here)

D.C. News:

  • The Biden administration plans to require nearly all foreign visitors to be vaccinated against COVID-19 in order to enter the U.S. The requirement would come as part of the administration’s phased approach to easing travel restrictions for foreign citizens to the country. The timeline for the rule is unclear. (Articles here, here, and here)

Life Sciences:

  • Moderna Inc. said its COVID-19 vaccine remains 93 percent effective after six months. Additionally, its three candidates for booster shots produced “robust antibody responses” against delta and other COVID-19 variants in a mid-stage trial. The company plans to apply for full approval for its shot from the FDA this month. (Articles here, here, and here)
  • The HHS Office of Inspector General will scrutinize the FDA’s accelerated approval pathway for drugs that treat serious conditions and fill unmet medical needs, the route the agency took for its controversial approval of Biogen Inc.’s Alzheimer’s disease treatment two months ago. The watchdog said it will review the FDA’s interactions with “outside parties, as well as other aspects of the process, such as deciding on this pathway and scientific disputes.” (Article here)

Payers:

  • CMS announced that monthly premiums for health coverage through the ACA federal marketplace fell an average of 40 percent because of a boost in subsidies from government stimulus funds. More than 1.5 million people have enrolled in health plans through the HealthCare.gov marketplace since the administration opened a special window February 15. Another 2.5 million who already had coverage took advantage of expanded assistance created by the American Rescue Plan stimulus that President Joe Biden signed into law in March. (Press release here)

Providers:

  • Leader’s Edge published an article by David Smith, CEO and founder of Third Horizon Strategies, providing a preview of a pending analysis that examines COVID-19’s impact on the country’s hospitals. The analysis found that COVID-19 caused significant financial pressure on hospitals, wiping out $282 billion-$393 billion in assets from losses not fully mitigated by government subsidies or gradual returns to pre-pandemic utilization levels. The analysis also found that some structural factors – Volume-based payment incentives, disjointed government response, etc. – heightened stress. (Article here)
  • The Commonwealth Fund ranked the U.S. health system ranks last in a new study on quality and accessible care among 11 high-income countries. According to the study, half of lower-income adults in the U.S. reported being unable to afford needed health care, compared to only a quarter of higher-income adults, and 38 percent of adults said they skipped out on care in the past year due to costs. One of the study’s key takeaways is that receiving adequate health care in the U.S. depends on one’s income, despite the U.S. spending the most on care. (Study here)

Public Health/Prevention:

  • WHO Director General Tedros Adhanom Ghebreyesus called for a halt on administering booster COVID-19 shots through at least September, given poorer countries are still struggling to access doses for high-risk groups. He noted that more than 80 percent of shots globally have so far gone to wealthier countries that make up less than half of the world’s population. White House press secretary Jen Psaki said the WHO was presenting a “false choice.” “More needs to happen, but we believe we can do both,” she said. (Articles here, here, here, and here)