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Category Archives: Health Care

Competition and the Cost of Medicare’s Prescription Drug Program

“The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (generally referred to as the Medicare Modernization Act, or MMA) substantially expanded the federal Medicare program by creating the prescription drug benefit known as Part D. In fiscal year 2013, Medicare Part D covered 39 million people. The federal government spent $59 billion net of premiums on Part D in that year; after accounting for certain payments from states under the program, the net federal cost was $50 billion, which represented 10 percent of net federal spending for Medicare. A combination of broader trends in the prescription drug market and lower-than-expected enrollment in Part D has contributed to much lower spending for the program—about 50 percent lower in 2013—than CBO projected when the MMA became law in 2003. Most beneficiaries of Part D choose among private drug plans to receive their coverage; others have employment-based coverage subsidized by Medicare Part D. The competitive design of Part D enables it to adapt flexibly to changing conditions, because plan sponsors (private insurance firms, each of which may offer several different plans) have ongoing incentives to develop new ways to control drug spending so as to minimize their costs, keep premiums low, and attract enrollees. Using the first few years of data from the Part D program, CBO found that spending was lower in years when, and in areas of the country where, more plan sponsors competed for beneficiaries. CBO’s analysis suggests that competition between plan sponsors in Part D could be strengthened further, and costs lowered further, through certain changes in the rules of the program, although such changes could have disadvantages as well.”

Survey Assesses How Uninsured Californians Fared After ACA Open Enrollment

“Last summer, just before the first open enrollment period under the Affordable Care Act (ACA), the Kaiser Family Foundation (KFF) conducted a baseline survey of California’s uninsured nonelderly adult population. After the open enrollment period came to a close, we conducted a second survey with the same group of individuals who participated in the baselineContinue Reading

New GAO Reports – Defense Contracting, Federal Grants, Healthcare.gov, Littoral Combat Ship

DEFENSE CONTRACTING: Factors DOD Considers When Choosing Best Value Processes Are Consistent with Guidance for Selected Acquisitions, GAO-14-584: Published: Jul 30, 2014. Publicly Released: Jul 30, 2014. FEDERAL GRANTS: Agencies Performed Internal Control Assessments Consistent with Guidance and Are Addressing Internal Control Deficiencies, GAO-14-539: Published: Jul 30, 2014. Publicly Released: Jul 30, 2014. HEALTHCARE.GOV: Contract Planning and Oversight Practices Were IneffectiveContinue Reading

New GAO Reports – Budget Issues, Combatting Nuclear Smuggling, Federal Real Property, 401(K) Plans, Medicaid Financing, Flood Insurance, USDA Farm Programs

BUDGET ISSUES: Opportunities to Reduce Federal Fiscal Exposures Through Greater Resilience to Climate Change and Extreme Weather, GAO-14-504T: Published: Jul 29, 2014. Publicly Released: Jul 29, 2014. COMBATING NUCLEAR SMUGGLING: Past Work and Preliminary Observations on Research and Development at the Domestic Nuclear Detection Office, GAO-14-783T: Published: Jul 29, 2014. Publicly Released: Jul 29, 2014. FEDERAL REAL PROPERTY: Better Guidance andContinue Reading

Free Exercise of Religion by Closely Held Corporations – CRS

Free Exercise of Religion by Closely Held Corporations: Implications of Burwell v. Hobby Lobby Stores, Inc. Cynthia Brougher, Legislative Attorney. July 23, 2014 “One of the ongoing controversies related to the Affordable Care Act (ACA) has been the scope of exemption from certain health care coverage requirements, including the contraceptive coverage requirement. Though closely divided, the U.S. Supreme Court’sContinue Reading

Tree and forest effects on air quality and human health in the United States

Tree and forest effects on air quality and human health in the United States. David J. Nowak, Satoshi Hirabayashi, Allison Bodine, Eric Greenfield. Environmental Pollution, October 2014. “Trees remove air pollution by the interception of particulate matter on plant surfaces and the absorption of gaseous pollutants through the leaf stomata. However, the magnitude and value of the effects of trees andContinue Reading

Cancer Vaccine Exists, Goes Unused

The Atlantic: “Every 20 minutes a person in the U.S. is diagnosed with with a human-papilloma virus-associated cancer. Most of those cancers could be prevented with an HPV vaccine. But fewer than half of American children are given the vaccination, CDC officials announced yesterday.  If as many people got vaccinated against HPV as do against whoopingContinue Reading

Census Bureau Updates Interactive HIV/AIDS Database

“The U.S. Census Bureau today released its annually updated interactive global resource on the prevalence of HIV infection and AIDS cases and deaths. First developed in 1987, the database now holds more than 164,000 statistics, an increase of approximately 5,900 new estimates in the last year, and is the most comprehensive resource of its kind in theContinue Reading

New GAO Reports – Aviation Safety, Fair Labor Standards, Indian Gaming, NTIS, Patient Protection, Small Business, Space Launch System

AVIATION SAFETY: FAA’s Efforts to Implement Recommendations to Improve Certification and Regulatory Consistency Face Some Challenges, GAO-14-728T: Published: Jul 23, 2014. Publicly Released: Jul 23, 2014. FAIR LABOR STANDARDS ACT: Department of Labor Needs a More Systematic Approach to Developing Its Guidance, GAO-14-629T: Published: Jul 23, 2014. Publicly Released: Jul 23, 2014. INDIAN GAMING: Preliminary Observations on the Regulation and Oversight ofContinue Reading

Washington Post/Kaiser Family Foundation Survey of Iraq and Afghanistan Active Duty Soldiers and Veterans

“This Visualizing Health Policy provides highlights from a survey that asked Iraq and Afghanistan active duty soldiers and veterans about whether their physical and emotional health is worse compared with before the wars, whether they personally know someone who has attempted or died by suicide, whether they experienced difficulty in transitioning back to civilian life,Continue Reading

Social Relationships and Mortality Risk: A Meta-analytic Review

Holt-Lunstad J, Smith TB, Layton JB (2010) Social Relationships and Mortality Risk: A Meta-analytic Review. PLoS Med 7(7): e1000316. doi:10.1371/journal.pmed.1000316 “Humans are naturally social. Yet, the modern way of life in industrialized countries is greatly reducing the quantity and quality of social relationships. Many people in these countries no longer live in extended families orContinue Reading

New GAO Reports – Coastal Zone Management, High Containment Labs, Medicaid, Special Education, U.S. Launch Enterprise

COASTAL ZONE MANAGEMENT: Opportunities Exist for NOAA to Enhance Its Use of Performance Information, GAO-14-592: Published: Jul 16, 2014. Publicly Released: Jul 16, 2014. HIGH-CONTAINMENT LABORATORIES: Recent Incidents of Biosafety Lapses, GAO-14-785T: Published: Jul 16, 2014. Publicly Released: Jul 16, 2014. MEDICAID: Assessment of Variation among States in Per-Enrollee Spending, GAO-14-456: Published: Jun 16, 2014. Publicly Released: Jul 16, 2014. SPECIAL EDUCATION: Additional FederalContinue Reading