Latest news with #Obamacare
Time of India
4 hours ago
- Health
- Time of India
Kennedy could soon reconstruct US preventive care panel
Washington: U.S. Health Secretary Robert F. Kennedy Jr. could imminently overhaul a key federal advisory panel that recommends which preventive services insurers must pay for, health and medical news website STAT News reported on Tuesday, citing a person familiar with the plans. Federal health officials are vetting new members for the U.S. Preventive Services Task Force , the report said. It also cited David Mansdoerfer, who advises a group allied with Kennedy, as saying he knew people being considered for the panel but that he declined to name them. Mansdoerfer, who served during President Donald Trump's first administration as deputy assistant secretary at the Department of Health and Human Services, later told Reuters that he knew "a couple" of those being considered. He added that he was not actively involved in the process, which he said could take from a few weeks to two or three months. The Office of the White House Liaison at HHS is in charge of the vetting, said Mansdoerfer, now the chief strategy adviser to the Independent Medical Alliance, a group of physicians allied with Kennedy. This was also the case with candidates for advisory committees during his time at the department, he said. Asked if the people he knew of who were under consideration were physicians, Mansdoerfer said they were all clinical health professionals. He had earlier told STAT that the existing panel was "MD heavy" and that the reorganized one was likely to include other kinds of healthcare providers. The Wall Street Journal reported on Friday that Kennedy planned to remove all of the panel's 16 members. An HHS spokesperson said Kennedy had not yet made a decision. The U.S. Preventive Services Task Force includes medical experts serving staggered four-year terms on a volunteer basis. Its role in choosing what services will be covered by insurers was established under the 2010 Affordable Care Act, also known as Obamacare. The 40-year-old group, whose recommendations provide guidance to doctors, looks at everything from routine screenings for breast cancer to drugs to prevent HIV infection.
Forbes
4 hours ago
- Health
- Forbes
Medicaid At 60: A Safety Net In Need Of Serious Repair
"The One Big Beautiful Bill Act, signed into law earlier this month, will address some of Medicaid's ... More biggest flaws," writes health policy expert Sally Pipes. "But it's left many others in place." Today, Medicaid turns 60. But this will be no diamond jubilee. What began in 1965 as a modest safety-net program has ballooned into the largest health entitlement in the country, covering nearly 80 million Americans, costing close to $900 billion a year, and delivering poor value for both patients and taxpayers. The One Big Beautiful Bill Act, signed into law earlier this month, will address some of Medicaid's biggest flaws. But it's left many others in place. President Lyndon B. Johnson created Medicaid to provide health coverage for truly needy populations: the disabled, blind, low-income elderly, and destitute children. In the 1980s, Congress added coverage for low-income pregnant women and children. The federal government covers between 50% and 77% of the cost for this 'legacy' population. In 2010, Obamacare expanded Medicaid eligibility further, to millions of able-bodied, working-age adults with incomes up to 138% of the federal poverty level. Tens of millions have enrolled under this provision. The federal government provides nine dollars in matching funds for every one dollar a state spends on this expansion population. The result? Medicaid's price tag has soared. In 2023, the program cost taxpayers $870 billion—up 8% from the year before. At this pace, it will surpass $1 trillion annually before the end of this decade. The millions of people enrolled in Medicaid do not receive quality care. One in three physicians refuses to accept new Medicaid patients, in part because the program pays them less than Medicare—and much less than commercial insurance. One review found that Medicaid enrollees were three times less likely to secure a specialist appointment compared to those with private insurance. These access problems fall hardest on the most vulnerable Medicaid beneficiaries. A 2018 report from the Foundation for Government Accountability found that more than 650,000 disabled Americans were languishing on waiting lists for home and community-based services. Nearly half were in states that expanded Medicaid to able-bodied adults. The program's design actively fuels that inequity. States receive more money from the federal government for expansion enrollees than 'legacy' enrollees. That discrepancy offers states a perverse incentive to prioritize enrolling healthy adults over those most in need. Medicaid's funding formula also encourages states to expand their programs. After all, every dollar they spend attracts at least one more dollar from the federal government—and sometimes as many as nine. And then there are the staggering levels of waste and abuse endemic to Medicaid. The government itself projects that Medicaid's improper payment rate in 2023 was nearly 5.1%—which equates to more than $31 billion in misspent funds. Independent estimates suggest the scope of the problem is much larger. According to the Paragon Health Institute, the program's improper payments reached $1.1 trillion over the last decade—roughly double the government's estimate. There's plenty the federal government can do to restore some sanity to Medicaid. The One Big Beautiful Bill Act represents a start. It put curbs on 'provider taxes,' whereby states extract revenue from hospitals and other providers, send the money back to them in the form of higher reimbursements, and claim matching federal funds in the process. The new law also directs states to perform more frequent eligibility checks. These routine redeterminations would ensure Medicaid benefits go only to those who still qualify—preserving access for the truly needy while reducing waste. Further, OBBBA will require able-bodied adults to work or otherwise contribute to their communities as a condition of receiving Medicaid benefits. This change alone could deliver more than $300 billion in savings over 10 years—and help people transition from dependency to private coverage and greater opportunities. Even with these significant changes, Medicaid spending is still projected to increase by 3% a year through 2034. That's not fiscally sustainable. Consequently, Congress will have to take another run at Medicaid reform soon. Lawmakers should revisit the inequity in Medicaid's funding formula that prioritizes enrolling the able-bodied over the truly needy. Not only is that perverse—it's expensive. Equalizing the federal match rate for all enrollees would save billions. Six decades in, it's time to stop treating Medicaid as untouchable. Through genuine reform, we can preserve the program for those actually in need—and ensure taxpayers are no longer forced to bankroll a failing system.
Yahoo
17 hours ago
- Health
- Yahoo
Kennedy could soon reconstruct US preventive care panel, STAT News reports
WASHINGTON (Reuters) -U.S. Health Secretary Robert F. Kennedy Jr. could imminently overhaul a key federal advisory panel that recommends which preventive services insurers must pay for, health and medical news website STAT News reported on Tuesday, citing a person familiar with the plans. Federal health officials are vetting new members for the U.S. Preventive Services Task Force, the report said. It also cited David Mansdoerfer, who advises a group allied with Kennedy, as saying he knew people being considered for the panel but that he declined to name them. Mansdoerfer, who served during President Donald Trump's first administration as deputy assistant secretary at the Department of Health and Human Services, later told Reuters that he knew "a couple" of those being considered. He added that he was not actively involved in the process, which he said could take from a few weeks to two or three months. The Office of the White House Liaison at HHS is in charge of the vetting, said Mansdoerfer, now the chief strategy adviser to the Independent Medical Alliance, a group of physicians allied with Kennedy. This was also the case with candidates for advisory committees during his time at the department, he said. Asked if the people he knew of who were under consideration were physicians, Mansdoerfer said they were all clinical health professionals. He had earlier told STAT that the existing panel was "MD heavy" and that the reorganized one was likely to include other kinds of healthcare providers. The Wall Street Journal reported on Friday that Kennedy planned to remove all of the panel's 16 members. An HHS spokesperson said Kennedy had not yet made a decision. The U.S. Preventive Services Task Force includes medical experts serving staggered four-year terms on a volunteer basis. Its role in choosing what services will be covered by insurers was established under the 2010 Affordable Care Act, also known as Obamacare. The 40-year-old group, whose recommendations provide guidance to doctors, looks at everything from routine screenings for breast cancer to drugs to prevent HIV infection. Solve the daily Crossword
Reuters
17 hours ago
- Health
- Reuters
Kennedy could soon reconstruct US preventive care panel, STAT News reports
WASHINGTON, July 29 (Reuters) - U.S. Health Secretary Robert F. Kennedy Jr. could imminently overhaul a key federal advisory panel that recommends which preventive services insurers must pay for, health and medical news website STAT News reported on Tuesday, citing a person familiar with the plans. Federal health officials are vetting new members for the U.S. Preventive Services Task Force, the report said. It also cited David Mansdoerfer, who advises a group allied with Kennedy, as saying he knew people being considered for the panel but that he declined to name them. Mansdoerfer, who served during President Donald Trump's first administration as deputy assistant secretary at the Department of Health and Human Services, later told Reuters that he knew "a couple" of those being considered. He added that he was not actively involved in the process, which he said could take from a few weeks to two or three months. The Office of the White House Liaison at HHS is in charge of the vetting, said Mansdoerfer, now the chief strategy adviser to the Independent Medical Alliance, a group of physicians allied with Kennedy. This was also the case with candidates for advisory committees during his time at the department, he said. Asked if the people he knew of who were under consideration were physicians, Mansdoerfer said they were all clinical health professionals. He had earlier told STAT that the existing panel was "MD heavy" and that the reorganized one was likely to include other kinds of healthcare providers. The Wall Street Journal reported on Friday that Kennedy planned to remove all of the panel's 16 members. An HHS spokesperson said Kennedy had not yet made a decision. The U.S. Preventive Services Task Force includes medical experts serving staggered four-year terms on a volunteer basis. Its role in choosing what services will be covered by insurers was established under the 2010 Affordable Care Act, also known as Obamacare. The 40-year-old group, whose recommendations provide guidance to doctors, looks at everything from routine screenings for breast cancer to drugs to prevent HIV infection.
Forbes
a day ago
- Business
- Forbes
UnitedHealth Reports $3.4 Billion Profit And Sees 2026 Earnings Growth
UnitedHealth Group profits fell to $3.4 billion in the second quarter as the giant provider of ... More health benefits and services grapples with rising costs of providing health insurance to millions of Americans, the company said July 29, 2025. In this photo, UnitedHealth Group Inc. signage stands in front of company headquarters in Minnetonka, Minnesota, U.S., on Wednesday, March 9, 2016. Photographer: Mike Bradley/Bloomberg © 2016 Bloomberg Finance LP UnitedHealth Group profits fell to $3.4 billion in the second quarter as the giant provider of health benefits and services grapples with rising costs of providing health insurance to millions of Americans. But the company, which brought back Stephen Hemsley to be chief executive officer earlier this year, says the 'company expects to return to earnings growth in 2026.' In May, UnitedHealth Group suspended its financial outlook for the rest of the year and replaced its top executive, Andrew Witty, as the parent of UnitedHealthcare grapples with rising healthcare costs in its Medicare Advantage business. Medicare Advantage plans contract with the federal government to provide health benefits to seniors. On Tuesday, UnitedHealth Group updated its 2025 outlook, which includes revenues of $445.5 billion to $448.0 billion, net earnings of at least $14.65 per share and adjusted earnings of at least $16 per share. The new outlook, which fell below what some analysts were forecasting, 'reflects first half 2025 performance and expectations for the remainder of the year, including higher realized and anticipated care trends,' the company said. 'UnitedHealth Group has embarked on a rigorous path back to being a high-performing company fully serving the health needs of individuals and society broadly,' Hemsley said in a statement accompanying the earnings report. 'As we strengthen operating disciplines, positioning us for growth in 2026 and beyond, the people at UnitedHealth Group will continue to support the millions of patients, physicians and customers who rely on us, guided by a culture of service and longstanding values.' UnitedHealth, which has more than 50 million health plan subscribers under its UnitedHealthcare health insurance business, is seeing rising costs among health plan members in all three government-subsidized benefits it helps manage: Medicaid, Medicare Advantage and individual coverage under the Affordable Care Act, also known as Obamacare. 'While we face challenges across our lines of business, we believe we can resolve these issues and recapture our earnings growth potential while ensuring people have access to high-quality, affordable health care,' UnitedHealthcare chief executive officer Tim Noel said in a statement accompanying UnitedHealth's earnings report. In the company's second quarter, UnitedHealthcare's 'consolidated medical care ratio of 89.4% increased 430 basis points year-over-year.' That compares to 84.8% in the year earlier period and well below the ratio in the lower 80th percentile where health insurers like to be. The increase in the medical cost ratio, which is the percentage of premium that goes toward medical costs, 'was primarily due to medical cost trends which significantly exceeded pricing trends, including both unit costs and the intensity of services delivered, and the ongoing effects of Medicare funding reductions,' the company said. UnitedHealth's cost struggles are among the parade of health insurance companies that have struggled in the last two years to control costs of subscribers in plans subsidized by the government. Just last week, Centene reported a rare quarterly as the provider of government-subsidized benefits struggles to manage costs of its health plan members. And earlier this month, Elevance Health, which sells Blue Cross and Blue Shield plans in 14 states, lowered its profit forecast for the rest of 2025 due to rising costs in its Medicaid plans and individual policies it sells under the ACA. In addition, Molina Healthcare lowered its earnings guidance for the rest of the year in the face of cost pressures in all three of the government-subsidized health insurance programs it helps manage. Medicare Advantage plans also contributed to struggles last year for Humana and CVS Health, which elevated a new chief executive in part to help gain control of its struggling Aetna health insurance business. CVS is also exiting the individual health insurance business, leaving about 1 million Aetna members in 17 states looking for new coverage in 2026.
