When your poll numbers are in the tank and there’s an election coming soon, what do you do? The Democratic Party solution seems to be all about purchasing healthcare voters. This is certainly in keeping with their healthcare philosophy of putting the government in control of your healthcare.
Two examples of this new campaign strategy were on full display recently. First, the Biden Administration went to their most reliable bullpen reliever when they invited former President Barack Obama to the White House for an event to reinvent ObamaCare. Knowing that “free stuff” is always popular with voters, they announced changes to ObamaCare to put even more Americans on this government-dependent healthcare.
Since its introduction in 2010 under the Obama Administration, ObamaCare has undergone many changes. This new healthcare legislation, passed without a single Republican vote, has struggled to live up to its hype. More Americans are now covered under this healthcare insurance, but the same individuals who can’t afford the premiums can’t afford the deductibles either.
The latest twist that the Biden Administration is proposing would extend coverage to the whole family for any employee covered under the plan. Currently workers can’t get ACA subsidies to lower their premiums if they get affordable health insurance coverage from an employer. But the definition of affordable is determined by the cost of the coverage for the employee and not for the whole family. This change is estimated to impact about five million people according to the Kaiser Family Foundation.
The result will be more people with healthcare insurance coverage – but not necessarily more people who can afford their healthcare. The underlying reason for this problem is the high cost of insurance under ObamaCare, because they require every policy to have coverage for essential health benefits – which includes unneeded coverage such as mammograms for males and prostate exams for females. This “one size fits all” philosophy only increases the cost of insurance, which increases not only the premiums the government is paying, but the deductibles the patients must pay, too.
Second, the Democratically controlled House of Representatives is proposing a price control cap on the cost of insulin. The Affordable Insulin Now Act (sounds like the Affordable Care Act) is a bill to solve a problem that doesn’t really exist. The Wall Street Journal editorial board says the bill caps the cost-sharing for insulin at $35 a month for diabetics with private insurance or on Medicare Part D. The bill’s Democratic sponsors call it “a critical drug pricing reform” to deal with “the skyrocketing cost of insulin.”
But the real story is more complicated. Sticker prices for insulin have increased, but those calculations ignore discounts negotiated by pharmacy-benefit managers. Over the past five years, net revenues to drug manufacturers on diabetes drugs “have been declining and patient out-of-pocket cost has been flat or risen only slightly,” says a 2020 report from IQVIA Institute for Human Data Science.
The gap between list and net prices can be huge. In 2019 patients paid less than $30 out of pocket for 74% of all diabetes prescriptions, according to IQVIA’s analysis. More than nine of ten were less than $75. But those without insurance may get stuck with higher prices or they must burn through a large deductible in their plan before coverage kicks in.
According to WSJ, the House bill would do nothing to change this. But it treats insulin makers as villains, even though many are trying to help their customers. Eli Lilly’s Insulin Value Program offers a discount card for $35 a month for insulin. The Trump Administration also tried to help in 2019 by allowing high-deductible plans to cover more care for chronic conditions before the deductible, including insulin.
The real solution to rising insulin prices is more competition – the opposite of what the House bill encourages. A better approach would be pushing the FDA to make it easier for generic equivalents to win approval, which would certainly lower insulin prices. Former FDA commissioner Scott Gottlieb was a strong proponent of speeding generic approvals under the Trump Administration.
WSJ says, “Democrats haven’t been shy about their broader plan to control the price of medicine through the euphemism of Medicare “negotiation.” This tells investors: Move your money out of better medicines or long-shot cures and into businesses that aren’t under political assault. That would be a terrible development for diabetics, especially as cell therapies may someday provide a cure. As former FDA commissioner Scott Gottlieb put it recently, it’s essential that diabetes treatments are affordable, but Congress and the public shouldn’t forget that the ‘ultimate goal is to free patients from insulin.’”
Beware the salesman who is selling snake oil just to get your money. Beware the politicians selling healthcare reform just to get your vote.