BHCG Monitor: Focus on Health Care Benefits

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BHCG Monitor: Health Care Reform - Notable News


Health Care Reform – Notable News

Supreme Court to Take on another ACA Challenge

On November 7 the U.S. Supreme Court unexpectedly agreed to hear an appeal of a July 22 U.S. District Court ruling concerning the validity of a key Affordable Care Act (ACA) component – specifically the provision of the law that allows the federal government to distribute tax credits (subsidies) to people buying coverage through the ACA’s health insurance marketplace which subsidize the cost of insurance for qualified individuals. The challengers in the case, King v. Burwell, maintain the provision in the law limits subsidies to “an exchange established by the state” and only people in states with their own exchanges can get subsidies.

Currently only 14 states (and the District of Columbia) have fully set up their own marketplaces, with the remainder utilizing the federal exchange. Given the large number of states affected, if the Supreme Court rules in favor of the challengers, many fear it would represent a major destabilization of the ACA and a mandatory dismantling of the law. However, some legal observers contend the decision to hear the case is “much ado about nothing,” since there is little chance the Court will ultimately accept the argument. Others welcome the Supreme Court’s decision to hear the case as a means to clarify the law’s intent and state’s rights regarding health care policy decisions.


BHCG Monitor: An Electronic Personal Health Record Primer


Soaring Specialty Drug Costs – What Can Be Done?

It is generally accepted that pharmacy costs are going to continue to rise faster than the general medical inflation, primarily due to the rapid increase in the utilization of specialty drugs. Specialty drugs, used to treat complex illnesses such as cancer and hepatitis C (see accompanying article in this edition of the Monitor), are consuming an increasing percentage of employers’ drug spend and overall health care spending. The pressure on employers to address the costs of specialty drugs is significant and growing. What strategies and tactics are employers adopting to address this critical issue?



Understanding the Hepatitis C Virus and Its Impact on Employers

By: Matthew Harman, PharmD, MPH.

This is an article originally published in EH Connect (Fall 2014), a magazine publication produced by Employers Health Coalition, Inc.

Making it the most common chronic bloodborne infection in the US, an estimated 3.2 million people are impacted by the Hepatitis C virus (HCV). From Congress to employers, HCV has recently generated news coverage, and many are concerned about the recently approved medications and high-cost therapies. To better understand the benefit implications of HCV, it is important to grasp the risk factors and clinical course of this infection.

HCV is passed through direct blood-to-blood contact, which is typically the result of sharing needles or by having a blood transfusion or organ transplant before July 1990. Once the infection is transferred, people can often live decades without experiencing symptoms of HCV, even though damage to the liver is occurring. In fact, roughly four out of five people infected with HCV will develop the chronic infection, and one out of five will likely develop cirrhosis of the liver. The risk of developing liver cancer from HCV is about 4 percent if left untreated.