Via Healio.com  

Source: Ted Eytan,  Flickr.com

By: Janel Miller

The average premium for the second lowest cost silver health insurance plans — the one used to determine final premium tax credits — will drop by a “historical” 1.5% for the first-time since the implementation of the federally-facilitated exchange in 2014, according to CMS.

However, experts told Healio Family Medicine that the agency’s actions put profit over patients and puts the well-being of many Americans at risk.

CMS claims

The average change in premium costs may not seem like a lot but is significant when put into historical context, Seema Verma, CMS administrator, said in a conference call with reporters.

“This is a very positive change from the double-digit increases we have seen over the past 2 years,” she said, noting that some states had seen increases of 200% and higher. The change in premiums was just one of the health insurance-related accomplishments under the Trump administration she lauded during the call.

According to Verma, states will soon be able to use waivers to increase their flexibility in sustaining their insurance markets. In addition, for the first time in several years, there will be an increase in insurance providers on the federal health insurance exchange market, she said.

“While some have been accusing [the Trump administration] of sabotage, the reality is we have been doing everything we can to mitigate the damage caused by Obamacare,” Verma said.

Experts weigh in

Arthur Caplan, PhD, founding head of medical ethics at New York University School of Medicine, and Robert Greenwald, JD, faculty director, Center for Health Law and Policy Innovation at Harvard Law School said in interviews CMS should not be patting itself on the back.

“The idea that the Trump administration is trying to save patients is ludicrous,” Caplan said in an interview. “It has permitted lousy cheap coverage, cheap, almost worthless policies to be sold,”  adding that is the “real reason why” CMS can make an announcement like this one.

“Putting this pig in a dress by claiming they’re helping people doesn’t make what they’re really trying to do — make the Affordable Care Act a footnote in history — go away. They’re putting money over people,” Caplan added.

“In no way does the Trump administration deserve credit for the state of the marketplace,” Greenwald agreed. “They have done everything in their power to destabilize it.”

According to Greenwald, states and insurance companies positively balanced the Trump administration’s actions by funding outreach and navigation efforts to promote the marketplace, adopting their own individual mandates to assure that there is diversity among marketplace applicants, passing laws that banned or limited the introduction of “junk” insurance plans, introducing a reinsurance system that results in lower premiums in their marketplaces, and allocating premium rate increases into silver-level plan premiums only.

Greenwald added it is not too late for clinicians and others to make their thoughts about health insurance known.

“If the American people want to see a strong marketplace this year, and the years ahead, they need to voice their opposition to efforts to repeal the Affordable Care Act and the health insurance marketplace,” he told Healio Family Medicine.

Via Center for Health Law and Policy Innovation

Robert Greenwald, CHLPI’s Faculty Director and Professor of Law, will be honored by Harvard Law School’s Student Government in April 2016 with the newly created Teaching & Advising Award. The Award is meant to recognize both exemplary instruction and the ability of an instructor to inspire personal and intellectual development outside the classroom.

The criteria for HLS Student Government Teaching & Advising Award included:

• Meaningful impact on the student experience at Harvard Law School;
• Development of student learning outcomes;
• Dedication to teaching and advising activities; and
• Ability to inspire personal, professional, and intellectual growth.

Congratulations to Professor Greenwald on receiving this award.

Via Center for Health Law and Policy Innovation

The New York Times released an article on August 25, 2015 on the call for increased access to life-saving medications for individuals with hepatitis C from health care experts and advocates. Robert Pear, the reporter behind “White House Is Pressed to Help Widen Access to Hepatitis C Drugs via Medicaid,” interviewed CHLPI director Robert Greenwald about the Center’s research on health insurance coverage of the Hepatitis C medication Solvaldi throughout the United States.

Excerpt from the article:

“Federal and state Medicaid officials should widen access to prescription drugs that could cure tens of thousands of people with hepatitis C, including medications that can cost up to $1,000 a pill, health care experts have told the White House.

The experts, from the Public Health Service and President Obama’s Advisory Council on H.I.V./AIDS, said restrictions on the drugs imposed by many states were inconsistent with sound medical practice, as reflected in treatment guidelines issued by health care professionals and the Department of Veterans Affairs…

…But Robert L. Greenwald, an expert on health law and policy at Harvard Law School, said: “These criteria defy clinical guidelines and best practices. Rather than recommending the exclusion of people who inject drugs, we should encourage earlier treatment as a way to prevent transmission of the virus.””

Read the full article

Via HLS News

The Center for Health Law and Policy Innovation (CHLPI) of Harvard Law School released the report “Food is Medicine: Opportunities in Public and Private Health Care for Supporting Nutritional Counseling and Medically Tailored, Home-Delivered Meals.”The report, funded in part by the M•A•C AIDS Fund, examines ways in which public and private health care programs like Medicaid, Medicare and new marketplace health insurance plans can support access to nutritional counseling and medically tailored home-delivered meals within their systems.

“We are at a unique point in time, when new health policy reforms, both within and outside of the Affordable Care Act, have opened the door for the inclusion of innovative services that both improve health outcomes and ultimately reduce health care costs,” said Robert Greenwald, Director of the Center.

“Through legal and policy analysis, our report identifies opportunities within our health care systems for integrating and reimbursing specific food and nutrition service interventions that can help move us toward reducing health disparities, promoting health, and reducing costs.”

Continue reading the full story here.

Robert Greenwald, Director of the Center for Health Law and Policy Innovation and Clinical Professor of Law

Via Houston Public Media

Under the new health law, all states had the option to expand Medicaid to insure more adults. California did it, and now that state has fewer uninsured people than Texas, which is now number one. Robert Greenwald is director of Harvard Law School’s Center for Health Law and Policy Innovation. He spoke to a group of Houston health leaders, suggesting they use new ways of framing the issue in the next legislative session. Greenwald says one major problem is refuting Governor Perry’s repeated claim that Medicaid is a broken system.

“It’s not that Medicaid is broken, it’s that Medicaid is expensive. And the reason it’s expensive especially in a place like Texas is that it’s limited to the most disabled, sickest, elderly population,” Greenwald said.

Greenwald says it would be different if Medicaid was offered to low-income, working adults. That population is relatively healthy and young. Getting them covered would not cost as much as the current program, and it would save money in the long run by keeping them healthy.

Continue reading the full story here.

Kristen Gurley ’15

By Kristen Gurley J.D. ‘15

The Harvard Law School Center for Health Law and Policy Innovation (CHLPI) recently released an insightful and action-oriented report on the landscape of type 2 diabetes in New Jersey. The report, entitled the 2014 New Jersey State Report: Providing Access to Healthy Solutions (PATHS) – An Analysis of New Jersey’s Opportunities to Enhance Prevention and Management of Type 2 Diabetes, serves as a resource for diabetes advocates and offers detailed policy recommendations for the prevention and management of the disease.

The report was a product of CHLPI’s PATHS project, which aims to strengthen federal, state, and local efforts to improve the type 2 diabetes landscape through strategic law and policy reform initiatives. The PATHS project, funded by the Bristol-Myers Squibb Foundation through its Together on Diabetes initiative, consists of state-level analyses in New Jersey and North Carolina, as well as federal-level recommendations and state best practices. It is the first product of a five year grant process, written over the course of eighteen months under the supervision of Clinical Fellows Amy Katzen of the Health Law and Policy Clinic (HLPC) and Allison Condra of the Food Law and Policy Clinic (FLPC), the two divisions of CHLPI.

Fourteen students worked with staff to conduct extensive research and more than fifty interviews with policymakers, government agencies, and non-profit organizations that are playing a role in the state’s diabetes response. Their detailed findings highlight the extent of the type 2 diabetes epidemic in New Jersey and provide actionable recommendations for diabetes advocates.

Report co-authors Allison Condra (left) and Amy Katzen (right) with New Jersey Senate President Stephen Sweeney at the New Jersey Diabetes Leadership Forum on March 27, 2014

“A frightening fact is that New Jersey ranks third in the nation for obesity among low-income children ages two to five, predisposing them to a future diabetes diagnosis. Nearly three-quarters of a million New Jersey adults are currently living with the disease,” said Allison Condra. “Our recommendations should serve as a resource for diabetes advocates within the state who are already working to take action.”

The PATHS report first details the impact of type 2 diabetes in New Jersey, and includes a profile of the state’s demographics, economy, political structure, and existing institutional capacity to address diabetes. Following this assessment, the report identifies existing policies that impact diabetes through the state’s food system and health care system. The report provides numerous detailed recommendations, including: making fruits and vegetables affordable and accessible to people in many low-income communities; helping New Jersey children gain access to healthy foods at school; making communities conducive to healthy, active living; providing access to the Diabetes Prevention Program; ensuring access to diabetes self-management education, medical nutrition therapy, and diabetes equipment and supplies; and enhancing care coordination for Medicaid/Family Care enrollees. Amy Katzen, explained, “by ensuring that all New Jerseyans living with type 2 diabetes have the tools, skills, and knowledge to manage their disease, we can prevent many of the most severe complications, keeping New Jersey healthier, happier, and more productive.”

To promote the PATHS report findings, CHLPI clinicians and students traveled to Trenton, New Jersey, to release the report at the New Jersey Diabetes Leadership Forum, on March 27, 2014. As Taylor Bates, ‘15 noted, “Ever since I started working on it, the PATHS NJ project has impressed me again and again with its thorough research on diabetes in New Jersey and the innovative solutions it offers. This event showed me that the community understands this problem and has the power to solve it. New Jersey has a chance to apply well-researched solutions to its growing diabetes epidemic, and based on what I saw at this event we’ll see a lot of progress in the coming years.”

The report was very well received by state legislators, agency policymakers, and community leaders. New Jersey Senate President Stephen Sweeney addressed the Forum attendees, describing his personal experience with diabetes and telling the audience, “I’m in your corner.”

“New Jersey has a very high prevalence of diabetes, with approximately 700,000 people living with the disease,” said Robert Greenwald, Director of CHLPI and Clinical Professor of Law at Harvard Law School, in addressing participants of the New Jersey Diabetes Leadership Forum. “This number is expected to double by 2025, and it is essential that advocates, legislators, and government agencies come together and take action now. Our hope is that the report will support these efforts and provide a resource to those that are already doing great work to address the prevention and care management needs of people living with or at risk for diabetes in the state.”

Read the full report here.

Cabbage is good for you.
Credit Ksenija Putilin / Flickr

Via: WGBH News
By: David B. Waters and Robert Greenwald, Director of the Center for Health Law & Policy Innovation

In the continuing debate about how to control soaring healthcare costs, poor nutrition and lack of access to healthy food are routinely ignored.

This is the case despite the fact that in a country as wealthy as the United States, one in three patients nationwide enters the hospital malnourished, adding a host of additional health challenges to patients’ prognoses and millions in additional health care costs.

Malnourished patients are significantly more likely than well-nourished patients to be re-hospitalized and suffer poor outcomes. Malnourished patients’ medications do not work as effectively. They often remain in the hospital longer and in many cases cannot continue critical treatments such as chemotherapy because they are not getting proper nutrition.

Simply put, there is a direct and important connection between nutrition and disease treatment and management. Food is medicine.

Continue reading the full article on WGBH News here.