Science Policy For All

Because science policy affects everyone.

Science Policy Around the Web – February 17, 2015

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By: Sara Cassidy, M.S., Ph.D.

Healthcare Policy

Everyone wants a piece of the action: The nation’s largest health insurer denied entrance into California’s marketplace

When the Affordable Care Act was initiated, it encouraged states to adopt their own insurance marketplaces to promote competitive pricing. Citizens and insurers alike were skeptical. To incentivize insurers’ participation from the outset, California was one of a few states to impose a waiting period of three years on companies who did not take part on opening day. Covered California surpassed its enrollment numbers in 2014 and is on target to increase enrollment by ~29% in 2015. UnitedHealthcare wants a piece of that pie, but its request to sell insurance statewide ex post facto was recently turned away by the Covered California advisory board. Consumer advocacy groups support the move by Covered California, as they believe insurers took a big risk being first-adopters, knowing that they likely would be signing up an unequal share of sicker-than-average people. However, California’s insurance commissioner believes restricting access is bad for business since more competition would likely drive down prices for the individual. The outcome from the Covered California advisory board was a compromise: Plans will be able to apply for entrance into the statewide market in 2016 if they were newly licensed since August 2012 (when the first-adopters opted in), or are managed care plans for Medicaid. Otherwise companies can apply to offer coverage in regions of the state where less than three carriers currently offer plans. This will allow large insurers like UnitedHealthCare limited participation into the marketplace until the moratorium is over is 2017.  (Michelle Andrews, NPR; Victoria Colliver, SF Gate; www.coveredca.com)

 

Regulatory Policy

Digital health monitors avoid FDA regulation

The wearable electronic health market (FitBit, smart phone apps, and the like) is predicted to be worth 11.6 billion dollars by 2020. Sustained lobbying by Apple, Intel and other digital health monitor companies has successfully persuaded the Food and Drug Administration to stay out of their business. Recently, the FDA agreed not to regulate technologies that receive, transmit, store, or display data from medical devices, and most mobile medication applications. However the industry and some members of Congress want more than promises; they want laws that assure the industry it can innovate and sell its products without government interference. For apps that monitor exercise routines and count calories, FDA regulation seems an over-reach, but what about apps that allow diabetics to plug glucometers into their smartphones to track insulin levels, or apps that take electrocardiograms to record cardiac events? These already exist, and sound like the types of medical devices the FDA would normally regulate to ensure safety and accuracy. And, as the market expands, it is easy to imagine it becoming increasingly difficult for patients and physicians to evaluate the quality and utility of these devices. As we enter the era of precision medicine, the mobile health market is posed to play a major role in personalized healthcare, but that position could be compromised without FDA oversight.  (Ashley Gold, Politico; Cortez et al (2014) NEJM 371:372-379; FDA)

 

Energy Policy

Republicans sign Keystone Pipeline Bill, Obama expected to veto

Speaker John Boehner (R-Ohio) staged a signing ceremony for a bill including plans to build the Keystone XL pipeline Friday the 13th, but the legislation won’t be forwarded to the White House until after the holiday weekend. President Obama is expected to veto the bill. The State Department has just finished collecting information on whether the project is in the nation’s best interest, and once Secretary of State John Kerry finishes reviewing the comments, they will be sent to Obama who will make the final decision. Opponents of the pipeline are optimistic Obama will reject the project, based on his recent negative comments. “It’s very good for Canadian oil companies, and it’s good for the Canadian oil industry but it’s not going to be a huge benefit to U.S. consumers, it’s not even going to be a nominal benefit to U.S. consumers,” Obama said in December. Despite this, the pipeline developer, TransCanada, has vowed not to give up on the project if Obama rejects the bill.  (Laura Barron-Lopez, The Hill)

 

 

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Written by sciencepolicyforall

February 17, 2015 at 11:24 am

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