Top of the Funnel | Macro Data + Policy Position Monitor + Earnings Call Commentary
PCE. Personal Consumption Expenditures on Health Care continue to normalize but remain elevated over pre-COVID levels (7.64% YoY in March 2022 v 5.05% in March 2019). As capacity in health care is fixed in the near term, the higher expenditures reflect higher cost services and procedures which translate into higher acuity.
Notwithstanding HCA’s comments last week – and we are starting to suspect the company’s connection to the Envision Healthcare subsidiary, Emcare, is playing a role – people are emerging from pandemic less healthy than they started. Inflation Chartbook here.
Updated and redesigned Policy Position Monitor can be found here
CONGRESS
Budget Hearings. SecHHS Becerra was on Capitol Hill to defend his budget. Top of mind for House Republicans (and likely Senate Republicans) is Medicare solvency. The Trustees 2021 report, as it has for at least five years, indicated Medicare would be insolvent by 2026 and Members want to know what the plan is and asked SecHHS for legislative proposals. The real objective here is to establish solvency of Medicare as an issue in the next session at which point Republicans hope to be in power.
The White House
Final ACA Exchange Rule. HHS finalized the PY 2023 Exchange rules. The most notable provision is the requirement that plan sponsors provide one standardized plan. Option overload has long been a problem for exchange plans which are meant to address the insurance needs of low-income individuals who often do not have the time or the education level to navigate their way through all the possibilities.
Prior Auth Run Amok. The Office of the Inspector General issued a report that said Medicare Advantage Plans were inappropriately denying coverage for services that would be available under traditional Medicare. The AHA and FAH have made inappropriate use of prior authorization a major issue and now they have a little ammo.
VRBPAC, More EUAs and FDA. The FDA has published the schedule for meetings in June to discuss several COVID-19 related matters including EUA applications from PFE, MRNA and Novavax. The FDA is making slow progress toward turning COVID-19 vaccine approvals into a more routine event not dictated by company ambition. It is tough sledding especially given how the White House has made a show of making PFE’s antiviral widely available. At least they are trying.
Other Stuff
Calendar. You can find 2021 here with searchable ticker list. You can find 2022 here.
Have a great weekend.
Emily Evans
Managing Director – Health Policy
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