Providers poised to pounce on midterm results for pharma beatdown
WINNERSProviders: With Medicaid expansion gaining momentum and the threat of overhauling the Affordable Care Act off the table for the next two years, providers' balance sheets will benefit from lower costs related to care for the uninsured and hospitals can plan for a somewhat more predictable future. Massachusetts providers also avoided a costly measure that would've required them to raise their nurse staffing levels and likely increase their pay. Uninsured consumers: An estimated 331,000 low-income individuals in Idaho, Nebraska and Utah will be covered by the Medicaid expansion. That being said, consumers are expected to bear more out-of-pocket costs, which can still limit access to care and increase providers' bad debt. Eyes are now on pro-Medicaid expansion governors in Kansas, Maine and Wisconsin. Generic drug manufacturers: A House controlled by the Democrats gives generic-drug manufacturers more support for the Creates Act, which aims to help more generic drugs get to market by removing some barriers that pharmaceutical companies use to limit access to samples of branded products. More competition typically translates to lower prices, which could also benefit consumers. California dialysis providers and Stanford Health Care: Dialysis giants DaVita and Fresenius Medical Care staved off a California measure that would have capped charges at 15% above the direct costs of dialysis treatment. Stanford Health Care in Livermore and Palo Alto, Calif., won't have to cap charges at 115% of direct treatment costs, as proposed by a union. LOSERSDialysis and Bay Area patients: On the other hand, dialysis patients and Stanford Health Care patients could still be subject to higher charges. Branded-drug manufacturers: They may have to endure a more bona fide attack on drug pricing from the Trump administration with the support of a Democrat-controlled House. Bolstering competition by adding more generic drugs would also eat away at their profits.Home-care patients: Maine voters last week rejected a ballot initiative that would have established an unprecedented program of universal, no-cost home care for seniors and disabled people.
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