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Subsidies for ACA marketplace plans are set to expire in 2025. Here’s what that means for healthcare.
September 30, 2024

Healthcare Brew

Thermo Fisher Scientific

Welcome back! It’s a stressful time. Between the upcoming election, back to school, and the approaching winter flu season, the anxieties of everyday life can feel overbearing. So instead of an additional news blurb today, we thought we’d give you time back to take a few deep breaths and have a moment of peace.

In today’s edition:

Explaining enhanced health insurance subsidies

🫁 First-of-its-kind transplant

Health plan headache

—Cassie McGrath, Maia Anderson

POLICY

Marketplace uncertainties

A pharmacy with a Caduceus on the front surrounded by the Democrat donkey and the Republican elephant Amelia Kinsinger

The presidential election is around the corner, and crucial healthcare issues could be on the line.

But another, perhaps more niche healthcare policy may also get put on the chopping block: enhanced health insurance subsidies. These federal subsidies provide financial assistance to more than 21 million consumers who get their health plans through the Affordable Care Act (ACA) marketplace, a government-run site.

In July, Nashville-based HCA Healthcare and Franklin, Tennessee-based Community Health Systems (CHS) addressed the topic of subsidies during Q2 earnings calls, as analysts questioned how the health industry would be affected if they were discontinued.

Tim Hingtgen, CEO of CHS, said during the call that while it may depend on the political landscape, the health system is working “to make sure that everyone understands the importance of the affordability of the exchange business to make sure we continue with some of the gains we’ve experienced over the last several years.”

With the subsidies set to expire at the end of 2025, here’s what to know before the year ends.

Keep reading here.—CM

   

Presented by Thermo Fisher Scientific

Testing, testing

Thermo Fisher Scientific

TRANSPLANT

Breath of relief

Surgeons performing a double lung transplant NM Media Relations

On June 10, her 42nd birthday, Amanda Wilk of Minnesota had more than just the day to celebrate. After battling colorectal cancer since 2017, Wilk rang the bell at Northwestern Medicine in Chicago to declare that she was officially cancer-free.

She was the first known patient to undergo a double lung transplant while diagnosed with Stage 4 colorectal cancer in the US.

According to the CDC, colorectal cancer is the fourth most common cancer linked to cancer-related deaths in both men and women in the US—with nearly 142,000 people newly diagnosed in 2022—and it’s becoming more widespread among patients under 50. If malignant cells enter the bloodstream, the cancer most often metastasizes first in the liver, followed by the lungs, bones, brain, or spinal cord, according to the nonprofit cancer research center City of Hope. One study found that about 20% of patients are already experiencing metastases when they are diagnosed.

While the first successful double lung transplant was in 1986, Northwestern surgeons have pioneered a new surgical technique for cancer patients who have exhausted all other options. The goal? To prevent the cancer from spreading during the actual transplant surgery.

Keep reading here.—CM

   

PAYERS

Climbing costs

Hospital cross symbol with money coming out of it. Anna Kim

Despite inflation cooling down, employer health plan costs are heating up, according to a September analysis from consulting firm Mercer.

The firm’s 2024 National Survey of Employer-Sponsored Health Plans, which includes data from more than 1,800 US employers, found that employer health plan expenses are expected to rise by 5.8% per employee in 2025, marking the third consecutive year of 5+% increases after a decade of steady 3% increases.

That 5.8% figure takes into account cost-cutting measures employers could take, such as raising deductibles. If employers do nothing, however, expenses could rise by about 7%, according to the analysis. That number would be even higher for smaller employers—defined as those with between 50–499 employees—at about 9%.

The why. One factor putting pressure on employer health plan prices, the analysts said, is the growing gap between the number of healthcare workers and the demand for healthcare services. And the issue will only continue to grow as the US population ages and more people need more healthcare services, according to the analysis.

Keep reading here.—MA

   

TOGETHER WITH SANOFI

Sanofi

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VITAL SIGNS

A laptop tracking vital signs is placed on rolling medical equipment. Francis Scialabba

Today’s top healthcare reads.

Stat: 67%. That’s how many healthcare organizations reported ransomware attacks in 2024, up from 60% in 2023. (Sophos)

Quote: “My children didn’t deserve to go without insurance. They’re kids. They have medical emergencies, things happen, and they deserve to be taken care of.”—Micaela Hoops, a mother whose three sons lost health insurance, on how her family was hit by Texas’s Medicaid “unwinding” (ProPublica)

Read: In a unanimous vote on Wednesday, the Senate decided to hold Steward Healthcare CEO Ralph de la Torre in contempt of Congress and asked the Justice Department to seek criminal charges against him—a first since 1971. (the Washington Post)

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