Trump administration targets hospital contracts
By: Ken Alltucker
USA Today
..... Americans who get health insurance through the workplace would pay less for health care if hospitals; anticompetitive deals with health insures were banned, a White House report says.
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The federal government has sued two major hospital systems over alleged anticompetitive deals. In separate antitrust lawsuits, the Justice Department accused the hospital systems New York-presbyterian and Ohio-Helaht of using their market positions to force health insurers to forgo lower-priced competitors.
..... In a new report, White House officials detailed potential savings if the federal government banned such anticompetitive contracts. Monthly premium son workplace insurance plans would drop 6.5%, which would yield annual savings of about $1,755 per family and $606 per individual, according to the White House Council of Economic Adviser report.
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The report estimated hospital prices would fall 18% in cities affected by anti-competitive deals. Such a ban would save about $4,100 for every patient admitted to a hospital that eliminated such contracting terms.
..... The White House Council of Economic Advisers published the report as the Trump administration seeks to counter attack from democrats on health care affordability.
..... Democrats have blamed congress Republicans and President Donald Trump for allowing enhanced Affordable Care Act subsidies to expire this year, [2026] making
ACA helaht insurance more expensive for some enrolled in marketplace plans. Meanwhile, more than 5 million people are expected to lose Medicaid coverage by 2034 because of work requirements and other changes to the federal-state program for low-income families, according to a Congressional Budget Office estimate.
..... Whit House officials say the report reveals how the administration is handling affordability. Instead of suing taxpayer dollars to fund subsidies to lower out-of-pocket costs for consumers, the administration is targeting rising prices charged by hospitals, drug companies and other health companies.
..... Trump also has sought to pressure pharmaceutical companies to lower prices on prescription drugs through his "most-favored-nation" deals. The administration also launched TrumpRx, a direct-to-consumer website listing discounted prescription drugs.
..... While the Trump administration has not adopted a rule or backed legislation to ban anticompetitive contracts, officials expect the DOJ's lawsuits will command the attention of industry leaders.
..... The White House report highlights three practices hospitals with a dominant market position use to block or limit competition from lower-cost health providers:
* Anti-steering provision prevent health insurers form directing patients to lower-cost medical providers.
* Anti-tiering language in contracts makes the insurer place the dominant hospital in the most favorable cost-sharing tier of an insurance plan. such moves can limit employer and insurer efforts to influence consumers to choose lower-cost hospitals.
* All-or-nothing contracts mandate insures include all of a dominant helaht system's hospitals and doctors as part of the insurance plan's network - or none at all. such provisions can prevent rival hospitals from attracting enough patients to adequately compete, the report said.