Marco Rubio Quietly Undermines Affordable Care Act
By ROBERT PEAR
WASHINGTON — A little-noticed health care provision that Senator Marco Rubio of Florida slipped into a giant spending law last year has tangled up the Obama administration, sent tremors through health insurance markets and rattled confidence in the durability of President Obama’s signature health law.
So for all the Republican talk about dismantling the Affordable Care Act, one Republican presidential hopeful has actually done something toward achieving that goal.
Mr. Rubio’s efforts against the so-called risk corridor provision of the health law has hardly risen to the forefront of the race for the Republican presidential nomination, but his plan limiting how much the government can spend to protect insurance companies against financial losses has shown the effectiveness of quiet legislative sabotage.
The risk corridors were intended to help some insurance companies if they ended up with too many new sick people on their rolls and too little cash from premiums to cover their medical bills in the first three years under the health law. But because of Mr. Rubio’s efforts, the administration says it will pay only 13 percent of what insurance companies were expecting to receive this year. The payments were supposed to help insurers cope with the risks they assumed when they decided to participate in the law’s new insurance marketplaces.
Mr. Rubio’s talking point is bumper-sticker ready. The payments, he says, are “a taxpayer-funded bailout for insurance companies.” But without them, insurers say, many consumers will face higher premiums and may have to scramble for other coverage. Already, some insurers have shut down over the unexpected shortfall.
“Risk corridors have become a political football,” said Dawn H. Bonder, the president and chief executive of Health Republic of Oregon, an insurance co-op that announced in October it would close its doors after learning that it would receive only $995,000 of the $7.9 million it had expected from the government. “We were stable, had a growing membership and could have been successful if we had received those payments. We relied on the payments in pricing our plans, but the government reneged on its promise. I am disgusted.”
Maine Insurance Co-op to Stop Offering Individual Plans
AUGUSTA, Maine — A Maine-based health insurance co-op with customers in Maine and New Hampshire says it will stop selling new individual insurance plans.
Community Health Options says Dec. 26 will be the last day to buy an individual plan from the co-op through HealthCare.gov. The New Hampshire Insurance Department says residents who already have coverage through the co-op will not be affected and premium rates for those plan-holders will not change.
The co-op decided to stop selling new plans because of significant enrollment growth over the past two years and higher-than-expected claims costs in 2015.
Community Health Options was founded in Maine in 2011 and began selling insurance in New Hampshire this year. The Affordable Care Act allowed for the creation of co-ops.
Martin Shkreli’s Latest Plan to Sharply Raise Drug Price Prompts Outcry
Martin Shkreli is once again provoking alarm with a plan to sharply increase the price of a decades-old drug for a serious infectious disease. This time the drug treats Chagas disease, a parasitic infection that can cause potentially lethal heart problems.
“It’s caused a lot of angst in the Chagas community,” said Dr. Sheba Meymandi, a professor at the University of California, Los Angeles, and director of a Chagas treatment center at Olive View-UCLA Medical Center. “Everyone’s in an uproar.”
The plan also is upsetting some organizations that supply drugs for neglected diseases because Mr. Shkreli has said he wants to take advantage of a federal program intended to encourage companies to develop such drugs. The program awards vouchers that can be sold to other companies for hundreds of millions of dollars.
Mr. Shkreli has said he hopes to obtain such a voucher by getting the Chagas disease drug approved by the Food and Drug Administration for sale in the United States. Critics say that it would be another case of the system being abused by awarding a voucher not for developing a new drug but merely for obtaining F.D.A. approval of a drug already used in tropical countries.
Mr. Shkreli, 32, a former hedge fund manager, declined to comment.
He set off a furor in September after his company, Turing Pharmaceuticals, acquired the rights to a 62-year-old drug for toxoplasmosis, another parasitic infection, and raised its price overnight to $750 a pill from $13.50.
Last month, Mr. Shkreli led an investor group that took control of a failing California biotechnology company, buying a majority of its shares on the open market at an average price of about $1.50 a share. The stock of the company, KaloBios Pharmaceuticals, now sells for about $28, based in part on expectations that Mr. Shkreli will make lots of money.
As one of his first moves at KaloBios, Mr. Shkreli agreed to license the worldwide rights to one version of benznidazole, a standard treatment in South and Central America, where Chagas disease is most common.
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Benznidazole has never been approved for sale in the United States but is provided free to patients by the Centers for Disease Control and Prevention on an experimental basis.
Mr. Shkreli said on a conference call with KaloBios investors last week that if the company won F.D.A. approval for benznidazole, it would have exclusive rights to sell it in the United States for at least five years. He said the price would be similar to that of hepatitis C drugs, which cost $60,000 to nearly $100,000 for a course of treatment.
In Latin America, benznidazole costs $50 to $100 for the typical two-month course of treatment.
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