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Coffee CAHC policy round-up: February 7, 2018

Coffee CAHC is a twice-weekly newsletter where we round up and comment on the latest health coverage policy developments both nationally and here in Maine. We hope you find these updates helpful!

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Coffee CAHC

115th Congress, 2nd session

128th Maine Legislature, 2nd regular session


Wednesday, February 7th, 2018

Good grief, February already?! Oh and hey look a snowstorm, that’s new…


National level

There hasn’t been a whole lot worth reporting at the federal level since last week, and honestly – after how things have gone over the past year – I’m actually kind of glad to be able to say that.

There are two “things to keep an eye on”, though.

The first is that there may finally, finally be progress on health center funding. There’s some “politics” happening between the House and the Senate right now on the shape of the latest spending package, but the good news is that the House version included a two-year extension of health center funding. The bad news is that the House bill seems to be a nonstarter in the Senate. We’ll see where it shakes out, but the fact that it’s being included in the conversation at all is…rather depressingly…“good” “news”.

The other very very very bad news is that the Trump Administration is making noise about imposing lifetime limits on Medicaid. In other words, once a person had hit X amount of time covered by Medicaid, they’d be banned forever. I’m sure I don’t need to tell any of you how apocalyptically stupid and unconscionable we think this would be. Expect lawsuits.


State level

Yesterday was the work session on LD 1406, the bill that would help make prescription drug prices more transparent by giving the Attorney General the authority to ask manufacturers of certain drugs for more information on how and why they set their prices. I think, overall, that the work session went fairly well.

We were encouraged by the fact that pretty much everybody in the room admitted that drug costs are rising and are a problem (hard fact to ignore these days), but naturally there was little agreement on what to do about it. Everybody, of course, claims that it’s not their fault! The finger pointing never ceases to amaze. As soon as you suggest that, gee, maybe drug manufacturers who set their market prices bear some responsibility for what those prices are, you set off a round-robin of whoa look over there it’s a big bad PBM omg wait behind you it’s an insurer!

The devil – as it always is, of course – is in the details on this one, and one thing that somebody said to the committee really stuck out in my mind: only one entity decides the price of drugs when they come to market, and that’s the companies that make the drugs. Which is why we feel this legislation is right to focus on those manufacturers.

Ultimately, after many hours of comment and debate, the committee (Judiciary) tabled the bill for now. We’ll keep you posted on what the next steps are, once we know.


Would you like to know more?

A few summers ago, I woke up in the middle of the night because I had heard some sound in my sleep, and discovered a bat flapping around my room.

Long story short, after doing some research about the potential risks of rabies exposure and whether or not I should get the “post-exposure prophylaxis” to prevent the disease, I went to the walk-in clinic in town to get a doctor’s advice. She cut right to the chase and told me “Look, the odds that you were exposed to rabies are pretty low, but the only way you’ll know for sure is if you die of rabies.”

I got the shots.

(Oh, and since I know you’re all thinking it right now, no – you don’t get rabies shots in the belly. Not anymore. Apparently they haven’t done it that way for, like, decades now. They’re pretty undramatic, typical arm jabs. Except that the immunoglobulin they give you right after exposure is based on weight. And, well, any of you who know me know that I’m…um…“cuddly”, let’s say. Which meant I got not one, not two, but seven injections on the first day, spaced strategically around various muscle groups. …so that part was a little bit dramatic.)

Which is why I can very much relate to this Vox story about the astronomically high cost of treating a potential rabies infection. I was so incredibly fortunate to be covered at the time by insurance that left me with only a comparatively reasonable ER copay to handle, but my bills were definitely right around $10,000. Unbelievable.


Until next time, friends, I remain,


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