Health Beat: New report shows Medicaid expansion can improve behavioral health care access

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NEW REPORT SHOWS MEDICAID EXPANSION CAN IMPROVE BEHAVIORAL HEALTH CARE ACCESS
The U.S. Department of Health and Human Services released a report on Monday (March 28) showing that states can greatly improve access to behavioral health services for residents by expanding Medicaid under the Affordable Care Act. Substance use disorders and mental illness are prevalent and serious public health problems in American communities.

According to the report, in 2014, the most recent year for which data is available, an estimated 1.9 million uninsured people with a mental illness or substance use disorder lived in states that have not yet expanded Medicaid under the Affordable Care Act and had incomes that could qualify them for coverage. The report found that people with behavioral health needs made up a substantial share of all low-income uninsured individuals in those states: nearly 30%. While some of these individuals had access to some source of health insurance in 2014, many will gain access to coverage only if their states expand Medicaid, and others would gain access to more affordable coverage.

NPR, KAISER HEALTH STARTS NEW SERIES ON OPIOID WITHDRAWAL IN NEWBORNS
Use of opiates during pregnancy can result in a drug withdrawal syndrome in newborns called neonatal abstinence syndrome (NAS). A new study to determine the extent, context and costs of NAS found that incidence of this growing medical problem is rising in the U.S. There was a five-fold increase in the proportion of babies born with NAS from 2000 to 2012, when an estimated 21,732 infants were born with NAS — equivalent to one baby suffering from opiate withdrawal born every 25 minutes.

As the U.S. opioid and heroin epidemic continues to grow, NPR and Kaiser Health news are taking a look at this new medical issue in the first of a four-part series called, Treating the Tiniest Opioid Patients.

CDC ISSUES NEW GUIDANCE, INFORMATION ON ZIKA VIRUS TRANSMISSION AND HEALTH EFFECTS
The CDC on Friday (March 5) issued new interim guidance related to Zika virus transmission and related health effects based on the accumulating evidence, expert opinion, and knowledge about the risk associated with other viral infections. Mounting evidence supports a link between Zika and microcephaly, a birth defect that is a sign of incomplete brain development, and possibly other problems such as miscarriage and stillbirth. The rate of these complications is not known but is being studied further. Even in places with active Zika transmission, women are delivering apparently healthy infants, but the CDC says healthcare providers need clear guidance to inform discussions with their patients about possible exposure to Zika virus, pregnancy planning, and timing of pregnancy.

FITCH: ANTHEM, EXPRESS LAWSUIT COULD SHAPE NATION’S PHARMACY BENEFITS MANAGEMENT BUSINESS MODEL
The outcome of a dispute between Anthem and Express Scripts, underscored by a lawsuit announced Monday, could have far-reaching effects on the evolving pharmacy benefits management (PBM) industry and implications for Express Scripts’ independent business model, Fitch Ratings service said in a recent report. Anthem is seeking $15 billion in damages against Express Scripts over the pharmacy-benefits manager’s drug pricing.

Fitch says the lawsuit challenges a fundamental aspect of PBM-insurer relationships: the value of a PBM’s negotiating power with pharmaceutical manufacturers. Fitch would partially attribute an outcome that ends on terms more favorable for Anthem to the company’s significant scale, which will expand further upon completion of its planned acquisition of Cigna. Anthem is Express Scripts’ largest client.