Trump signs Executive Order to Promote Insurance Principles Championed by UM Doctor
- President Trump signs executive order on chronic disease treatment expansion issue
- Championed by University of Michigan doctor and researcher A. Mark Fendrick
- Order mandates IRS let high-deductible plans cover critical medications, services from first dollar
President Donald Trump signed an executive order Monday instructing the Treasury Department and Internal Revenue Service to write rules within 120 days that would allow people covered by high-deductible health plans with health savings accounts with chronic diseases easier access to life-saving treatments.
Bipartisan legislation was also introduced in the U.S. Senate to accomplish the same thing, although the Chronic Disease Management Act goes into more detail and lists about 20 specific services and medications that should be covered. Sens. John Thune, R-S.D., and Tom Carper, D-Del., co-sponsored the bill.
In a statement, Thune said support’s Trump’s executive order to move the coverage expansion process more quickly. He said he has supported Fendrick’s VBID efforts since 2016.
“Diseases like diabetes, arthritis, and other chronic ailments can be debilitating for many people, but when managed properly, the result can benefit both the patient and the broader health care system, too,” said Thune in a statement.
“By effectively managing these conditions, there’s less risk for additional and potentially costlier treatment in the future. This is a common-sense policy for patients with chronic illnesses, whether the results are achieved through existing executive branch authority or by the force of law. If it’s the former, I hope the administration will look to our legislation as a framework from which they could draft applicable regulations.”
Fendrick said he received assistance from many health care groups and organizations, more recently the Smarter Healthcare Coalition, a Washington, D.C.-based lobbying and advocacy group.
“Health plans usually are not trying to cover things, but they and employers understand that this policy will lower out-of-pocket costs deemed high value for many Americans,” said Fendrick, adding that his research shows that giving people access to high-value services reduces long-term costs and improves health outcomes.
“I am hopeful that the IRS guidance will allow plans to incorporate changes for the 2020 year. We don’t have much time for that to get done, but no later to see such a change for 2021,” Fendrick said.
Chronic conditions covered under the proposal included those seeking life-saving opioid addiction medication and treatment, including Naloxone overdose treatment or other opioid treatment medications, Fendrick said.
Deaths and overdoses in Michigan from opioid a misuse rank 18th-highest in the nation. In 2016, 2,356 people died of drug overdoses, more deaths than from car accidents. From 1999 to 2016, the total number of overdose deaths involving any type of opioid increased more than 17 times in Michigan from 99 to 1,699.
Two types of prescription drugs, painkillers and tranquilizers, are the leading cause of misuse. Opioids range from such illegal drugs as heroin to prescription pain medicine that include oxycodone, hydrocodone, morphine, methadone, and codeine.
VBID, which was born in Michigan and is used in a growing number of commercial, Medicare and Medicaid plans, encourages people to use higher-value medical services by offering low or no copayments. It was hatched in the Affordable Care Act of 2010. Studies have shown VBID in benefit design plans can improve outcomes and reduce long-term costs.
The bill would change Section 223 of IRS regulations to allow health benefit plans to exclude from deductible coverage a condition that is “substantially disabling or life threatening, has a high risk of hospitalization or other significant adverse health outcomes and requires specialized delivery systems across domains of care.”
The IRS change would include predeductible coverage of chronic diseases as diabetes, asthma, heart failure, chronic obstructive pulmonary disease, and a high-cost condition that is claiming 115 lives per day — opioid addiction.