Health
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- Written by: Elizabeth Larson
The report compiles information submitted by nine health insurers in California about covered prescription drugs, including prescription drugs dispensed at a plan pharmacy, network pharmacy, or mail order pharmacy for outpatient use, and include the following drug categories: generic, brand name, and specialty.
CDI-regulated insurers reported to the department the 25 most frequently prescribed drugs, the 25 most costly drugs by total annual plan spending, and the 25 drugs with the highest year-over-year increase in total annual plan spending for calendar year 2017 for individual and group coverage.
This mandated reporting by insurers is meant to demonstrate the overall impact of drug costs on health insurance premiums in California.
"Our Prescription Drug Cost Transparency Report is an important first step toward providing more information for consumers and policymakers regarding the cost of drugs," said Commissioner Jones. "More work needs to be done by policymakers to address the rising cost of drugs which significantly contribute to overall healthcare costs and health insurance premiums."
Notable findings:
– These CDI regulated health insurers and their policyholders spent more than $1.2 billion on prescription drugs in 2017.
– Generic drugs comprise 84 percent of prescriptions and 21 percent of spending, while specialty drugs comprised only 3 percent of prescriptions, but 52 percent of spending.
– The cost of prescription drugs (after considering rebates) is 13.4 percent of premiums.
– The 25 most costly specialty drugs alone accounted for more than a quarter of the total annual spend for all drugs.
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- Written by: California Attorney General's Office
Attorney General Becerra’s filing moves his legal defense of the ACA to the Fifth Circuit Court of Appeals, where he will appeal the lower court’s ruling that the ACA is unconstitutional.
“Our goal is simple: to stand up for the law of the land – the Affordable Care Act – in order to keep healthcare affordable and accessible for millions of Americans,” said Becerra. “This shouldn’t be a debate; the ACA has been the law for nearly a decade and is the backbone of our healthcare system. This case impacts nearly every American – workers covered by employers, families, women, children, young adults, and seniors – so we will lead the ACA’s defense as long and far as it takes. It’s troubling to think anyone would go back to the days when Americans with serious medical conditions like pregnancy or devastating illnesses like cancer or diabetes could be denied or charged more for coverage due to a preexisting condition.”
On Dec. 14, 2018, the district court issued an opinion in Texas v. U.S., ruling that the ACA was unconstitutional, but that decision lacked clarity.
As a result, Attorney General Becerra filed an expedited motion to continue the legal defense and ensure that the ACA continues to be implemented and enforced nationwide.
On Dec. 30, 2018, the district court granted Attorney General Becerra’s request to certify the judgement for appeal, and to stay the judgment pending that appeal.
Thursday’s filing continues the coalition’s legal defense of the ACA, with a request to appeal the district court’s Dec. 14 opinion in the Firth Circuit.
California’s coalition will continue to defend the law against this unfortunate decision that could wreak havoc on the entire American healthcare system and risk lives in every state. Nearly every American could be affected by this attempt to undermine the ACA, including:
– 133 million Americans, including 17 million kids, with preexisting health conditions.
– Young adults under 26 years of age, who are covered under a parent’s health plan.
– Nearly 12 million Americans who received coverage through Medicaid expansion.
– 12 million seniors who receive a Medicare benefit to afford prescription drugs.
– Working families who rely on tax credits and employer-sponsored plans to afford insurance.
An electronic copy of the notice of appeal can be found here.
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- Written by: California Attorney General's Office
Attorney General Becerra’s brief argues that the ACA remains the law, and details the harm that ending the ACA will have on the U.S. health system, states, and millions of Americans.
“It’s hard to imagine a world in which millions of Americans could lose healthcare, but these are the stakes right now in federal court,” said Attorney General Becerra. “The Trump Administration shows little regard for Americans’ healthcare, lives, or the law. Every American could be affected by this case’s outcome: children, seniors, workers covered by employers or through the Marketplace, and the hundreds of millions of people with a pre-existing condition. This shouldn’t be a debate: the ACA is the law of the land, and we will continue to challenge this dangerous attempt to undermine Americans’ health.”
On Dec. 14, 2018, the Court issued an opinion in Texas v. U.S., ruling that the ACA was unconstitutional.
The decision lacked clarity. As a result, Attorney General Becerra filed an expedited motion to continue the legal defense and ensure that the ACA continues to be implemented and enforced nationwide.
The motion additionally requested that the court certify the opinion, so that it may be appealed to the Fifth Circuit Court of Appeals immediately.
According to briefs filed by Texas and the federal government, all of the parties agree that the court’s Dec. 14 order has no immediate effect, that the court should certify the order for immediate appeal in the Fifth Circuit and that proceedings in the district court should be stayed pending the outcome of that appeal.
Attorney General Becerra has requested that the court rule on the motion before Jan. 1, 2019.
An electronic copy of the brief can be found here.
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- Written by: University of California, Berkeley
The study of 208 middle-aged African American women from the San Francisco Bay Area is the first to examine the links between racial discrimination and allostatic load, a measure of chronic physiologic stress in the body that is a predictor of a variety of chronic diseases.
Higher levels of educational attainment may buffer some of the negative health effects of discrimination, the team found.
“Racial discrimination has many faces. It is not being able to hail a cab, getting poor service in stores and restaurants, being treated unfairly at work, being treated unfairly by police and law enforcement and being followed around in stores because of racial stereotypes,” said Amani M. Allen, an associate professor of epidemiology and community health sciences in UC Berkeley’s School of Public Health. “We found that experiencing racial discrimination repeatedly can create a state of biological imbalance that leaves certain groups of people more susceptible to chronic disease.”
Numerous studies show that African American women have higher levels of allostatic load, a collection of biological factors like high blood pressure and high blood sugar that collectively raise an individual’s risk of developing chronic illness.
African American women are also more likely than other racial and gender groups to experience chronic diseases, including heart disease, stroke, diabetes and cancer.
While previous research has linked racial discrimination to specific conditions, this study, appearing online this month in the journal Psychoneuroendocrinology, is the first to examine the association between racial discrimination and allostatic load.
“We know that African American women suffer disproportionately from chronic disease, and we know a lot about what contributes to these diseases – diet, physical activity, access to care and even genetics in some cases,” Allen said. “However, these factors fall short of explaining the disparities faced by African American women. The goal of our study was to examine whether racial discrimination is in itself a type of stressor that may be related to higher levels of allostatic load, thereby increasing risk of chronic illness among this group.”
Each participant completed a questionnaire rating their experiences of racial discrimination in different contexts, including finding housing, finding employment, at work, at school, getting credit for a bank loan or mortgage, and in healthcare settings. The team also gave each participant a physical exam, recording their height, weight, blood pressure, blood sugar and measures of inflammation and other health indicators that can contribute to allostatic load.
Study participants were provided with the results of their physical exams and given educational materials about health risks facing African American women. “It was important to us that this be an informative experience for them,” Allen said.
The team broke down the analysis by educational attainment and poverty status, unearthing some surprising trends. For African American women with a high school diploma or less, experiencing a high level of racial discrimination correlated with much higher allostatic load. However, this trend was reversed for highly educated women, for whom very high levels of racial discrimination correlated with lower allostatic load.
The researchers hypothesize that these differences may be partly attributed to how women interpret the racial discrimination they face.
“There are better health outcomes associated with those who attribute their racial discrimination experiences to systemic racism and do something about it as opposed to just accepting it and engaging in self-blame,” said Marilyn D. Thomas, a doctoral candidate in epidemiology at Berkeley. “Since we found that less-educated women were less likely to report racial discrimination, we suspect that those who have higher education may be more prepared to acknowledge and report racism versus internalizing it and blaming themselves.”
While the relationship between racial discrimination and allostatic load also varied by poverty status, the trends were not as pronounced as they were for education level.
The researchers stress that while education is a powerful predictor of health, it should not be seen as an antidote to the potential adverse health effects of racial discrimination.
“We need to think about the determinants of health in different ways,” Allen said. “They are not just access to care, genetics or even socioeconomic position. We need to look at the social conditions of people’s day-to-day lives, and how we might improve those conditions so that every person, regardless of their race, their gender or anything else, has an equitable opportunity to live optimally. Unequal treatment is bad for health.”
Other authors include Eli K. Michaels, Alexis N. Reeves and S. Leonard Syme of the division of epidemiology at UC Berkeley; Uche Okoye and Melisa M. Price of the division of community health sciences at UC Berkeley; Rebecca E. Hasson of the school of kinesiology and public health at the University of Michigan; and David H. Chae of the department of human development and family studies at Auburn University.
This work was supported by research grants from the University of California, Berkeley (UCB) Hellman Fund, UCB Population Center, UCB Research Bridging Grant, UCB Experimental Social Science Laboratory, Robert Wood Johnson Health and Society Scholars Program (UCB site), UC Center for New Racial Studies, and UCB Institute for the Study of Societal Issues, National Institute of Minority Health and Health Disparities grant P60MD006902 and National Institute of General Medicine Science grant UL1GM118985.
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