The Federal Trade Commission (FTC) is opening an investigation into the business practices of pharmacy benefit managers (PBMs). PBMs have been in the hotseat for quite some time. Executives from the largest PBMs were recently called to testify before Congress to explain whether their business practices lead to higher drug prices. In the latest inquiry, the FTC announced it will require the six largest PBMs to provide a range of information and business records on operations.
Category: Cost of Healthcare
Is it OK for Apple and Walmart Associates to be on Medicaid?
The CEO of L.A. Care Health Plan recently blogged about walking into an Apple store in downtown Los Angeles and discovering the sales associate who assisted him was a client. L.A. Care is a purveyor of both Medicaid managed care plans and Obamacare plans sold on the Covered California health insurance marketplace. He was aghast when the sale associate said she was covered through Medi-Cal, the California Medicaid program.
The Family Glitch
Obamacare law says that health insurance at work is “affordable” if the employee has to pay no more than 9.5% of his wages for self-only coverage. If it is affordable, neither the worker nor his family is entitled to subsidized insurance in the (Obamacare) exchanges. The Biden administration wants to change that rule administratively (without Congress) to deem health insurance “unaffordable” if the premium for the entire family is greater than 9.5% of wages.
Who Does the AARP Represent?
The AARP, the legendary advocacy for seniors aged 50 and above, has come under increased scrutiny in recent years for its marketing partnerships. Much of AARP’s revenue comes from licensing its name and logo to sell a wide range of goods and services targeted to seniors. The AARP is undoubtedly a senior advocacy, but it is also a marketing juggernaut that sells insurance.