Expensive hepatitis drug challenges Medicaid programs' funding

Jul 26 2014

State officials are nervous about how to afford the new medicine, which can run $84,000 for treatment. Also in Medicaid news, federal data show children using emergency room treatment at night or weekends are often on Medicaid.

The Washington Post's Wonkblog: The Drug That's Forcing America's Most Important – And Uncomfortable – Health-Care Debate
Expensive specialty drugs aren't new to health care. But Sovaldi stands out because it is aimed at helping millions of Americans who carry hepatitis C, and a large share of those infected are low-income and qualify for government coverage. Its arrival also coincides with the aggressive expansion of Medicaid and private coverage under the Affordable Care Act, whose purpose was to extend health care to tens of millions Americans who previously couldn't afford it (Millman, 7/24).

CQ Healthbeat: More Medicaid Families Sought Emergency Room Care, Statistics Show
Three-fourths of children treated in emergency rooms in 2012 were taken at night or on weekends, according to federal statistics released Thursday. The figures also showed that families on Medicaid were more likely than those with private insurance or without any coverage to use the emergency department. The frequency with which people use pricey emergency department care is getting attention as policymakers struggle to find ways to lower federal health spending. Lawmakers want to persuade people to use less expensive outpatient care whenever possible. The Centers for Disease Control and Prevention statistics released Thursday suggests that families still use the emergency room in part because of convenience, and that Medicaid families may need help in finding a primary care physician or understanding when an emergency visit is necessary (Adams, 7/25).