State Farm offers renewals for people affected by LA fires it planned to drop
State Farm says it will offer renewals to policyholders affected by the Los Angeles County fires. The announcement reverses its initial plans to drop coverage.
The decision affects policies for homeowners, renters and condo associations. It includes about 70% of the residential policies it has in Pacific Palisades.
The coastal community has suffered significant destruction in this month’s fires, with widespread damage and most residents forced to evacuate their homes.
Thousands of other policyholders around LA County will also be able to renew. However, the offer will not apply to policies that lapsed before Tuesday, Jan. 7.
The Illinois-based insurance giant drew criticism in California for its decision last March to not renew thousands of insurance policies in the state, as many areas in California face increased risk of natural disasters.
State Farm’s decision comes after the California state insurance commissioner’s office pushed insurers to hold off on not renewing policies for people in fire zones.
A spokesperson for the insurance commissioner said the office is working with State Farm to get more information.
‘Big 3’ pharmacy benefit managers marked up drugs by $7.3B: FTC
The nation’s three largest pharmacy benefit managers (PBMs) made significant markups to “lifesaving” medications at pharmacies they owned, the Federal Trade Commission said Tuesday, Jan. 14. The preliminary report comes as PBMs face increased scrutiny and bipartisan legislation to rein them in.
The “Big 3” pharmacy benefit managers marked up generic drugs filled by their affiliated pharmacies by hundreds and even thousands of percent, according to the FTC’s preliminary report.
The regulator said the markups allowed CaremarkRX, Express Scripts and OptumRX to earn $7.3 billion in revenue from dispensing those drugs from 2017 to 2022. The FTC said the $7.3 billion is the difference between the estimated cost to acquire the drug and what they are being reimbursed.
The report is part of an ongoing FTC investigation into the PBM market.
“The FTC staff’s second interim report finds that the three major pharmacy benefit managers hiked costs for a wide range of lifesaving drugs, including medications to treat heart disease and cancer,” outgoing FTC Chair Lina Khan said in a statement. “The FTC should keep using its tools to investigate practices that may inflate drug costs, squeeze independent pharmacies, and deprive Americans of affordable, accessible healthcare—and should act swiftly to stop any illegal conduct.”
A trade group representing PBMs cast doubt on the veracity of the latest report.
“It’s clear this report again fails to consider the entirety of the prescription drug supply chain and makes sweeping assertions about the role of PBMs disconnected from a full appreciation of their critical cost-saving role for employers, unions, taxpayers, and patients,” the Pharmaceutical Care Management Association said in a statement to Straight Arrow News.
The FTC said patients paid $297 million for these drugs in 2021, while plan sponsors paid $4.8 billion. Between 2017 and 2021, costs for both parties increased about 21% per year for commercial health plans and 14% to 15% for Medicare Part D claims.
It’s another narrative PCMA is pushing back against. In a survey commissioned by the trade group, 90% of responding employers “expressed satisfaction with their PBMs’ clarity and transparency of contract terms,” while 88% “expressed satisfaction with their PBMs’ ability to provide the lowest costs for employees at the pharmacy counter.”
A PBM is an intermediary between insurance companies and pharmacies. Ultimately, the middlemen decide whether a drug is covered and how much the pharmacy and the patient must pay for the medication.
Critics of PBMs said consolidation in the industry is a major problem. In multiple cases, insurance providers, PBMs and pharmacies are all owned by the same corporation.
CaremarkRX is part of a group owned by health insurance firm Aetna and pharmacy heavyweight CVS. OptumRX is part of UnitedHealth Group. Cigna owns Express Scripts.
The FTC’s interim report found the PBMs in question reimbursed the pharmacies they owned more than providers that weren’t under their umbrella.
PBMs are receiving bipartisan criticism in Congress. In December, Sens. Elizabeth Warren, D-Mass., and Josh Hawley, R-Mo., sponsored a bill that would force companies that own health insurers or pharmacy benefit managers to sell off their pharmacy business.
Texas AG sues Allstate, Arity for alleged unlawful data collection
Texas Attorney General Ken Paxton is suing Allstate and its subsidiary, Arity, for allegedly unlawfully collecting the data of more than 45 million Americans and using it to raise insurance rates. Paxton claims Allstate and Arity “would pay app developers to incorporate its software to track consumers’ driving data,” according to a press release.
The lawsuit states that Allstate embedded software in third-party apps, causing consumers to download it unknowingly. Once installed, the software allowed Allstate to track consumers’ location and movements in real-time, creating what is described as the “world’s largest driving behavior database.”
The lawsuit further alleges that Allstate and other insurers used the consumer data collected through these third-party apps to increase premiums when quotes were requested or coverage was renewed.
In a statement, Paxton said: “The personal data of millions of Americans was sold to insurance companies without their knowledge or consent in violation of the law. Texans deserve better, and we will hold all these companies accountable.”
Paxton alleges that Allstate’s actions violated the Texas Data Privacy and Security Act (TDPSA). The law requires clear notice and informed consent regarding the use of Texans’ sensitive data.
However, a representative for Allstate Corporation told Fox News that its data collection system “fully complies with all laws and regulations.”
Paxton is seeking thousands of dollars in civil penalties per violation and “full restitution or restoration to all the consumers who suffered a loss.”
Total estimated cost of California wildfires triples to $150 billion as blazes rage on
The estimated total cost of the destructive southern California wildfires has nearly tripled as first responders struggle to contain the largest blazes. The economic toll could reach $135 billion to $150 billion, according to experts at AccuWeather, up from their previous high estimate of $57 billion.
“Hurricane-force winds sent flames ripping through neighborhoods filled with multi-million-dollar homes,” AccuWeather Chief Meteorologist Jonathan Porter said in a statement. “The devastation left behind is heartbreaking and the economic toll is staggering. To put this into perspective, the total damage and economic loss from this wildfire disaster could reach nearly 4 percent of the annual GDP of the state of California.”
As officials work to contain the fires, which continue to grow in size, AccuWeather experts say the estimate for “total damage and economic loss may be revised upward, perhaps even substantially.”
The area from Malibu to Santa Monica has some of the most expensive properties in the United States. The median home value in the area is more than $2 million, with Pacific Palisades sitting right in the middle of the region.
If AccuWeather’s estimates ring true, these fires will become the most costly natural disaster in U.S. history.
Hurricanes tend to be the most costly natural disasters in the U.S. Hurricane Katrina in 2005 is currently the most costly in history, according to Kiplinger, which compiled data from NOAA and adjusted for inflation.
Most expensive natural disasters in U.S. history
5. Superstorm Sandy (2012), $82.0 billion.
4. Hurricane Maria (2017), $107.1 billion.
3. Hurricane Ian (2022), $112.9 billion.
2. Hurricane Harvey (2017), $148.9 billion.
1. Hurricane Katrina (2005), $186.3 billion.
Meanwhile, insured losses from the southern California fires could reach $20 billion, according to JPMorgan. Analyst Jimmy Bhullar said that number could rise “even more if the fires are not controlled.” Raymond James issued a similar estimate, saying insured losses could range from $11 billion to $17.5 billion. Morningstar analysts estimated insured losses will exceed $8 billion.
“When you have these things like wildfires or hurricanes or floods, and the loss affects a large portion of the population, especially in a very small geographical area at the same time, insurance works, but it doesn’t work as well,” said Chuck Nyce, a professor of risk management and insurance at Florida State University. “It becomes more expensive, and the losses to the insurance company, when they become what they call ‘correlated,’ it makes insurance companies’ cost of capital higher, it makes their losses higher, it makes them more reluctant to do a large volume of business in a specific area.”
As insured losses mount, homeowners in the area will face an uphill battle to rebuild.
State Farm, a major insurer in the state, reportedly canceled hundreds of policies for homes in the Pacific Palisades over the summer to avoid “financial failure.” But there are options for those who can’t find private coverage in their communities.
“People forget that if you look across the United States, if you look at the first three quarters of 2024, there were 25 different events in the United States that caused more than a billion dollars in damage to properties,” Nyce told Straight Arrow News. “When we think about these disasters, we think of these areas like, ‘Oh, Florida is the problem,’ or, ‘Oh, California is the problem.’ They are much more widespread than people realize.”
In California, Fair Access to Insurance Requirements (FAIR) “is a syndicated fire insurance pool comprised of all insurers licensed to conduct property/casualty business in California.” It is an insurer of last resort, when homeowners can’t get policies from private companies.
The program uses no public or taxpayer funding, but that doesn’t stop the cost from being spread to policyholders throughout the state.
As estimates of the total economic toll and insured losses continue to rise, a number of major players in insurance saw their stock slide to open trading on Friday. This includes firms like Travelers, Allstate and AIG.
California wildfires causing $57 billion in damage as providers canceled insurance
The devastating southern California wildfires could cause between $52 billion and $57 billion in economic losses, according to experts at AccuWeather. But homeowners affected have unique insurance factors in play as they try to put their lives back together. In the months leading up to the disaster, many affected homeowners lost their original insurance coverage.
There are at least five fires covering more than 45 square miles affecting the region. The Palisades Fire is the biggest, burning through nearly 27 square miles and destroying more than 1,000 buildings. As of the morning on Thursday, Jan. 9, it was zero percent contained and being called the most destructive fire in Los Angeles’ history.
“Should a large number of additional structures be burned in the coming days, it may become the worst wildfire in modern California history, based on the number of structures burned and economic loss,” AccuWeather Chief Meteorologist Jonathon Porter said.
In the wake of the devastation, homeowners in the area will face an uphill battle to rebuild. State Farm, a major insurer in the state, reportedly canceled hundreds of policies for homes in the Pacific Palisades over the summer to avoid “financial failure.”
“Insurance is a social good,” said Chuck Nyce, a professor of risk management and insurance at Florida State University. “It is really good at covering a loss that you may have when a bunch of other people who have the same exposure to it don’t have the loss at the same time. For one person who has an auto accident, there are hundreds of people who are insured who don’t have an accident at the same time.”
“When you have these things like wildfires or hurricanes or floods, and the loss affects a large portion of the population, especially in a very small geographical area at the same time, insurance works, but it doesn’t work as well,” Nyce said. “It becomes more expensive and the losses to the insurance company, when they become what they call ‘correlated,’ it makes insurance companies’ cost of capital higher, it makes their losses higher, it makes them more reluctant to do a large volume of business in a specific area.”
Filling the insurance void
Insurers have been backing out of the area as wildfires become more frequent and destructive. But there are options for those who can’t find private coverage in their communities.
“Every state has some type of a residual market called a FAIR plan. In most states, that will enable you to get access to that insurance, even if the private market is not willing to provide it,” Nyce said.
In California, Fair Access to Insurance Requirements “is a syndicated fire insurance pool comprised of all insurers licensed to conduct property/casualty business in California.” The program uses no public or taxpayer funding. But that doesn’t stop the cost from being spread to policyholders throughout the state.
“States have a variety of different ways in which they fund their FAIR plans. Some of them just allocate those policies to insurance companies,” Nyce said. “Other ones, what they’ll do is they will bill the insurance companies for losses that the FAIR plan absorbs. And if that’s the case in many states, what those insurance companies do, they can pass through those additional losses that they’re paying to the FAIR Plan to their current policyholders. So even though the state’s not paying for it, the citizens of that state are paying for it.”
The number of California FAIR policies has doubled between 2020 and 2024, reaching more than 450,000 customers, as insurers dialed back coverage in fire-ravaged regions. Since 2020, FAIR’s insurance exposure has surged from $153.43 billion to more than $458.08 billion, a 200% increase.
Nyce said all of this will eventually result in a secondary problem for people seeking homeowner policies.
“Price, availability, affordability, these are all issues that are going to be on the docket for California, probably for the next 10 or 20 years, with regard to insurance.”
“Sitting with my family, watching the news, and seeing our home in Malibu burn to the ground on live TV is something no one should ever have to experience,” she wrote in an Instagram post. “This home is where we built so many precious memories … My heart and prayers are going out to every family affected by these fires.”
Despite the fact that many homeowners in the Palisades Fire have the means to recover, Nyce still says it’s not a good idea to go without insurance.
“These are some of the wealthiest homes in the country, some of the most expensive homes in the country, they can afford it, then they should be able to afford their insurance premiums,” he contended.
Bill would force Big Health Care to sell pharmacies within 3 years
A group of bipartisan lawmakers introduced legislation that would force companies that own health insurers or pharmacy benefit managers to divest the pharmacies they own. Sens. Elizabeth Warren, D-Mass., and Josh Hawley, R-Mo., said they hope to end the “gross conflict of interest that enables these companies to enrich themselves at the expense of patients and independent pharmacies.”
Under this legislation, which is not likely to pass before the end of the session, it would be illegal to directly or indirectly own a pharmacy while owning either an insurance company or pharmacy benefit manager, known as a PBM. Companies that do would have three years to sell off the pharmacy business.
The bill, which targets the biggest health care companies in the world, is called the Patients Before Monopolies Act, or PBM Act.
“It’s a middleman between a drug manufacturer and the pharmacy, and ultimately to the patient who needs the medication,” said Wendell Potter, a former Cigna insurance executive. “And insurance companies used to just hire them or use them to access the medicines and be their consultant.”
But now, major insurance companies own the PBMs.
Earlier this year, the Federal Trade Commission released an interim report on PBMs’ effect on prescription drug prices. That report found the top three PBMs, all owned by health insurance companies, control around 80% of prescription drug claims for 270 million people.
“PBMs have manipulated the market to enrich themselves — hiking up drug costs, cheating employers, and driving small pharmacies out of business,” Warren said in a statement.
“This legislation will stop the insurance companies and PBMs from gobbling up even more of American health care and charging American families more and more for less,” Hawley added.
The industry pushed back against the assertions from the senators.
“This proposed legislation would severely limit access to safe and affordable pharmacies that patients value and rely on for prescription drugs,” a PBM trade group, Pharmaceutical Care Management Association, said in a statement. “The truth is PBM-affiliated pharmacies, including mail-service and specialty pharmacies, have a proven track record of providing convenient, reliable, and affordable options for patients to access prescription drugs.”
In a survey commissioned by PCMA, 90% of responding employers “expressed satisfaction with their PBMs’ clarity and transparency of contract terms,” while 88% “expressed satisfaction with their PBMs’ ability to provide the lowest costs for employees at the pharmacy counter.”
Consolidation in the industry put a lot of power in the hands of PBMs, according to Potter.
CVS bought pharmacy benefits manager Caremark in 2007 for nearly $21 billion. It also owns health insurer Aetna.
Meanwhile, insurer UnitedHealth Group owns Optum, which has the PBM OptumRX.
All three of these companies offer mail-in pharmacy products, and CVS has nearly 10,000 physical locations.
“These companies ultimately saw that there would be a way for them to make excess profits by owning these pharmacy benefit managers,” said Potter, who is now president of the Center for Health and Democracy. “So Cigna’s now more apt to be described as a PBM or pharmacy benefit manager that also happens to own health insurance plans or operate health insurance plans. It’s an entirely different company.”
“I started practicing pharmacy way back in 1980 and PBMs really started out as being nothing but processing,” Rep. Buddy Carter, R-Ga., told Straight Arrow News. “They just process claims. And all of a sudden, formularies became very prevalent, in hospital settings and in other ways, and insurance companies began to understand that they could influence the price of a medication by including them on their primary, on their formulary.”
Formularies are lists of prescription drugs covered by an insurance plan.
“You have patient steering, where the PBMs, the insurance companies, are steering their patients toward their pharmacy, and they reimburse their pharmacies more than they reimburse independent retail pharmacies,” Carter said. “Secondly, you know, there are oftentimes when the independent retail pharmacy can’t even participate, can’t even service the patient.”
Carter said there are many cases where pharmacies are reimbursed less by insurance than the drug costs. Because of issues making ends meet, hundreds of independent retail pharmacies are closing every year.
Meanwhile, major health care companies are gobbling up independent pharmacies, only to close down hundreds of stores a year themselves.
UnitedHealthcare CEO murder suspect fights extradition to NY, denied bail in PA
New details continue to emerge about the man charged with murder in the killing the UnitedHealthcare CEO. And wildfires burn out of control in southern California as strong winds are forecast to make matters worse. These stories and more highlight your Unbiased Updates for Wednesday, Dec. 11, 2024.
UnitedHealthcare CEO murder suspect fights extradition to NY, denied bail in PA
Luigi Mangione remains in custody in Pennsylvania as he fights extradition to New York one week after authorities say he shot and killed UnitedHealthcare CEO Brian Thompson outside a Manhattan hotel.
The murder suspect did not waive his extradition to New York. That means Mangione will remain in custody in Pennsylvania as he has 14 days to challenge the detention.
The Manhattan District Attorney’s Office said it will seek a governor’s warrant to force extradition to New York where Mangione faces multiple charges, including second-degree murder. New York Gov. Kathy Hochul said she will sign a warrant for his extradition to ensure he is “tried and held accountable.”
Watch the @ABC7NY interview where Deputy Commissioner of @NYPDCT Rebecca Weiner and Chief of @NYPDDetectives Joseph Kenny discuss the ongoing investigation regarding the Midtown Manhattan homicide ⬇️ pic.twitter.com/3WH9Y0JkMJ
In court Tuesday, Mangione was denied bail on the felony charges of forgery and carrying a firearm without a license in Pennsylvania.
“He has indicated a plea of not guilty. The only charges that we’ve seen thus far, have been the ones here in Pennsylvania. And we have pled not guilty to those charges,” his attorney Thomas Dickey told reporters.
As the investigation in New York murder continues, NYPD Chief of Detectives Joseph Kenny told Fox News they are looking into whether the suspect suffered a back injury and filed any claims with the insurance industry prior to the shooting. Mangione’s roommate in Hawaii told various broadcasts Mangione’s back surgery caused him great pain and he was extremely angry about it.
Mangione had three pages of writing on him when he was arrested inside a Pennsylvania McDonald’s Monday morning, Dec. 9. The NYPD said the notes were addressed to “the feds” and told authorities he acted alone.
Investigators said Mangione may have been inspired by the Unabomber Ted Kaczynski and they’re working to determine whether Thompson was the target of “a symbolic takedown” against corporate corruption.
In November, Mangione’s mother had filed a missing persons report for him in San Francisco. According to the San Francisco Chronicle, that came after no one had heard from Mangione since July.
In a statement, Mangione’s family said, “Our family is shocked and devastated by Luigi’s arrest. We offer our prayers to the family of Brian Thompson and we ask people to pray for all involved.”
Fallout from South Korea’s short-lived martial law period
The fallout from South Korea’s martial law declaration widens as the imprisoned former defense minister attempted to take his own life.
Former Defense Minister Kim Yong-hyun, who is currently being detained at a facility in Seoul on alleged collusion with President Yoon Suk Yeol in imposing martial law last week, attempted to take his own life late Tuesday night.https://t.co/aHM6HP5TUS
Authorities said former defense minister Kim Yong-hyun has been moved to an isolation room after an attempt on his own life before his formal arrest warrant was issued Tuesday night. Kim was the first public figure to be detained over the martial law declaration on Dec. 3 and is accused of being the one to recommend the move.
Separately Tuesday, South Korean police said they sent officers to search President Yoon Suk Yeol’s office as part of the investigation into the declaration.
Yoon is now banned from leaving the country as police and prosecutors investigate whether he and his supporters in the government as well as the military committed an insurrection when they sent armed troops into the National Assembly last week to try to prevent lawmakers from gathering to cancel the martial law decree. They were ultimately unsuccessful; lawmakers voted unanimously to end martial law just six hours after it was put in place.
Investigators have vowed to arrest, or at least detain, Yoon, who is still the country’s president. He refused to resign after an impeachment attempt on Saturday, Dec. 8, failed when members of his party left parliament and boycotted the vote.
The country’s main opposition party says it’s preparing a new impeachment motion and a vote on that is expected as early as this Saturday, Dec. 14.
Malibu wildfire reaches more than 3,000 acres, 0% contained
Firefighters in Southern California are battling a raging wildfire that has prompted evacuations and damaged homes in the affluent beach community of Malibu, northwest of Los Angeles. The Franklin Fire has spread to more than 3,000 acres and was 0% contained as of CalFire’s update at 9:47 p.m. PT Tuesday.
The fast-moving inferno broke out late Monday night and quickly grew, fueled by strong Santa Ana winds. Some gusts were reported as strong as 90 miles per hour.
Widespread Red Flag conditions across much of Southern California due to Santa Ana Winds will continue to be a threat to residents and property throughout the week.
The Franklin Fire in L.A. County has already consumed over 2200 acres this morning, forcing many evacuations. For… pic.twitter.com/7diQcNdi6B
More than 1,500 firefighters had been assigned to battle the flames and smoke.
Students, teachers and administrators at Pepperdine University were told to shelter in place as the fire kept getting closer and closer. Final exams were canceled.
There have been no reports of deaths or serious injuries, but officials said the fire has destroyed at least seven homes so far. The National Weather Service forecast days of extreme dry windy weather ahead.
Federal judge blocks sale of Infowars to The Onion
Jones was forced to put the platform up for sale to help pay $1.5 billion in damages that he owes to the families of the Sandy Hook Elementary School shooting victims for falsely claiming the massacre in Connecticut was a hoax.
Tuesday night, a federal bankruptcy judge said there was a lack of transparency in the auction process, and it failed to maximize value for the victims’ families, even though they had given their approval for Infowars to be sold to The Onion for an undisclosed amount of money.
NJ lawmaker calls for ‘limited state of emergency’ over drones
Republican state Sen. Jon Bramnick said mysterious drones seen flying over New Jersey in recent weeks should prompt a “limited state of emergency.” Bramnick said in a statement New Jersey should ban all drones until the public receives an explanation regarding these multiple sightings.
His statement came after the mayors of 21 New Jersey towns wrote a letter to Gov. Phil Murphy demanding action.
The FBI so far has only said it is doing all it can to figure out what is going on and the public can continue to call in tips.
This comes a year after GM grounded its fleet of driverless vehicles after an accident in California that led to Cruise being fined $1.5 million.
GM, which owns about 90% of Cruise, said it intends to buy the remainder of the company and will combine GM and Cruise technical teams. GM cited an “increasingly competitive robotaxi market” as one reason it will no longer fund the business.
Cruise founder Kyle Vogt, who left the company in 2023, reacted to the news on X saying, “In case it was unclear before, it is clear now: GM are a bunch of dummies.”
Anthem cancels controversial anesthesia policy after widespread outrage
Anthem Blue Cross Blue Shield is canceling a proposed policy change on anesthesia coverage after extensive backlash. On Nov. 1, Anthem announced they would soon cap anesthesia coverage to a certain time limit and would deny anesthesia claims that exceeded the allotted minutes.
While the American Society of Anesthesiologists promptly reacted to the proposal, the policy did not gain widespread attention until the assassination of UnitedHealthcare CEO Brian Thompson. After a day of public outcry, Anthem told Straight Arrow News they are canceling the policy.
“There has been significant widespread misinformation about an update to our anesthesia policy,” Anthem BCBS told Straight Arrow News in a statement. “As a result, we have decided to not proceed with this policy change. To be clear, it never was and never will be the policy of Anthem Blue Cross Blue Shield to not pay for medically necessary anesthesia services. The proposed update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well-established clinical guidelines.”
Original story: People are outraged over a health insurance company’s new policy on paying for anesthesia. Anthem Blue Cross Blue Shield will soon cap anesthesia coverage to a certain time limit. If insurance is billed for a patient’s anesthesia needs that exceed that set amount of time, Anthem says it’ll deny the claim.
The new policy would affect patients with Anthem coverage in Connecticut, Missouri, and New York starting Feb. 1, 2025.
The killing unleashed a social media fury, revealing what many Americans think about health insurance companies. That brought this little-known anesthesia change to light.
When she heard about it Wednesday, New York Gov. Kathy Hochul, D, called it “outrageous,” and said, “I’m going to make sure New Yorkers are protected.”
Anthem said it’ll use, “CMS Physician Work Time values to target the number of minutes reported for anesthesia services. Claims submitted with reported time above the established number of minutes will be denied.”
The only exclusions are patients younger than 22 years old and maternity-related care.
“This is just the latest in a long line of appalling behavior by commercial health insurers looking to drive their profits up at the expense of patients and physicians providing essential care,” ASA President Dr. Donald E. Arnold said. “This egregious policy breaks the trust between Anthem and its policyholders who expect their health insurer to pay physicians for the entirety of the care they need.”
Arnold called it “a cynical money grab by Anthem.”
The criticism continued on social media and drew the attention of several politicians and doctors.
babe wake up your surgery isn’t done yet but we can’t afford anymore anesthesia https://t.co/5nWfrluA9e
Biden proposes requiring Medicare and Medicaid to cover weight loss drugs
As President Joe Biden wraps up his term, his administration is proposing that Medicare and Medicaid cover popular weight loss medications. The new rule would dramatically expand access to anti-obesity drugs like Wegovy, Ozempic and Mounjaro.
As of now, Medicare and Medicaid only cover these drugs if they’re prescribed to treat certain conditions like diabetes. This new proposal could provide coverage for patients looking to use them exclusively for weight loss.
The change would dramatically reduce out-of-pocket costs for the drugs, which can cost more than $1,000 for a month’s supply, according to the White House. The CDC estimates more than 40% of Americans are considered obese and could benefit from these drugs.
The new rule would expand access to the drugs for 3.4 million Americans who use Medicare and another 4 million people enrolled in Medicaid, White House officials said.
How family caregivers can navigate challenges and access support
November is National Family Caregivers Month, a time to recognize the efforts of family caregivers across the United States. While caregiving provides meaningful rewards, it also comes with significant challenges because of the physical, emotional and financial strain.
This role involves assisting aging, ill or disabled loved ones with tasks like managing medications, providing personal care and overseeing daily activities.
According to a 2020 report by the AARP, an estimated 53 million unpaid caregivers were in the U.S. That figure represents an increase of 9.5 million compared to 2015.
While many caregivers willingly take on this role, this same study found nearly a quarter of them report difficulties maintaining their own health. Some even said their health had worsened as a result of their caregiving responsibilities.
The financial contribution of caregivers is also substantial. AARP estimated in 2021 that unpaid family caregivers provided care valued at $600 billion.
Financial support for caregivers
For those looking to ease the financial burden, USA.gov outlines several options for family members to get paid as caregivers:
State Medicaid programs: Some states allow caregivers to receive compensation through Medicaid programs, though eligibility requirements vary. Contact your state’s Medicaid office for more information.
Long-term care insurance: Certain policies allow family members to be compensated for caregiving.
Veterans programs: Three programs are available for veterans and their caregivers.
Other resources: Paid family leave and assistance from Local Area Agencies on Aging (AAA) are additional options to explore.
Supporting caregivers’ health
The Center for Disease Control and Prevention (CDC) offers recommendations to help caregivers maintain their health and well-being:
Respite care: Taking periodic breaks from caregiving responsibilities can reduce stress and improve overall well-being.
Seek support: Family, friends, health care providers, nonprofit organizations or government agencies can provide help with tasks or emotional support.
Offer support to caregivers: If you know a caregiver, simple gestures like running errands or checking in regularly can make a big difference.
Caregiving plays an essential role in many families but it requires both emotional and financial support. Understanding the resources available can help caregivers manage their responsibilities and maintain their well-being.