Health Brief: ACA Repeal Could Stretch Into Spring

Washington Brief

  • Congressional Republicans could begin their efforts to repeal the Affordable Care Act as soon as Tuesday by introducing a budget resolution in the Senate, though the process could stretch into early spring, or later. Several questions still remain about what legislation repealing the 2010 health care law will include. (The Washington Post)
  • Vice President-elect Mike Pence will meet with House Republicans Wednesday to discuss plans for the Obamacare repeal, the same day President Barack Obama will huddle with Hill Democrats to plot their pushback to GOP efforts. (Politico)
  • Top House Democrats are stressing the benefits of the ACA, hoping to rally public support for the law as Republicans hope to repeal it. (The Associated Press)

Business Brief

  • Some Obama-era changes to how health care is provided and paid for have significantly changed how some health systems operate, and could extend past a potential repeal of the health care law that sparked such reforms. (The New York Times)
  • Industry groups face many unknowns in the new year, and some are finding it difficult to plan ahead when they don’t know what types of reforms are coming to the health care industry. (Modern Healthcare)
  • The number of new drugs approved by the Food and Drug Administration last year hit a six-year low, dropping sharply compared to the previous two years. Agency officials pointed, in part, to receiving fewer applications from drugmakers and rejecting or delaying more requests. (Washington Examiner)

Chart Review

Supporting Family Caregivers of Older Americans
New England Journal of Medicine

Events Calendar (All Times Local)

115th Congress Convenes 12 p.m.
President Obama Meets With Hill Democrats on Obamacare 9 a.m.
No events scheduled
No events scheduled



Outlook for 2017: Healthcare re-reform
Harris Meyer, Modern Healthcare

2017 had been shaping up as a year focused on fixing the Affordable Care Act’s insurance markets, slowing prescription drug price hikes, expanding Medicaid, improving mental healthcare and spreading value-based payment and delivery. Suddenly there’s a new, more conservative agenda. And almost everything in healthcare is up in the air.

Pence to huddle with House Republicans Wednesday
Rachael Bade, Politico

Vice President-elect Mike Pence will rally House Republicans Wednesday morning on a plan to repeal Obamacare, POLITICO has learned — a counter-punch to President Barack Obama’s visit to the Hill the same day. Pence will meet with the full House Republican Conference to talk about the party’s plan to dismantle Obama’s signature health care law, according to a House Republican leadership aide.

Zika threat isn’t over, CDC director warns pregnant women thinking about beach vacations
Helen Branswell, Stat

Over the past year, the Centers for Disease Control and Prevention took the extraordinary step of urging pregnant women to avoid travel to dozens of mainly Latin American countries to stave off infection with the Zika virus. With inclement weather prompting Americans to muse about winter vacations in sunny climes, the CDC wants to make it clear: That recommendation still stands.

Here are the eight Trump Cabinet picks Democrats plan to target
Ed O’Keefe, The Washington Post

Democratic senators plan to aggressively target eight of Donald Trump’s Cabinet nominees in the coming weeks and are pushing to stretch their confirmation votes into March — an unprecedented break with Senate tradition. Such delays would upend Republican hopes of quickly holding hearings and confirming most of Trump’s top picks on Inauguration Day.

Stocks Gain With Commodities Amid China Optimism: Markets Wrap
Adam Haigh and Eddie Van Der Walt, Bloomberg News

Stocks rose with commodities on signs China’s economy is strong enough for policy makers to keep pushing for economic reforms in 2017. Crude touched an 18-month high and bonds fell.


Why Obamacare is unlikely to die a swift death
Kelsey Snell and Mike DeBonis, The Washington Post

Congressional Republicans have long boasted that once they claim the reins of power, they will act quickly and decisively to roll back what they view as the most onerous piece of President Obama’s domestic agenda: the Affordable Care Act. But their actions starting Tuesday to end Obamacare will be far less sweeping, at least initially, than a full-blown repeal of the law.

Job No. 1 for a New Congress? Undoing Obama’s Health Law
Robert Pear, The New York Times

House Republicans Fret About Winning Their Health Care Suit
Carl Hulse, The New York Times

Congressional Republicans have a new fear when it comes to their two-year-old health care lawsuit against the Obama administration: They might win. The incoming Trump administration could choose to no longer defend the executive branch against the suit, which challenges the administration’s authority to spend billions of dollars on health insurance subsidies for low- and moderate-income Americans, handing House Republicans a big victory on separation-of-power issues.

Dems, GOP get ready for showdown on Obamacare
Jennifer Haberkorn and Rachana Pradhan, Politico

The long-standing fight over Obamacare’s repeal is about to become a battle over messaging. Instead of doing a victory lap after they start dismantling the law in January, Republicans will not only have to rewrite a massive law, they’ll have to quickly sell the public on the idea that their plan is cheaper and won’t leave millions of Americans uninsured.

Republicans Primed for Push to Dismantle Obama’s Policies
Richard Lardner, The Associated Press

Members of the 115th Congress will be sworn in at noon Tuesday, setting off an aggressive campaign by Republicans who control the House and Senate to dismantle eight years of President Barack Obama’s Democratic policies. One of the biggest and most immediate targets is Obama’s Affordable Care Act, which many Republicans have long sought to gut and has been blamed as a primary cause for a lackluster economic recovery.

Democrats Extol Health Care Law in Bid to Derail GOP Repeal
Richard Lardner, The Associated Press

Senior House Democrats on Monday extolled the benefits of President Barack Obama’s health care law in hopes of derailing Republican plans to gut the statute and over time replace it. In a conference call with reporters, House Minority Leader Nancy Pelosi said the GOP will begin its “assault” on the health care law when the 115th Congress convenes Tuesday.

Democrats to Demand Trump Veto Changes to Medicare and Social Security
Niels Lesniewski, Roll Call

The top Democrats in the House and Senate want President-elect Donald Trump to pledge to veto legislation that would slash Medicare and Social Security benefits. House Minority Leader Nancy Pelosi of California and incoming Senate Minority Leader Charles E. Schumer of New York joined with Sen. Bernie Sanders, I-Vt., in a “Dear Colleague” letter that asks members of Congress to hold rallies and events on Jan. 15 (the Sunday before Trump’s inauguration) to oppose the Republican budget plan.

House, Senate headed for clash on Medicare
Alexander Bolton, The Hill

Senate and House Republicans are headed for a clash over whether to tackle Medicare reform under President-elect Donald Trump. Senate Republican leaders prefer to focus narrowly on an ObamaCare replacement bill that does not contain changes to Medicare — a cautious approach that reflects their slim majority.

Aetna Fight for Humana Awaits Judge’s Ruling in U.S. Case
David McLaughlin, Bloomberg News

Aetna Inc.’s fight to complete its purchase of Humana Inc. is now with a federal judge who must decide whether the combination of the two health insurers should be blocked because it risks raising consumers’ costs. U.S. District Judge John D. Bates in Washington heard final arguments Friday from the companies and the Justice Department about the $37 billion deal, which the government says should be stopped.


After Obama, Some Health Reforms May Prove Lasting
Abby Goodnough and Robert Pear, The New York Times

Fragments of bone and cartilage arced across the operating room as Dr. R. Michael Meneghini drilled into the knee of his first patient at a hospital here at dawn. Within an hour, the 66-year-old woman had a replacement joint made of titanium and cobalt chrome, and she was sent home the next day.

Hospitals in Safety Net Brace for Health Care Law’s Repeal
Abby Goodnough, The New York Times

Jason Colston Sr. went to the emergency room at Temple University Hospital last month with his calf swollen to twice its normal size. A bacterial infection had entered his bloodstream, requiring him to spend nine days at Temple, where patients are overwhelmingly poor.

Cleveland Clinic CEO Said to Be Out of Running for VA Secretary
Shannon Pettypiece and Jennifer Jacobs, Bloomberg News

Cleveland Clinic chief Toby Cosgrove has withdrawn his name from consideration as secretary of the Department of Veterans Affairs, a post that would have put him in charge of the health care and benefits of more than 20 million U.S. veterans, a source familiar with the matter said. Chief aides of President-elect Donald Trump wanted Cosgrove for the job, but asked him to tell them if he could make this commitment before they made the formal offer, the source said.

Pharma, Biotech and Devices

Drug approvals lowest in six years
Paige Winfield Cunningham, Washington Examiner

Drug approvals in 2016 were down sharply from the year before and were the lowest in six years. The Food and Drug Administration gave the nod to just 22 new medications, after approving 45 new drugs in 2015.

Soaring insulin prices prompt insurance shift
Jayne O’Donnell, USA Today

Many parents of diabetic children and adults suffering with type 1 or type 2 diabetes are bracing for changes in insurance coverage of their insulin next year, as prices of the vital medication continue to soar. Higher insurance deductibles and changes in the prescription brands covered by some insurers are raising concerns among some people with diabetes.

Costly Drug for Fatal Muscular Disease Wins F.D.A. Approval
Katie Thomas, The New York Times

The Food and Drug Administration has approved the first drug to treat patients with spinal muscular atrophy, a savage disease that, in its most severe form, kills infants before they turn 2. “This is a miracle — seriously,” Dr. Mary K. Schroth, a lung specialist in Madison, Wis., who treats children who have the disease, said of the approval, which was made last week.

Abbott gets U.S. antitrust approval to buy St. Jude Medical
Diane Bartz, Reuters

Healthcare company Abbott Laboratories has won U.S. antitrust approval for its proposed $25 billion acquisition of medical device maker St. Jude Medical Inc, the U.S. Federal Trade Commission said on Tuesday. Abbott agreed to divest two medical devices used in cardiovascular procedures to resolve FTC concerns the acquisition would stifle competition, the commission said in a statement.

Health IT

Food and Drug Administration final guidance protects medical devices from hacks
Joseph Conn, Modern Healthcare

The Food and Drug Administration has finalized guidance on keeping medical devices such as pacemakers and insulin pumps safe from hacks. Device makers should develop “a structured and comprehensive program to manage cybersecurity risks” even after their products are sold, according to Dr. Suzanne Schwartz, associate director for science and strategic partnerships at the FDA’s Center for Devices and Radiological Health.

Opinions, Editorials and Perspectives

Tom Price as HHS Secretary, Seema Verma to CMS: What to Watch For
William Pierce, Morning Consult

Based on my experience as a senior staffer at HHS under former Secretary Tommy Thompson, there are a couple of truisms that are important as we evaluate the nomination of Tom Price as HHS Secretary and Seema Verma as CMS Administrator. In practical terms, the HHS Secretary is a huge management position that requires the requisite skills.

Repeal all of Obamacare and replace immediately
Sen. Rand Paul (R-Ky.), Rare

Congress will, as its first course of action, vote to repeal Obamacare. It cannot happen soon enough.

The Health Data Conundrum
Kathryn Haun and Eric J. Topol, The New York Times

There’s quite a paradox when it comes to our health data. Most of us still cannot readily look at it, but there’s been an epidemic of cybercriminals and thieves hacking and stealing this most personal information.

Snatching Health Care Away From Millions
Paul Krugman, The New York Times

If James Comey, the F.B.I. director, hadn’t tipped the scales in the campaign’s final days with that grotesquely misleading letter, right now an incoming Clinton administration would be celebrating some very good news. Because health reform, President Obama’s signature achievement, is stabilizing after a bumpy year.

‘Reconciliation’ Could Roll Back Obamacare but Roil Senate
Daniel J. Hemel and David J. Herzig, The Wall Street Journal

The effort by the GOP to peel away parts of the Affordable Care Act could also lead to a showdown over how the Senate runs, due to Republicans’ use of a special Senate rule that allows certain legislation to move through with a simple majority, rather than the 60-vote supermajority typically required. In this rollback push, Republicans are turning to a process called budget reconciliation.

Repeal and Delay Is Forever
Jonathan Chait, New York Magazine

The Republican Party has used health care to its advantage for the last seven years by following the same strategy: advocating an alternative plan that does not and cannot exist. During this entire time, President Obama has held power.

Research Reports

As Millions of Americans Sign Up for ACA Coverage, a New Study and Consumers’ Stories Point to Reform’s Successes
Sara R. Collins, The Commonwealth Fund

Despite the threat of repeal, Affordable Care Act (ACA) marketplace enrollment is running ahead of last year’s pace. This week, the U.S. Department of Health and Human Services (HHS) reported that 6.4 million people have newly enrolled in health plans through, the ACA’s federal health insurance marketplace.

Supporting Family Caregivers of Older Americans
Jennifer L. Wolff et al., New England Journal of Medicine

Every day, millions of older Americans (those 65 years of age or older) manage basic health and functioning needs with the help of family caregivers. These family caregivers (defined as relatives, partners, friends, or neighbors who provide help because of a personal relationship rather than financial compensation) may arrange and attend medical appointments, participate in routine and high-stakes treatment decisions, coordinate care and services, help with daily tasks such as dressing and bathing, manage medicines, obtain and oversee the use of medical equipment, handle bills and banking, and ensure that older adults’ needs for food and shelter are met.