Health Brief: Administration Members With House Experience Struggle to Strike Health Bill Deal

Washington Brief

  • Despite a combined 30 years of experience serving in the House, Vice President Mike Pence, Health Secretary Tom Price and Budget Director Mick Mulvaney have struggled to reach a deal with their former colleagues on a plan to replace the Affordable Care Act. (The Wall Street Journal)
  • The White House’s latest concession to conservatives — a plan to reduce premiums — would need to cut payments to doctors and hospitals and would require billions of dollars in extra government spending to meet its goals, according to an analysis by consulting firm Milliman Inc. (Bloomberg News)
  • A coalition of liberal groups launched a seven-figure TV ad buy slamming moderate Republicans in seven competitive districts over the GOP’s now-stalled Obamacare replacement plan. (Politico)

Business Brief

  • Despite Republican pronouncements about the demise of Obamacare’s individual insurance market, a Standard & Poor’s analysis shows that insurers significantly reduced their losses last year, are likely to break even this year and that most could turn at least a small profit in 2018. (The New York Times)
  • A measure moving through the Maryland General Assembly would give the state attorney general the power to sue drug companies that dramatically increase the price of off-patent or generic drugs. (The Washington Post)
  • Most expenditures of health care billionaire Patrick Soon-Shiong’s research foundation flow to his own businesses and nonprofits, and the majority of its grants have gone to entities that have business deals with his for-profit firms. (Politico)

Chart Review

Events Calendar (All Times Local)

National Coalition on Health Care forum on Medicaid per capita allottments 10 a.m.
No events scheduled
Manhattan Institute event on “Yelp for Health” 12 p.m.
No events scheduled
No events scheduled



Trump Administration’s House Veterans Struggle to Rally Support in Chamber
Kristina Peterson, The Wall Street Journal

They had 30 years of combined service in the House of Representatives, deep ties to the Republican Party’s conservative wing and the backing of a president who is popular with their party’s base. But three former congressmen now serving at the top ranks of the Trump administration misread their former House colleagues and failed, at least so far, in their effort to push an overhaul of the Affordable Care Act through the chamber.

TV ads slam Republicans over would-be Obamacare repeal
Kyle Cheney, Politico

Moderate House Republicans who flirted with supporting the GOP’s now-stalled Obamacare replacement will face attack ads in their districts this week for doing so. Save My Care, a coalition of left-leaning health care advocacy groups fighting to preserve Obamacare, is launching a seven-figure TV ad buy in seven competitive House districts across the country.

Reversal: Some Republicans now defending parts of ObamaCare
Peter Sullivan, The Hill

The House’s debate over repealing ObamaCare has had an unintended effect: Republicans are now defending key elements of President Obama’s health law. Many House Republicans are now defending ObamaCare’s protections for people with pre-existing conditions, in the face of an effort by the conservative House Freedom Caucus to repeal them.

Healthcare creates 13,500 jobs in March as ACA repeal scare slowed growth
Maria Castellucci, Modern Healthcare

As plans to repeal and replace the Affordable Care Act took center stage last month, job growth in the healthcare sector slowed significantly. The industry produced 13,500 new jobs in March, which is much less than the 31,400 new positions created in February, according to the most recent jobs report issued Friday by the Bureau of Labor Statistics.

Stocks Mixed, Dollar and Oil Gain as Risks Linger: Markets Wrap
Adam Haigh and Samuel Potter, Bloomberg News

A sense of unease lingered across markets, with global stocks mixed as investors weighed looming security risks and French bonds retreating ahead of the election. The dollar edged higher with Treasuries and oil advanced.


No ‘Death Spiral’: Insurers May Soon Profit From Obamacare Plans, Analysis Finds
Reed Abelson, The New York Times

In contrast to the dire pronouncements from President Trump and other Republicans, the demise of the individual insurance market seems greatly exaggerated, according to a new financial analysis released Friday. The analysis, by Standard & Poor’s, looked at the performance of many Blue Cross plans in nearly three dozen states since President Barack Obama’s health care law took effect three years ago.

This community has slipped through the cracks of the US health care system
Helen Branswell, Stat News

Thousands of people in this northwestern corner of Arkansas, many of them working poor, are from a faraway constellation of islands, the most famous of which is known as Bikini. They can live and work here without visas.

Medicaid coverage for 715k Ohioans hangs in balance as debate rages
Laura A. Bischoff, Dayton Daily News

While John Kasich crusades across Ohio and the country to save Medicaid expansion — a key pillar of the Affordable Care Act — his Republican colleagues in Congress and the Ohio Statehouse are pretty clear that they don’t like it. In his 2017 State of the State address in Sandusky last week, Kasich recounted coming across a man on the side of the road in a rough part of Columbus.


GOP Health Plan Relies on Cutting Payments to Doctors, Hospitals
Zachary Tracer, Bloomberg News

A Republican health-care plan to lower insurance premiums would need to cut payments to hospitals and doctors to the same level as federally-set Medicare rates and would require billions of dollars in extra government spending to meet its goals, according to an independent analysis of the policy. The Republican amendment made Thursday adds what’s called the Federal Invisible Risk Sharing Program to the legislation to help appease conservatives and get the bill through the House.

Ex-New York assemblyman, doctors charged in illegal opioid prescription scheme: officials
Laila Kearney, Reuters

A former New York assemblyman and a dozen pain clinic workers were arrested on Friday, accused of operating some of the largest “pill mills” in the northeastern United States and illegally prescribing more than 6 million opioid pills, law enforcement officials said. Alec Brook-Krasny, who served in the New York State Assembly from 2006 to 2015 representing South Brooklyn, was charged with conspiracy and scheming to defraud by unlawfully selling prescriptions, the U.S. Drug Enforcement Administration’s New York division said in a statement.

Pharma, Biotech and Devices

Maryland on track to give attorney general power to sue for drug price-gouging
Ovetta Wiggins and Josh Hicks, The Washington Post

Maryland could become the first state to give its attorney general the power to take legal action against drug companies that dramatically increase the price of off-patent or generic drugs under a measure that is moving through the General Assembly. Attorney General Brian E. Frosh (D) proposed the legislation, which received final approval in the Senate on Friday.

China Emerges as Powerhouse for Biotech Drugs
Preetika Rana, The Wall Street Journal

A new cancer drug licensed by Eli Lilly LLY -0.05% & Co. was discovered by a six-year-old startup on the outskirts of Shanghai, and derived from the ovary cells of Chinese hamsters. Lilly now is planning to test it on Americans.

Health IT

How Washington’s favorite cancer fighter helps himself
Darius Tahir, Politico

Patrick Soon-Shiong, the California health care billionaire, believes the United States is fighting a flawed war on cancer, “stuck in dogma.” His bracing critique caught the attention of Joe Biden and, more recently, Donald Trump, who met privately with Soon-Shiong twice during the transition, as he reportedly angled for a role in the administration.

Opinions, Editorials and Perspectives

How Trump and the FDA Can Create a Pharmaceutical Manufacturing Renaissance
Ajaz Hussain et al., Morning Consult 

In January, President Donald Trump said, “We have got to get our drug industry back.” Later that month, at a meeting in the Oval Office with executives of eight large innovator pharmaceutical companies, he said he wanted them to bring drug prices “way down,” and promised to curb regulations and lower tax rates to boost their competitiveness.

Reviving Repeal and Replace
The Editorial Board, The Wall Street Journal

Republicans left Washington on Friday without a health-care deal, despite renewed negotiations after last month’s fiasco and a burst of White House diplomacy. Perhaps the two-week recess will be a cooling-off period and we hope the House’s factions can agree on a deal.

A warning from the polls about letting Obamacare “explode”
Drew Altman, Axios

President Trump has said the Democrats will take the fall politically if and when Obamacare “explodes.” But new polling shows that the public will hold Trump and the GOP accountable for failing to address problems in the marketplaces, not the Democrats.

Tom Price: Remember your roots as a Grady physician
Allyson Herbst, Stat News

Dear Secretary Price, In the wake of the recent failure to pass the American Health Care Act, I would like to share with you some reflections on the state of American health care from my perspective as a resident physician at Grady Memorial Hospital, Atlanta’s public hospital, where you trained in orthopedic surgery more than thirty years ago. I first heard about Grady when I was applying to medical school.

The Blame Game on Drug Prices Is Getting Dangerous
Charley Grant, The Wall Street Journal

Drug manufacturers and the companies that pay for drugs are once again squabbling over why medicines are so expensive. That has the potential to upend the opaque and very profitable three-way relationship among pharma companies, insurers and pharmacy-benefit managers.

Research Reports

The Effects of E-Cigarette Minimum Legal Sale Age Laws on Youth Substance Use
Dhaval Dave et al., The National Bureau of Economic Research

We use difference-in-differences models and individual-level data from the national and state Youth Risk Behavior Surveillance System (YRBSS) from 1991 to 2015 to examine the effects of e-cigarette Minimum Legal Sale Age (MLSA) laws on youth cigarette smoking, alcohol consumption, and marijuana use. Our results suggest that these laws increased youth smoking participation by 0.7 to 1.4 percentage points, approximately half of which could be attributed to smoking initiation.