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Health Brief: CBO Analysis of Senate Health Bill Delayed


Government Brief

  • The Congressional Budget Office won’t release a cost estimate of the Senate health care legislation on Monday as was expected. The delay gives the nonpartisan budget analysts more time to score the revised bill, but it is unclear whether the projection will take into account a contentious proposal from Sen. Ted Cruz (R-Texas) to allow insurers offer stripped-down plans. (Bloomberg)
  • Senior Trump administration officials seeking to lobby support for Senate Republicans’ health care push received a chilly reception from governors of both parties at a closed-door meeting in Rhode Island. (The New York Times)
  • The Senate’s postponed procedural vote on the health care bill energized Republican critics of the legislation, with Sen. Rand Paul (R-Ky.) predicting it would strengthen opposition efforts by giving them more time to mobilize against the measure. (The Washington Post)

Business Brief

  • The health insurance lobby denounced the inclusion of the Cruz amendment in unusually pointed words, warning that it would send premiums skyrocketing for people with high medical costs. (Vox)
  • Clinical laboratories, outpatient heart labs and a bladder cancer drug lobbied federal government policymakers to secure favorable policies in Medicare’s latest payment rules. (Axios)
  • After successfully lobbying a decade ago to keep their tax-exempt status, the nation’s largest not-for-profit hospitals have had a boost in revenues. But that hasn’t stopped them from cutting spending on charity care. (Politico)

Chart Review

Events Calendar (All Times Local)

Monday
Center for American Progress Action Fund event on drug prices with Rep. Pallone 10 a.m.
Tuesday
The Hill hosts an event on mental health care with Gov. McAuliffe, Rep. Lance 8:20 a.m.
House Energy and Commerce subcommittee hearing on 340B drug pricing program 10:15 a.m.
National Pharmaceutical Council webinar on out-of-pocket costs 12 p.m.
Wednesday
House Ways and Means subcommittee hearing on waste, fraud and abuse in Medicare 10 a.m.
Manhattan Institute event on drug pricing with former Sen. Coburn 10 a.m.
National Press Foundation event on preventative health care 1:45 p.m.
Senate Competitiveness Caucus event on drug production 3:30 p.m.
Thursday
The Hill event on the drug delivery system 8 a.m.
House Energy and Commerce subcommittee hearing on bipartisan reforms to Medicare 10 a.m.
Friday
No events scheduled

General

No CBO Health Score Monday as McConnell Delays Vote for McCain
Laura Litvan, Bloomberg

The Congressional Budget Office won’t release a score on the revised Republican health care bill on Monday, as many had expected, as consideration of the controversial measure is delayed by a medical scare for one of its potential Senate backers. Majority Leader Mitch McConnell said late Saturday that he’s postponing plans to begin Senate debate in the next few days after Republican Senator John McCain said he’ll be home in Arizona recovering from unexpected surgery.

GOP opponents to Senate health-care bill see vote delay as an advantage
Elise Viebeck, The Washington Post

Republican critics of the Senate’s latest version of health-care legislation were energized after leaders postponed votes on the measure, yet another sign the bill’s fortunes are in limbo. A vocal conservative opponent of the measure, Sen. Rand Paul, predicted the delay would strengthen critics’ position by giving them more time to mobilize against the bill.

Governors Give Chilly Reception to Health Bill Push
Jonathan Martin and Alexander Burns, The New York Times

A handful of Republican governors rebuffed on Saturday an attempt by their Democratic counterparts to issue a joint statement from the nation’s governors expressing opposition or even concern about the Senate health care bill. But a smaller, bipartisan group of influential governors still may release a statement of their own in the coming days, a move that would greatly imperil passage of a measure that is already listing.

More hurdles as Senate again delays vote on GOP health bill
Hope Yen and Erica Werner, The Associated Press

The Senate delayed a highly anticipated vote this coming week to repeal and replace the nation’s health care law after Sen. John McCain’s announced absence due to surgery, an enormous setback as time dwindles for Republicans to pass the signature legislation after years of promises. The decision by Senate Majority Leader Mitch McConnell late Saturday came not long after McCain’s office disclosed that he had undergone surgery to remove a blood clot from above his left eye.

How the White House and Republicans underestimated Obamacare repeal
Nancy Cook and Burgess Everett, Politico

The longer Republican efforts to repeal Obamacare flounder, the clearer it becomes that President Donald Trump’s team and many in Congress dramatically underestimated the challenge of rolling back former President Barack Obama’s signature achievement. The Trump transition team and other Republican leaders presumed that Congress would scrap Obamacare by President’s Day weekend in late February, according to three former Republican congressional aides and two current ones familiar with the administration’s efforts.

European Stocks Retreat; Metals Jump on China Data: Markets Wrap
Samuel Potter, Bloomberg

Economic data was the key driver for markets on Monday, with industrial metals and mining companies rallying on better-than-expected Chinese growth and stocks retreating after European inflation figures. The U.S. dollar steadied while the euro and pound fell as Brexit negotiations resumed.

Payers

Insurers shred Senate health care bill: “Premiums will skyrocket for preexisting conditions”
Dylan Scott, Vox

Health insurance companies have largely bit their tongues about the Senate health care plan, but they are turning against it now, warning that a recent revision would send premiums skyrocketing for people with high medical costs. The insurance industry has been one of the few health care sectors to even tentatively embrace the Senate’s plan, as Vox has documented, but that has changed in the last few days.

The subtle lobbying wins in Medicare’s outpatient rule
Bob Herman, Axios

Several health care company executives and lobbyists who quietly met with federal government policymakers a couple months ago secured favorable policies in Medicare’s latest payment rules. Clinical laboratories, outpatient heart labs and a bladder cancer drug each won particular measures.

In Clash Over Health Bill, a Growing Fear of ‘Junk Insurance’
Reed Abelson, The New York Times

Julie Arkison remembers what it was like to buy health insurance before the Affordable Care Act created standards for coverage. The policy she had was from the same insurer that covers her now, but it did not pay for doctor visits, except for a yearly checkup and gynecological exam.

In an arid, lonely stretch out west, the health coverage that bloomed is now at risk
Amy Goldstein, The Washington Post

In this speck of high desert, along a stretch of highway that Life magazine once called the loneliest road in America, the only doctor in town comes just one day a week. In the past few years, though, health insurance has arrived in force.

Health-Law Taxes Divide the GOP, Signaling a Shift
Richard Rubin, The Wall Street Journal

Republican efforts to pass a health-care bill have revealed a party fissure on tax policy with potentially far-reaching repercussions. In his latest attempt to rewrite President Barack Obama’s signature health-care law, Senate Majority Leader Mitch McConnell (R., Ky.) retained a 3.8% investment-income tax and a 0.9% payroll tax that apply to individuals earning more than $200,000 and married couples earning more than $250,000.

The Kodiak Kickback: the quiet payoff for an Alaska senator in the Senate health bill
Jeff Stein, Vox

Buried in Senate Republicans’ new health care bill is a provision to throw about $1 billion at states where premiums run 75 percent higher than the national average. Curiously, there’s just one state that meets this seemingly arbitrary designation: Alaska.

Health Insurers Try Paying More Upfront To Pay Less Later
Mark Zdechlik, Minnesota Public Radio

Michael McBrayer of St. Paul, Minn., needs to pay a lot attention to his health. “I give myself shots multiple times a day, as well as controlling my diet and exercise,” he said.

Providers

How hospitals got richer off Obamacare
Dan Diamond, Politico

A decade after the nation’s top hospitals used all their advertising and lobbying clout to keep their tax-exempt status, pointing to their vast givebacks to their communities, they have seen their revenue soar while cutting back on the very givebacks they were touting, according to a POLITICO analysis. Hospitals’ behavior in the years since the Affordable Care Act provided them with more than 20 million more paying customers offers a window into the debate over winners and losers surrounding this year’s efforts to replace the ACA.

Pharma, Biotech and Devices

Big Pharma Spends on Share Buybacks, but R&D? Not So Much
Gretchen Morgenson, The New York Times

Under fire for skyrocketing drug prices, pharmaceutical companies often offer this response: The high costs of their products are justified because the proceeds generate money for crucial research on new cures and treatments.

AstraZeneca’s CEO? We Still Don’t Know If He’s Staying or Going
Chip Cummins, The Wall Street Journal

The mystery surrounding the intentions of the chief executive of AstraZeneca AZN 4.57% PLC, one of the world’s largest pharmaceutical firms, remains…a mystery. Two days after an Israeli news report said Chief Executive Pascal Soriot had agreed to take the top job at a rival drug giant, Israel-based Teva Pharmaceutical Industries Ltd. TEVA -3.89% , AstraZeneca continues to say it won’t comment, labeling that report—and more recent reports that he is staying on—as market rumors and speculation.

The Trump administration says a new plan will cut drug prices. It’s not that simple
Erin Mershon, Stat News

When the Trump administration unveiled a new Medicare proposal this week to cut payments to hospitals as part of a drug reimbursement program, Health and Human Services Secretary Tom Price called the plan a “significant step toward fulfilling President Trump’s promise to address rising drug prices.” It may not be that simple.

Health IT

Senators push CMS to recoup improper Meaningful Use payments; physicians cry foul
Matt Kurht, Fierce Healthcare

Two Republican senators are asking the Centers for Medicare & Medicaid Services why the agency hasn’t taken action to recoup $729 million worth of Meaningful Use incentive program overpayments. As part of a program to encourage providers to shift to electronic health records, CMS incorrectly paid an estimated $729 million in incentive payments to healthcare professionals who did not actually meet Meaningful Use requirements between May 2011 and June 2014, according to the audit (PDF) by the Department of Health and Human Services’ Office of Inspector General (OIG).

Opinions, Editorials and Perspectives

Cancer Data Being Suppressed by International Organization
Dan Perrin, Morning Consult 

Right now, there is a controversy that has called into question a finding by an international organization that a common chemical is a cancer-causing agent. Last month, Reuters reported on new data that might mean the final nail in the coffin for allegations that glyphosate, the active ingredient in the world’s most widely used weed killer, is a known carcinogen.

The next step on health care: Let the states decide
Bill Cassidy, The Washington Post

We do not know whether Senate Republicans will pass the latest plan to replace Obamacare. But something must be done.

Health Care Coverage Is Not Enough. We Need Delivery System Reform.
Donald M. Berwick, HuffPost

It’s well known that the bill to repeal the Affordable Care Act (ACA) now making its way through the Senate would deny coverage to tens of millions of Americans. Less well known is that it would also hit the brakes on “delivery system reform,” the work of doctors and hospitals to improve quality and reduce costs. In other words, it would make quality of care worse.

The fundamental error in the CBO’s health-care projections
Marc Short and Brian Blase, The Washington Post

In the coming days, the Congressional Budget Office will release an updated analysis of the Senate bill to repeal and replace Obamacare. The CBO will likely predict lower health insurance coverage rates if the bill becomes law.

Republicans Leap Into the Awful Known
Paul Krugman, The New York Times

Sometime in the next few days the Congressional Budget Office will release its analysis of the latest version of the Republican health care plan. Senator Mitch McConnell is doing all he can to prevent a full assessment, for example by trying to keep the C.B.O. from scoring the Cruz provision, which would let insurers discriminate against people with pre-existing conditions.

Research Reports

Can Financial Incentives Help People Trying to Establish New Habits? Experimental Evidence with New Gym Members
Mariana Carrera, The National Bureau of Economic Research

We conducted a randomized controlled trial testing the effect of modest incentives to attend the gym among new members of a fitness facility, a population that is already engaged in trying to change a health behavior. Our experiment randomized 836 new members of a private gym into a control group, receiving a $30 payment unconditionally, or one of 3 incentive groups, receiving a payment if they attended the gym at least 9 times over their first 6 weeks as members.