Health Brief: Despite Health Bill Disagreements, Senate GOP Still Plans for Vote This Month

Washington Brief

  • Majority Leader Mitch McConnell is still aiming for a floor vote on the Senate’s health care bill by the end of June, even though lingering disagreements, particularly over Medicaid, threaten to derail their efforts. (The Washington Post)
  • Some Republicans are openly questioning their leaders’ approach to overhauling the nation’s health insurance system without holding a single hearing on their bill and without a formal, open drafting session. (The New York Times)
  • The result of Georgia’s special election, the most expensive House race in U.S. history, could hinge on protections for people with pre-existing health conditions. (Stat News)

Business Brief

  • Senior Trump administration officials are preparing an executive order aimed at lowering drug costs. One policy under consideration is value-based purchasing. (Bloomberg News)
  • In more than 10 states, a growing number of major insurers are planning premium hikes averaging 20 percent to account for instability on the individual marketplaces. (The Wall Street Journal)
  • Despite the strain on Obamacare exchanges across the country, Cleveland Clinic announced a new venture with insurer Oscar Health that will offer individuals coverage on and off the marketplaces. (Modern Healthcare)

Chart Review

Events Calendar (All Times Local)

No events scheduled



GOP Senate leaders aim to bring health-care legislation to the floor by end of June
Sean Sullivan and Kelsey Snell, The Washington Post

Senate Republican leaders are aiming to bring a major revision to the nation’s health-care laws to the Senate floor by the end of June even as lingering disagreements, particularly over Medicaid, threaten to derail their efforts, several Republicans familiar with the effort said Thursday. President Trump and Senate Majority Leader Mitch McConnell (R-Ky.) are pressing for an ambitious timeline to complete the bill, although it is being drafted in the Senate with little assistance from the White House.

Secrecy Surrounding Senate Health Bill Raises Alarms in Both Parties
Thomas Kaplan and Robert Pear, The New York Times

As they draft legislation to repeal the Affordable Care Act, Senate Republican leaders are aiming to transform large sections of the American health care system without a single hearing on their bill and without a formal, open drafting session. That has created an air of distrust and concern — on and off Capitol Hill, with Democrats but also with Republicans.

It’s the most expensive congressional race ever, and it may hinge on health care
Max Blau, Stat News

The most expensive congressional race in U.S. history may hinge on the wonky topic of preexisting conditions. Democrat Jon Ossoff, trying to seize a suburban Atlanta seat held by Republicans since 1979, has spent weeks railing against the GOP health care bill passed by House lawmakers this spring.

Conservatives Sound Alarm About Senate Health Bill
Kristina Peterson et al., The Wall Street Journal

Conservatives inside and outside the Senate GOP are sounding alarms over the emerging shape of the chamber’s bill to dismantle the Affordable Care Act, a sign that the faction’s support may be increasingly difficult to secure. Pressure from outside groups has intensified in recent days, and conservative lawmakers have signaled their concern that the Senate bill doesn’t do enough to curb spending on the Medicaid federal-state program for the poor or to reduce health-care premiums—two of their top goals.

Murkowski: ‘I just truly do not know’ if I can support GOP health bill
Nathaniel Weixel, The Hill

Sen. Lisa Murkowski (R-Alaska), a potential key swing vote on an ObamaCare repeal-and-replace plan, isn’t sure she could support the emerging Senate Republican healthcare bill. When asked Thursday if she had confidence she could eventually support a bill, Murkowski said she didn’t know.

Rand Paul denounces ‘new entitlements’ in emerging health bill
Peter Sullivan, The Hill

Sen. Rand Paul (R-Ky.) sharply criticized central elements of the emerging Senate Republican healthcare bill on Thursday, indicating that he will vote against it unless dramatic changes are made. Paul denounced as “new entitlements” two core elements of the Republican bill in both the House and Senate: a refundable tax credit to help people buy insurance and a “stabilization fund” of money to help bring down premiums.

Bipartisan medical marijuana legislation reintroduced
Kyle Stewart, Roll Call

A bipartisan group of senators and representatives have reintroduced legislation that would enable states to set their own medical marijuana policies. That is at odds with a letter U.S. Attorney General Jeff Sessions sent to congressional leaders, in which he asked that federal medical marijuana protections be reversed.

As Opioid Panel Meets, Some Say Action, Not Study, Is Needed
Abby Goodnough, The New York Times

Weeks before the presidential election, at a packed rally in New Hampshire, Donald J. Trump recounted the story of a young woman and her boyfriend who had fatally overdosed within a year of each other. He promised not just a border wall to keep drugs out, but also more access to treatment.

Shares End Week Stronger as Havens Yen, Bonds Fade: Markets Wrap
Eddie Van Der Walt, Bloomberg News

Global stocks bounced back from the previous session’s losses as shares in Europe were buoyed by corporate news. Havens including the yen and bonds declined while oil rose with metals.


Insurers Look to Ramp Up Premiums in Health Law Exchanges
Anna Wilde Mathews and Louise Radnofsky, The Wall Street Journal

A growing number of major insurers are seeking premium increases averaging 20% or more for next year on plans sold under the Affordable Care Act, according to rate proposals in more than 10 states that provide the broadest picture so far of the strains on the marketplaces. As Republicans try to pass a health-care bill to overhaul the ACA, the attention has focused on insurers’ withdrawals from a few states that risk leaving some consumers with no exchange plans next year.

Cleveland Clinic jumps into insurance biz with Oscar Health
Shelby Livingston, Modern Healthcare

While many health insurers are fleeing the individual market, health system Cleveland Clinic is jumping into the insurance business head first with the New York-based startup Oscar Health. Ohio’s Cleveland Clinic and the tech-focused Oscar said Thursday they are launching a joint venture health insurance company that will offer individuals coverage on and off the Affordable Care Act’s exchanges at a time when most other insurers are jumping ship because of financial losses and regulatory uncertainty perpetuated by the Trump administration and Republican-controlled Congress.

GOP chairman pushes for ObamaCare payments to be made
Rachel Roubein, The Hill

A top Senate Republican is calling for critical payments to insurers to be funded through 2019 either by administrative action, legislation or both. At a hearing Thursday, Sen. Lamar Alexander (R-Tenn.) — the chairman of the Senate Health, Education, Labor and Pensions Committee — made the recommendation for making the payments to Health and Human Services (HHS) Secretary Tom Price.

Seesawing Family Income Threatens Kids’ Medicaid Coverage In Texas
Shefali Luthra, Kaiser Health News

Dawn Poole often worries about whether her children qualify for Medicaid and have access to the care they need. Much of her anxiety is a direct result of living in Texas.


South Carolina’s two largest hospital networks to merge
Mary Katherine Wildeman, The Post and Courier

In a deal shifting the health care landscape in South Carolina, the state’s two largest hospital systems — Palmetto Health and Greenville Health System — announced Thursday that they will merge. The systems claim together they will reach 1.2 million patients per year and treat about one-third of all Medicaid patients statewide.

Pharma, Biotech and Devices

Trump Administration Prepares a Drug Pricing Executive Order, Sources Say
Anna Edney and Justin Sink, Bloomberg News

President Donald Trump’s administration is preparing an executive order aimed at lowering U.S. drug costs, according to people familiar with the matter, a move that could come within weeks on a campaign issue that has been largely left out of Republican legislative efforts in Congress. Top health and budget officials in the administration will meet Friday to discuss the issue, according to the people, who asked not to be identified because the session is private.

Drug pricing moves toward center stage on Capitol Hill, this time in House
Erin Mershon, Stat News

A key House committee is preparing for a hearing on drug pricing, as Republicans show an increasing willingness to examine an issue frustrating their constituents. Rep. Michael Burgess of Texas, who helms the health subcommittee of the Energy and Commerce Committee, told STAT Thursday his subcommittee will hold a hearing on the drug pricing issues, as well as the related “supply chain,” he said.

Health IT

Apple is quietly working on turning your iPhone into the one-stop shop for all your medical info
Christina Farr, CNBC

Imagine turning to your iPhone for all your health and medical information — every doctor’s visit, lab test result, prescription and other health information, all available in a snapshot on your phone and shared with your doctor on command. No more logging into hospital websites or having to call your previous doctor to get them to forward all that information to your new one.

Phone app helps doctors reframe opioid talks with patients
Carla K. Johnson, The Associated Press

A phone app is helping doctors have difficult conversations with patients about lowering doses of opioids. Primary care doctors prescribe nearly half the opioids dispensed in the U.S. They’re increasingly being called upon to stem the flow of the highly addictive pills into medicine cabinets.

A Message from PhRMA:

Former FBI Director Louis Freeh: Drug “importation proposals would force law enforcement agencies to make tough prioritization decisions that leave the safety of the U.S. prescription drug supply vulnerable to criminals seeking to harm patients.” Read the full report.

Opinions, Editorials and Perspectives

Reform Prescription Drug Labeling to Benefit Patients and Their Doctors
David Beier, Morning Consult 

Next time your doctor writes you a prescription, ask about the drug labeling rules. They are so arcane that most doctors will mumble and demur, but your doctor is not to blame — the Food and Drug Administration’s antiquated communication rules are.

I’ve covered Obamacare since day one. I’ve never seen lying and obstruction like this.
Sarah Kliff, Vox

Republicans do not want the country to know what is in their health care bill. This has become more evident each day, as the Senate plots out a secretive path toward Obamacare repeal — and top White House officials (including the president) consistently lie about what the House bill actually does.

Don’t Blame Trump When ObamaCare Rates Jump
Chris Jacobs, The Wall Street Journal

Insurers must submit applications by next Wednesday to sell plans through, and these will give us some of the first indicators of how high Obama Care costs will skyrocket in 2018. ObamaCare supporters can’t wait to blame the coming premium increases on the “uncertainty” caused by President Trump.

Trump says the House health-care bill is ‘mean.’ He’s wrong.
Michael A. Needham, The Washington Post

Anyone who thinks real compassion is found in a federal government program hasn’t spent much time at the post office. That’s the central insight motivating the inclusion of the state waiver from the Obamacare program in the House-passed American Health Care Act.

Pharma companies fight behind-the-scenes wars over generic drugs
Robin Feldman, Stat News

All good things must come to an end” is a proverb that brand-name drug makers have trouble taking to heart. Just look at the strategies used to prevent competitors from bringing less-expensive generics to market.

A Message from PhRMA:

Did you know? Canadian authorities have expressly stated they are not responsible for the safety and quality of prescription drugs exported from Canada into the United States. Get the facts.

Research Reports

Changes in Hospital Quality Associated with Hospital Value-Based Purchasing
Andrew M. Ryan et al., The New England Journal of Medicine

In our study, HVBP was not associated with improvements in measures of clinical process or patient experience and was not associated with significant reductions in two of three mortality measures. (Funded by the National Institute on Aging.)

Would States Eliminate Key Benefits if AHCA Waivers are Enacted?
Gary Claxton et al., Kaiser Family Foundation

As the debate over amending health insurance market rules continues, proponents of changing the law have proposed reducing the health benefits provided by non-group plans as a potential way to lower premiums in the market. The Affordable Care Act (ACA) prescribes 10 categories of essential health benefits that non-group and small-group policies must cover, and provides in most cases that the scope of these benefits should be similar to those in employer group health plans, which cover most non-elderly Americans.