Health Brief: GOP Aims to Repeal, Shore Up ACA

Washington Brief

  • Even as they attempt to repeal and replace the Affordable Care Act, the Trump administration is poised to issue a proposed regulation aimed at shoring up the law’s insurance markets, and House Republicans are working on legislation with a similar purpose. (The New York Times)
  • Congressional Republicans are divided over whether they should repeal Obamacare’s taxes. While nixing the taxes would be an ideological victory for conservatives, doing so would also decrease government revenue by almost $1.1 trillion, according to the Congressional Budget Office. (The Associated Press)
  • Sen. Lamar Alexander (R-Tenn.), chairman of the Committee on Health, Education, Labor and Pensions, is urging fellow Republicans to proceed with caution on repealing Obamacare, as GOP lawmakers continue to find themselves berated by angry constituents at town halls across the nation. (Politico)

Business Brief

  • Aetna, Anthem, Cigna and Humana cumulatively spent about $1.5 billion on legal and financial fees since their proposed mergers were announced in 2015. (Axios)
  • Marathon Pharmaceuticals won approval to sell an old steroid treatment, long available to be imported from abroad for about $1,200 a year,  as an “orphan drug.” The drug’s new listed price is $89,000 a year. (The Washington Post)
  • Sanofi is selling five over-the-counter products to Ipsen for 83 million euros. The sale was announced as Sanofi moves to complete a 22.8 billion-euro asset swap with Boehringer Ingelheim GmbH. (Bloomberg News)

Chart Review

Events Calendar (All Times Local)

No events scheduled
Headache & Migraine Policy Forum luncheon 12 p.m.
KPMG event on the health IT agenda 8:30 a.m.
Senate Appropriations Committee hearing on mental health care treatment and services 10:30 a.m.
Families USA Health Action 2017 8:30 a.m.
House Judiciary subcommittee hearing on competitive health insurance Reform Act of 2017 10 a.m.
Senate Finance Committee confirmation hearing on Seema Verma’s nomination to lead CMS 10 a.m.
Friday 7:30 a.m.



Republicans, Aiming to Kill Health Law, Also Work to Shore It Up
Robert Pear, The New York Times

After denouncing the Affordable Care Act as an abomination for seven years, Republicans in Congress, working with the Trump administration, are urgently seeking ways to shore up health insurance marketplaces created by the law. While President Trump said as a candidate that “Obamacare is certain to collapse of its own weight,” Republicans fear such an outcome because, now that the fate of the health law is in their hands, they could be blamed by consumers and Democrats.

GOP dilemma on health law taxes: To repeal or not to repeal?
Alan Fram, The Associated Press

Republicans love cutting taxes, especially if they were authored by a president named Barack Obama. But as they push their wobbly effort to erase his health care overhaul, they’re divided over whether to repeal the levies the law imposed to finance its expanded coverage for millions of Americans.

Ex-New Hampshire congressman under consideration as Trump’s ‘drug czar’
Dylan Scott, Stat News

Frank Guinta, a former New Hampshire lawmaker who helped create an opioid crisis task force in Congress, has discussed serving as President Donald Trump’s “drug czar” with Trump’s team, according to several individuals familiar with the discussions. Since the election, Guinta has spoken with top Trump aides about serving as director of the Office of National Drug Control Policy — a position colloquially known as the nation’s “drug czar”— multiple individuals, speaking on condition of anonymity, told STAT this week.

New HHS Secretary Tom Price faces a crushing inbox
Harris Meyer and Virgil Dickson, Modern Healthcare 

Newly confirmed HHS Secretary Tom Price likely will spend his first few days focusing on efforts to stabilize the individual health insurance market as Republicans work to repeal and replace the Affordable Care Act. Following the pattern of strictly party-line votes on two previous nominees—Attorney General-designate Sen. Jeff Sessions and Betsy DeVos for education secretary—the former congressman from Georgia was approved on a 52-47 vote.

The stealth Republican force behind Obamacare repeal
Burgess Everett and Jennifer Haberkorn, Politico

Republican town halls are erupting with protests as Americans fret over the future of their health insurance. But listen to Lamar Alexander for a few minutes, and you might think not a single bad thing will come of the GOP’s plan to rip apart Obamacare and stitch together a replacement.

Sanders, Schumer call for nationwide pro-ObamaCare rallies
Mallory Shelbourne, The Hill

Sens. Charles Schumer (D-N.Y.) and Bernie Sanders (I-Vt.) on Saturday called for nationwide rallies in support of ObamaCare, calling GOP efforts to repeal and replace the healthcare legislation “chaos.” “We are encouraging Democratic senators to lead rallies in their states. This is not a Democratic issue, a Republican issue or an Independent issue,” the senators said in a letter.

The folks packing Republican town halls

These days, Deborah Johnson is on edge. She says she’s worried she won’t qualify for Social Security disability benefits, anxious about her middle son’s recovery from a car accident last year, and feeling the pervasive effects of her complex post-traumatic stress disorder that dates back to an abusive childhood. But by her mid-morning coffee on a recent Thursday, Johnson was feeling pretty good.

China’s Tech Tycoons’ Healthcare Dreams Aren’t Coming True
Bloomberg News

In 2014, billionaire Jack Ma, founder of online retail giant Alibaba Group Holding Ltd., declared his ambition to make China’s hospitals better, drugs cheaper and people healthier. Others in China’s tech universe were becoming equally bullish on health care, and that year alone, investment in the internet health sector surged about sevenfold to $1.4 billion.

Global Stocks Keep Climbing as Treasuries Decline: Markets Wrap
Adam Haigh and Samuel Potter, Bloomberg News

Rumors of the reflation trade’s demise seem to have been at least a little exaggerated, as investors shifted to equities from bonds and the dollar edged higher. Global stocks continued a rally before data this week provides detail on the strength of U.S. consumer prices, and ahead of speeches from a range of Federal Reserve officials.


Lawyers and bankers reap $1.5 billion from failed health insurance mergers
Bob Herman, Axios

Those massive health insurance mergers may be dead, but the lawyers and investment bankers who worked feverishly to get the deals approved still walked away with big paychecks. Aetna, Anthem, Cigna and Humana cumulatively spent about $1.5 billion on legal and financial fees since their proposed mergers were announced in summer 2015, according to documents filed with the Securities and Exchange Commission.

AARP lays down marker on Medicare
Encarnacion Pyle, The Columbus Dispatch

Throughout his presidential campaign, Donald Trump repeatedly vowed to protect Medicare because so many older Americans depend on the federal program to help cover their health-care costs. One of the most influential senior lobbying groups wants to remind Trump of his promise.

Addiction Treatment Grew Under Health Law. Now What?
Katharine Q. Seelye and Abby Goodnough, The New York Times

Chad Diaz began using heroin when he was 12. Now 36 and newly covered by Medicaid under the Affordable Care Act, he is on Suboxone, a substitute opioid that eases withdrawal symptoms and cravings, and he is slowly pulling himself together. “This is the best my life has gone in many, many years,” Mr. Diaz, a big man wearing camouflage, said as he sat in a community health center here.


Paying for population health
Shelby Livingston, Modern Healthcare

Trinity Health system executives take home heftier paychecks when they keep patients healthy and out of the hospital. The annual incentive pay for each executive, including the 93-hospital system’s CEO, is docked if Trinity’s total patient population doesn’t show reduced rates of obesity, smoking, readmissions and hospital-acquired conditions.

Hospital ‘provider fee’ bill gains final OK
Aaron Gould Sheinin, The Atlanta Journal Constitution

Legislation needed to renew a fee on Georgia hospitals to help close a more than $900 million gap in Medicaid funding is on its way to Gov. Nathan Deal’s desk. The state House on Friday voted 152-14 to give final approval to Senate Bill 70, which authorizes the Department of Community Health board to levy the fee for another three years.

Health care providers, policy race to keep up with rising opioid deaths
Susan Spencer, The Telegram & Gazette 

Nineteen faces, mostly young and mostly male, smile at the camera from Worcester District Attorney Joseph D. Early Jr.’s website. The pictures reflect happier times among area residents ranging in age from 22-year-olds Eva Hall of Worcester and Michael Valerio of Sutton, to 55-year-old Thomas Morrell of Northbridge.

Q&A: Dr. Richard Afable discusses healthcare competition in L.A. basin
Modern Healthcare

Last July’s merger of Providence Health & Services of Renton, Wash., and St. Joseph Health of Irvine, Calif., gave the combined 50-hospital chain a greater presence in the highly competitive Los Angeles market. Modern Healthcare Editor Merrill Goozner last week spoke with Dr. Richard Afable, CEO of St. Joseph Hoag Health, part of St. Joseph Health, about the merger’s implication for competition in the L.A. basin.

Pharma, Biotech and Devices

An old drug gets a new price to fight a rare disease: $89,000 a year
Carolyn Y. Johnson, The Washington Post 

An old steroid treatment, long available outside the United States, received approval this week for a rare disease that afflicts about 15,000 Americans. Though not previously approved in the United States, the drug, deflazacort, has for years been available to patients suffering from the devastating and fatal disease Duchenne muscular dystrophy; families can import it from abroad for about $1,200 per year on average.

Marathon’s move on rare-disease drug puts PhRMA in a tight spot
Dylan Scott, Stat News

The latest drug-pricing controversy is going to be more difficult for the industry’s Washington representatives to untangle themselves from. This time, the company in question is a part of the club.

Sanofi Agrees to Sell Five Over-the-Counter Drugs to Ipsen
Caroline Chen and Manuel Baigorri, Bloomberg News

Sanofi agreed to sell some over-the-counter products to Ipsen SA as it edges closer to completing a 22.8 billion-euro ($24.2 billion) asset swap with Boehringer Ingelheim GmbH. Ipsen will pay 83 million euros for five products including Prontalgine, a painkiller, the Paris-based company said in a statement Monday.

Trump wants the FDA to move faster. His actions are having the opposite effect.
Julia Belluz, Vox

A presidential transition is an inherently uncertain time to be a federal employee. New leaders must be appointed.

Grassley Launches Inquiry Into Orphan Drugs After KHN Investigation
Sarah Jane Tribble, Kaiser Health News

Republican Sen. Chuck Grassley, chairman of the Senate Judiciary Committee, has opened an inquiry into potential abuses of the Orphan Drug Act that may have contributed to high prices on commonly used drugs. In a statement, Grassley said the inquiry is “based on reporting from Kaiser Health News” and strong consumer concern about high drug prices.

Ex-drug company CEO Shkreli to speak at Harvard
The Associated Press

Controversial former pharmaceutical executive Martin Shkreli is set to speak at Harvard while out on bail awaiting his federal securities fraud trial. The former CEO of Turing Pharmaceuticals is expected to talk about investing and healthcare at an event organized by the Harvard Financial Analysts Club.

Health IT

Memorial Sloan Kettering physicians outline the future of precision oncology
Evan Sweeney, Fierce Healthcare

Precision medicine efforts have only scratched the surface of cancer treatment transformation, and experts at one of the nation’s leading oncology centers say continued success will rely on advancements in genomic sequencing technology, improved data sharing and better access to cutting-edge medication. Over the last several years there have been significant advancements in precision medicine research, particularly for oncology patients.

A Message from the Coalition for Affordable Prescription Drugs:

Federal programs, state governments, employers, unions and others partner with PBMs to address rising prescription drug costs, keep patients healthy and deliver value for the health system. Visit for more.

Opinions, Editorials and Perspectives

Congress Should Step Up to Support Patient Access to Quality, Affordable Care
Harold Wimmer and Laurie Fenton Ambrose, Morning Consult 

As Congress and the new administration begin to address our nation’s health care, there is great concern about what imprint will be left on patients. This uncertainty weighs heavily on the minds of the American public who want access to high quality and affordable care.

GOP Grand Scheme On Obamacare Repeal & Tax Reform Quickly Going South
Stan Collender, Forbes

The GOP strategy on quickly repealing the Affordable Care Act and enacting tax reform that seemed to be so creative and smart when it was first revealed right after the election may soon become the prime source of legislative hell for House and Senate Republicans. Knowing that a Senate filibuster was virtually certain on ACA repeal and highly probable on tax reform, the GOP plan was to use the reconciliation process — which prevents filibusters — to pass them both.

LSD to Cure Depression? Not So Fast
Richard A. Friedman, The New York Times

Psychedelics, the fabled enlightenment drugs of the ’60s, are making a comeback — this time as medical treatment. A recent study claimed that psilocybin, a mushroom-derived hallucinogenic, relieves anxiety and depression in people with life-threatening cancer.

Dana-Farber would make a ‘strong statement’ by canceling its Mar-a-Lago event
Donald M. Berwick, Stat News

Boston’s Dana-Farber Cancer Institute has announced that, despite growing protest, it will not cancel its February 18th fundraiser at Donald Trump’s Mar-A-Lago resort. But it also said it would not go back to “controversial venues” in the future.

A Message from the Coalition for Affordable Prescription Drugs:

Federal programs, state governments, employers, unions and others partner with PBMs to address rising prescription drug costs, keep patients healthy and deliver value for the health system. Visit for more.

Research Reports

Rolling Back the ACA’s Medicaid Expansion: What Are the Costs for States?
Sara Rosenbaum, The Commonwealth Fund 

Millions of people have gained health insurance coverage though the Affordable Care Act’s (ACA) Medicaid eligibility expansion, adopted by 31 states and Washington, D.C., over the past three years. Should Congress decide to eliminate or reduce federal funding for this coverage as part of ACA repeal, states that expanded will be faced with the prospect of either maintaining coverage out of their own funds or dropping the new beneficiaries from the program.