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Health Brief: GOP Considering 4 ACA Replacement Measures

Washington Brief

  • Republicans are considering four different Affordable Care Act replacement measures and are hoping the relevant committees will begin working on legislation this month. House leaders are still eyeing a key vote in March. (Politico)
  • Thirty-five percent of respondents in a Morning Consult poll reported not knowing the Affordable Care Act and Obamacare were the same law. (The New York Times)
  • The Trump administration is throwing its support behind “Right to Try” legislation that would make it easier for terminally-ill patients to access medicines not yet approved by the Food and Drug Administration. Vice President Mike Pence met Tuesday with advocates of the proposal. (The Wall Street Journal)

Business Brief

  • Pharmaceutical stocks fell again Tuesday after White House Press Secretary Sean Spicer affirmed that President Donald Trump is committed to allowing Medicare to negotiate drug prices. (Bloomberg News)
  • Gilead Sciences, which manufactures two hepatitis C treatments, cut sales staff after a drop-off in sales of the two drugs at the end of last year. (Washington Examiner)
  • Justine Handelman will succeed Alissa Fox as Blue Cross Blue Shield Association’s senior vice president of the Office of Policy and Representation and will oversee the group’s lobbying and policy development, according to a spokesman. Fox is retiring in April.

Chart Review

Cost-sharing reduction plan payments under the ACA
Association for Community Affiliated Health Plans

Events Calendar (All Times Local)

Wednesday
No events scheduled
Thursday
Brookings Institution event on Obamacare markets 9 a.m.
Friday
No events scheduled

 

General

Republicans fear for their safety as Obamacare protests grow
Rachael Bade, Politico

House Republicans during a closed-door meeting Tuesday discussed how to protect themselves and their staff from protesters storming town halls and offices in opposition to repealing Obamacare, sources in the room told POLITICO. House GOP Conference Chairwoman Cathy McMorris Rodgers invited Rep. David Reichert, a former police sheriff, to present lawmakers with protective measures they should have in place.

Drug researchers warn Trump’s travel ban will hurt anti-disease work
Jessie Hellmann, The Hill

More than 100 leaders in the biotech community warned President Trump that his travel ban could deeply damage U.S. leadership in the development of new medicines. In a letter published in Nature Biotech, a top scientific journal, founders and leaders of biotechnology companies expressed “deep concern and opposition” to the travel ban, which bars citizens from seven majority-Muslim countries from entering the United States.

CMS Chief Nomination Is Advancing in Vetting Process, HHS Says
Kerry Dooley Young, Roll Call

The Office of Government Ethics may “very soon” publicly post an agreement with Seema Verma, the Trump administration’s choice to run the Centers for Medicare and Medicaid Services, the Health and Human Services Department told CQ Roll Call. The deal would bring her nomination closer to Senate consideration.

HHS Pick Price Made ‘Brazen’ Stock Trades While His Committee Was Under Scrutiny
Marisa Taylor and Christina Jewett, Kaiser Health News

Health and Human Services secretary nominee Tom Price showed little restraint in his personal stock trading during the three years that federal investigators were bearing down on a key House committee on which the Republican congressman served, a review of his financial disclosures shows. Price made dozens of health industry stock trades during a three-year investigation by the Securities and Exchange Commission that focused on the Ways and Means Committee, according to financial disclosure records he filed with the House of Representatives.

GOP Shrugs at Price’s Stock Trades in Bid to Confirm Trump Picks
Anna Edney, Bloomberg News

Tom Price is on a glide path to win Senate confirmation later this week as Health and Human Services secretary, where he would lead President Donald Trump’s effort to undo Obamacare, even as Democrats insist he still needs to answer questions about his stock trades. Senate Republicans have brushed off concerns raised by Democrats that Price, a Republican representative from Georgia, purchased stock in a few health-care companies and may have been financially motivated to develop or vote in favor of legislation that would benefit those businesses.

AARP threatens to sue Trump administration over ObamaCare change
Peter Sullivan, The Hill

The AARP says it would consider suing the Trump administration if it went forward with a regulation that would allow insurers to charge older people more under ObamaCare. The Department of Health and Human Services is in the process of putting forward a regulation on “stabilization” of the ObamaCare marketplaces, and The Huffington Post reported on Monday that one proposal in the regulation is to change the ratio set out under ObamaCare on how much more insurers can charge older people compared to younger people.

Earnings Buoy Stocks as Peripheral Bonds Recover: Markets Wrap
Natasha Doff and Aleksandra Gjorgievska, Bloomberg News

European stocks got a boost from earnings pointing to improving corporate and economic health, while bonds from Italy to France recovered as attention was diverted away from political risk.Vinci SA jumped after saying 2017 should mark the start of a recovery in construction work.

Payers

One-Third Don’t Know Obamacare and Affordable Care Act Are the Same
Kyle Dropp and Brandon Nyhan, The New York Times

A sizable minority of Americans don’t understand that Obamacare is just another name for the Affordable Care Act. This finding, from a poll by Morning Consult, illustrates the extent of public confusion over a health law that President Trump and Republicans in Congress hope to repeal.

The Quieter Assault Against Obamacare
Kellie Mejdrich, Roll Call

The Republican drive to deliver a death blow to President Barack Obama’s health care law has overshadowed a quieter assault using annual government funding bills that’s gone on for years. It’s not as glamorous or high-decibel as the news conferences and floor debates surrounding the repeal of the law, but it certainly has proved controversial.

Obamacare repeal-replace effort begins to jell
Jennifer Haberkorn, Politico

Republicans on Capitol Hill and within the Trump administration are scrambling to get Obamacare repeal efforts back on track by stuffing as much of a replacement policy as possible into a repeal bill. Four replacement measures are under consideration, with a goal of beginning work on the legislation in the relevant House committees by the end of February, according to congressional sources familiar with the tentative plans.

White House Pumps Brakes on Obamacare Replacement
John T. Bennett, Roll Call

The White House appears to be changing its diagnosis for President Donald Trump signing into law a measure that would replace the 2010 health care law with a Republican-crafted plan. Press Secretary Sean Spicer on Tuesday would not guarantee that Trump would sign legislation putting in place a GOP-crafted alternative to the health care law this year, saying instead that the president is “optimistic” that will happen.

The GOP’s growing problem of how to pay for Obamacare replacement
Caitlin Owens, Axios

Republicans may quickly learn there’s no such thing as an easy way to pay for health reform. After years of attacking Obamacare’s industry taxes and other funding sources, the GOP is running out of ways to pay for their replacement plan without using the options they’ve criticized so heavily in the past.

Issues Facing Republicans in Replacing Affordable Care Act
Robert Pear, The New York Times

Ever since Democrats began pushing the Affordable Care Act through Congress more than seven years ago, Republicans have been trying to come up with an alternative. Candid conversations leaked from a conclave of Republican lawmakers in Philadelphia last month, and public comments since, show they are nowhere near agreement.

GOP boxed in replacing unpopular Obamacare coverage mandate
Paul Demko, Politico

The most hated piece of Obamacare is the mandate requiring most Americans to get health insurance. The Republican alternatives on the table may not prove any more popular.

Freedom Caucus members open to Sanford’s ObamaCare replacement
Jessie Hellmann, The Hill

A new ObamaCare replacement plan from Rep. Mark Sanford is viewed favorably by the conservative Freedom Caucus, Rep. David Brat (R-Va.) said Tuesday. While the caucus hasn’t taken a formal position on the bill, Brat said it is widely liked by its members.

Debating Obamacare’s future, Cruz and Sanders detour to the past
Dan Diamond, Politico

A prime-time debate between Sens. Bernie Sanders (I-Vt.) and Ted Cruz (R-Texas) about the future of Obamacare ended up mostly being about the past as the two lawmakers fell back on their respective 2016 presidential campaign arguments about health care as a human right versus freedom-crushing government intervention.

WellCare profit soars on rising Medicaid enrollment
Shelby Livingston, Modern Healthcare

WellCare recorded a giant increase in profit in the fourth quarter of 2016, bolstered by membership growth in its Medicaid business and reduced Medicare Advantage costs. The Tampa, Fla.-based insurer recorded net income in the quarter ending Dec. 31 of $44.9 million, up 245.4% from the same quarter a year ago.

Providers

Cleveland Clinic resident barred by Trump’s immigration  order returns to work
Casey Ross, Stat

A Cleveland Clinic resident who was barred from the US following President Trump’s immigration order made a triumphant return to the hospital Tuesday, receiving loud applause and cheers from her colleagues. Dr. Suha Abushamma told a crowd of clinic employees and journalists, “I want to say how happy I am to be back here in Cleveland with my friends, my fiance, and all the people I consider part of my family. I missed everyone so much.”

Pharma, Biotech and Devices

Trump Sinks Drug Stocks Again on Medicare Drug Price Negotiation
Cécile Daurat and Toluse Olorunnipa, Bloomberg News

President Donald Trump supports Medicare drug price negotiations, his spokesman said Tuesday, remarks that sent pharmaceutical stocks swinging again as investors tried to assess whether drugmakers will be forced into bidding wars for government business. “He’s for it, yes,” White House spokesman Sean Spicer said at a press briefing in response to a question asking to clarify Trump’s position on the matter.

White House Backs ‘Right to Try’ Law for Terminally Ill Patients
Thomas M. Burton, The Wall Street Journal

The White House is giving a big boost to proponents of a federal Right to Try law that they contend would give terminally ill patients easier access to medicines that haven’t won approval from the Food and Drug Administration. Some supporters of the bill met Tuesday with Vice President Mike Pence, and last week they won a supportive statement from President Donald Trump, who has been contending that too many FDA rules in general pose unnecessary hurdles to drug approval.

Sales plunge for maker of hepatitis C cures
Robert King, Washington Examiner

A drug maker heavily criticized for high prices saw a sharp drop in sales at the end of last year, prompting it to cut sales staff. Gilead Sciences reported Tuesday that its earnings fell 33 percent in the fourth quarter of 2016 from the year before.

Pharmacies Thrive Selling Opioids For Depressed Small Town Pain
Phil Galewitz, Kaiser Health News

This economically depressed city in the foothills of the Appalachian Mountains is an image of frozen-in-time decline: empty storefronts with faded facades, sagging power lines and aged streets with few stoplights. But there is one type of business that seems to thrive: pharmacies.

A Lobbying Group Is Freaking Out Over What Trump May Do To Drug Prices
Azeen Ghorayshi, Buzzfeed News

The lobbying group for pharmacy benefit managers — the health plan negotiators caught in the cross hairs of the debate over skyrocketing drug prices — are extremely worried about President Trump’s plans for them, an internal memo says.

Health IT

Technology, data analytics transform wellness programs
Evan Sweeney, Fierce Healthcare

As employee wellness programs have evolved beyond a cost-control measure to become more ingrained in corporate culture, technology and data analytics are taking on a larger role. The corporate wellness industry has become a far more diverse market, leaving health plans to decide whether to develop their own wellness program, contract with a vendor or acquire an existing wellness program, according to a study in Health Affairs.

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Opinions, Editorials and Perspectives

A Solution to High Drug Prices
Dennis M. Lanfear, Morning Consult

President Donald Trump’s meeting with leaders from large pharmaceutical manufacturers last week, and the president’s commitment to finding market-based solutions to the problem of high drug prices deserves praise. Like Trump, I believe prescription drug prices are out of control.

Republicans Have Lost the Plot on Their Obamacare Repeal
The Editorial Board, The New York Times

President Trump and Republican lawmakers have never been able to explain how they would improve on the Affordable Care Act, which they’ve promised to quickly repeal and replace with something better. Now, it’s increasingly evident that they have no workable plan and might never come up with one.

A Message from PhRMA:

It is not a video game. It is not a screen saver. Our latest #GoBoldy ad showcases how breakthrough immunotherapy treatments are destroying cancer cells inside the human body, revolutionizing how scientists fight this deadly disease. Watch now at www.GoBoldly.com

Research Reports

Cost-sharing reduction plan payments under the ACA
Association for Community Affiliated Health Plans

The Patient Protection and Affordable Care Act (ACA) provides a federal subsidy, known as a cost-sharing reduction (CSR), to qualifying low-income households that purchase silver-level coverage in the insurance marketplaces. Qualifying low- income households are those at 100% to 250% of the federal poverty level (FPL).

Decomposing Medical-Care Expenditure Growth
Abe Dunn et al., National Bureau of Economic Research

Medical-care expenditures have been rising rapidly, accounting for over 17 percent of GDP in 2012. In this study, we assess the sources of the rising medical-care expenditures in the commercial sector.