Health Brief: GOP Leaders Ready to Move on From Health Care Despite White House Pressure

Government Brief

  • Senate Republican leaders signaled that they intend to move on from health care to other legislative priorities, bucking pressure from the White House to continue trying to repeal and replace the Affordable Care Act. (The Washington Post)
  • GOP Sens. Lindsey Graham (S.C.) and Bill Cassidy (La.) are pushing a health care proposal that would reroute billions of dollars set aside for Obamacare directly to the states in the form of annual block grants. But that approach is also likely to face the internal divisions that doomed Republicans’ three attempts last week to undo the ACA. (Politico)
  • The White House’s opioid commission recommended President Donald Trump declare a federal state of emergency over the nation’s addiction crisis. (The Hill)

Business Brief

  • Health and Human Services Secretary Tom Price, a former orthopedic surgeon, has taken a number of steps that are favored by his former physician colleagues, including quietly rolling back regulations that have been criticized by provider groups. (Stat News)
  • Trump could decide as soon as today to stop making key payments to insurers that help them reduce cost-sharing for low-income consumers. If he chooses to end the payments, senior Republicans said they would consider appropriating the funds, which are crucial to stabilizing the nation’s Obamacare exchanges. (Washington Examiner)
  • Diagnostics company LabCorp agreed to a $1.2 billion deal to acquire contract-research organization Chiltern to expand its oncology offerings. (Reuters)

Chart Review

Events Calendar (All Times Local)

No events scheduled
Brookings Institution event on procedure and politics in Congress 10 a.m.
Senate Finance Committee considers assistant HHS nominee Basset 10 a.m.
No events scheduled

Why are medicines more expensive in the United States?

The share of health care spending attributable to medicines in the United States is in line with countries such as Canada, France and Germany. Unlike many nations that seek cost containment through price controls, which restrict access to medicines, the United States relies on its competitive marketplace to control costs. For example, Americans have access to cancer medicines about two years earlier than many European countries. Let’s talk about cost.


GOP leaders say it’s time for Senate to move on from health care
Sean Sullivan, The Washington Post

Senate Republican leaders signaled Monday that they intend to move on from health care to other legislative priorities, even as President Trump continued to pressure lawmakers to repeal and replace the Affordable Care Act. The discord comes amid uncertainty in the insurance industry and on Capitol Hill about what will come next after last week’s dramatic collapse of the GOP’s effort to scrap the seven-year-old landmark law.

Newest GOP health care attempt faces same tough odds
Adam Cancryn, Politico

Senate Republicans couldn’t agree on a way to repeal and replace Obamacare. So now they’re contemplating a totally different approach: Blow it up and let the states sort it out.

White House opioid commission urges Trump to declare federal state of emergency
Jessie Hellman, The Hill

The White House’s opioid commission is recommending that President Trump declare a federal state of emergency over the epidemic, which has struck dozens of states. The commission, led by New Jersey Gov. Chris Christie (R), filed a long-awaited report on the crisis on Monday after missing its second deadline extension earlier this month.

Lesson for Trump: Hardball Against Senators Is a Game He Can Lose
Carl Hulse, The New York Times

The recalcitrant senator kept crossing up the inexperienced new president on big-ticket legislation even though they represented the same party. Frustrated and angry, the White House fought back, threatening retaliation both petty and portentous, eyeing federal jobs and programs in the state of the rebellious lawmaker to force obedience.

What’s Next for Dean Heller After Health Care Votes?
Bridget Bowman, Roll Call

Sen. Dean Heller’s vote to support a bill to repeal the 2010 health care law — while rejecting others — may make an already tough re-election campaign even harder. The Nevada Republican was already facing pressure from voters on the left and the right, his own party’s leadership and the White House going into last week’s Senate health care votes.

Stocks Gain as Earnings Roll In; Dollar Steadies: Markets Wrap
Adam Haigh and Samuel Potter, Bloomberg

Global stocks advanced following the latest set of corporate results, with European shares tracking a jump in Asian peers on both earnings and promising economic data. The U.S. dollar traded sideways after Monday’s drop, as investors digested the latest developments in Washington.


Trump may force Congress to act on Obamacare insurer payments
Kimberly Leonard, Washington Examiner

Republicans in Congress may soon have to appropriate federal funds to insurers they fought to hold off for several years under Obamacare, or otherwise risk being blamed for a chain reaction of insurer exits and premium hikes. President Trump is expected to issue a decision as early as Tuesday on whether his administration will continue to deliver these payments to insurers, known as cost-sharing reduction subsidies.


With Tom Price in charge, doctors are winning again in Washington
Erin Mershon, Stat News

As the Senate was barrelling toward one of its votes to repeal the Affordable Care Act earlier this summer, Tom Price was corralling a small group of doctors into a tiny, dimly lit conference room in a nondescript building in downtown Dallas. It was, on its surface, another of the health secretary’s many meetings with “victims” of Obamacare — this time with some of the conservative physicians who felt the law was hurting their patients and their own bottom lines.

What’s the right Rx for lowering hospital readmissions?
Kristen Schorsch, Modern Healthcare

Patients recovering from hip replacements and strokes at St. Pauls House, a short-term rehab center in Chicago’s Irving Park neighborhood on the North Side, are used to seeing doctors and nurses make rounds almost daily. Doctors check that these patients, typically in their 70s or older, are taking the right medications, since prescriptions can get mixed up when they see one physician after another in the hospital.

US hospitals set record for fast heart attack care
Marilynn Marchione, The Associated Press

There’s never been a better time to be treated for a heart attack. U.S. hospitals have set a record for how quickly they open blocked arteries, averaging under one hour for the first time since these results have been tracked.

Pharma, Biotech and Devices

LabCorp to expand oncology offerings with $1.2 billion Chiltern buy
Akankshita Mukhopadhyay, Reuters

Diagnostics company Laboratory Corp of America Holdings (LH.N) said on Monday it would buy privately owned contract research organization (CRO) Chiltern International Ltd for nearly $1.2 billion in cash to expand its oncology offerings. The CRO industry is undergoing a wave of consolidation as pharmaceutical companies strive to cut costs, reduce clinical trial times and expand their research and development presence.

Express Scripts to cover Mylan’s EpiPen, exclude rivals
Michael Erman and Bill Berkrot, Reuters

Pharmacy benefit manager Express Scripts Holding Co said on Monday it would favor drugmaker Mylan Inc’s versions of the EpiPen lifesaving allergy treatment over the allergy auto-injectors of other companies. The nation’s largest pharmacy benefit manager said it was excluding alternatives to the auto-injector made by Impax Laboratories Inc, privately held Kaleo and A-S Medication from its widely used list of covered drugs.

23andMe is recruiting 25,000 people for a study on depression and bipolar disorder
Christina Farr, CNBC

At-home DNA-testing company 23andMe is recruiting 25,000 people for a study to determine how genes influence brain functions in people diagnosed with depression and bipolar disorders. The Google-backed company’s latest project is a collaboration with the Milken Institute, a medical research nonprofit, and Lundbeck, a drug developer, to study the genetics — and also symptoms, behavior and other environmental factors — associated with bipolar and major depressive disorders.

Caregivers Are Too Slow to Reach for EpiPens, Study Finds
Steph Yin, The New York Times

A severe, rapid allergic reaction calls for a dose of epinephrine as soon as possible. The medicine counteracts potentially dangerous symptoms, such as a plunge in blood pressure and closing of the airways. In extreme cases, it can mean the difference between life and death.

Patients Take Big Risks When Stopping Statins
Sumathi Reddy, The Wall Street Journal

A new study on statins—widely used medicines that lower cholesterol levels—highlights the dangerous outcomes that occur when patients stop taking them due to adverse side effects. One in five patients taking a statin reports a side effect, mainly muscle aches, according to the study.

Health IT

Virtual assistants like Amazon’s Alexa could change the way care is delivered
Rachel Z. Arndt, Modern Healthcare

Alexa can order your groceries, hail you a ride and tell you how many teaspoons are in a tablespoon (it’s three). Now, the Amazon virtual assistant can also give you medical advice and look up and recite clinical information.

Pharma, device manufacturers worry government-sponsored hackers will target research, financial information
Evan Sweeney, Fierce Healthcare

Pharmaceutical companies and medical device manufacturers see hackers as the biggest threat to their organizations, and executives are primarily concerned that bad actors will target their company’s financial information and intellectual property. More than half of senior IT and security executives at large pharmaceutical, biotechnology and medical device companies said the biggest threat to their organization was government-sponsored hackers, according to a survey of 100 executives released by the auditing and advisory firm KPMG.

A Message from PhRMA:

What’s the biggest driver of health care spending?
The biggest cost driver in our health care system is chronic disease. Patients with chronic diseases, such as diabetes, account for 90 percent of all health care spending and chronic disease is the leading causes of death and disability in the United States. Let’s talk about cost.

Opinions, Editorials and Perspectives

Pharma and the Opioid Crisis: In Search of Solutions
David Beier, Morning Consult 

Today’s opioid crisis is killing and maiming far more people than are affected by traffic accidents. Just as the auto industry moved from an era of muscle cars to today’s air bags, collision warning and auto-braking systems, so the drug industry must rethink its role beyond traditional research and development around pain medicine.

Finally, a real plan to fix Obamacare
The Editorial Board, The Washington Post

During Republicans’ unilateral push to replace Obamacare with a flimsier system, they insisted that they were on a rescue mission to save a collapsing policy the Democrats had forced on the country. In reality, Obamacare was not the disaster they described, and their plans to replace it would have been far worse for needy people.

Government Opioid Abuse
The Editorial Board, The Wall Street Journal

Opioid abuse ranks among the nation’s biggest public health challenges with drug overdoses now the leading cause of death among Americans under the age of 50. While the causes are complex and multiple, politicians and their trial lawyer friends aren’t letting the crisis go to waste.

HillaryCare Lessons for Today
Joe Lieberman, The Wall Street Journal

One of the greatest bonuses of my years in the Senate was getting to know Sen. John McCain. John has consistently served causes larger than himself, beginning with our country. The speech he gave on the Senate floor last week, followed by his “no” vote after midnight Thursday on a health-care bill nobody wanted to become law, was one of his finest hours.

Sending Health to Rural Ghana via Traveling Medics
Andrew Green, The New York Times

Hayford Amponsam was making his daily rounds in this small town in south-central Ghana when he came across an infant who was dangerously ill. She had bloody diarrhea and had been coughing up thick mucus for days. Her mother had only sought treatment from a nearby traditional healer.

Research Reports

The Welfare Effects of Long-Term Health Insurance Contracts
Benjamin R. Handel et al., The National Bureau of Economic Research

Reclassification risk is a major concern in health insurance. We use a rich dataset with individual-level information on health risk to empirically study one possible solution: dynamic contracts.