Health Brief: GOP Split on Repealing ACA Taxes With Law

Washington Brief

  • Congressional Republicans are divided on whether to repeal Affordable Care Act taxes when they repeal the law, with a group of members saying the taxes should be addressed as part of an effort to complete tax reform later this year. (Bloomberg News)
  • The Senate is poised to vote on a budget resolution — the first step in orepealing Obamacare — by the end of the week. (Morning Consult)
  • Not only are Hill Republicans split on how to address the Obamacare taxes, there’s a group of lawmakers who are worried about repealing the law without immediately replacing it, and some with concerns about plans to defund Planned Parenthood. Still, no Republican has said they would vote against a repeal measure. (The Hill)

Business Brief

  • The J.P. Morgan Healthcare Conference starts Monday, a four-day event that can be telling for how biotech stocks will perform over the year. (The Wall Street Journal)
  • UnitedHealth Group announced its plans to purchase Surgical Care Affiliates, a chain of outpatient surgery centers, and signaling a move toward a more varied health care company. (The New York Times)
  • Health care industry leaders are warning of a doomsday scenario if Congress repeals the Affordable Care Act without a replacement plan, with executives waiting to hear about what happens with the law’s cost-sharing subsidies and the individual mandate, among other things. (Politico)

Chart Review

Events Calendar (All Times Local)

HHS Secretary Sylvia Burwell speaks on the Affordable Care Act 12:30
No events scheduled
Brookings Institution event on research and development 10 a.m.
Cato Institute discussion on the 115th Congress’ agenda 10 a.m.
AEI panel discussion on fixing health care 8 a.m.



This Week: Goodbye from Obama, Grillings for Trump’s Cabinet Picks
Meghan McCarthy, Morning Consult

The last full week of Barack Obama’s presidency is packed with work setting up the incoming administration of President-elect Donald Trump. Obama will give his farewell address on Tuesday, and Trump follows on Wednesday with his first press conference since July 27.

Obama vs. Trump: 5 ways they clash — or don’t — on health and science
Dylan Scott, Stat

Donald Trump has promised to change Washington, and he surely will. Yet while he may play some wild cards in the realms of medicine, science, and public health, you can also look for some surprising continuity with President Obama’s administration.

Obamacare repeal jeopardizes mental health, addiction coverage
Jayne O’Donnell and Terry DeMio, USA Today

Sherri Reynolds’ son Qual has been drug free for 16 months, thanks in large part to treatment he got through Medicaid under the Affordable Care Act. Reynolds knows firsthand what can happen when people can’t get coverage: Her 20-year-old stepson, Jarvis, suffered from mental illness and killed himself in 2010 after he couldn’t get medical treatment.

Currencies Gripped by Political Risk, Oil Slumps: Markets Wrap
Eddie Van Der Walt and Natasha Doff, Bloomberg News

Political risks rippled across foreign-exchange markets with the pound, Turkish lira and South Korean won leading declines, while gold rose on haven demand and Chinese buying. Stocks dropped with oil. Sterling dropped to a 10-week low after the Prime Minister Theresa May indicated she prioritized regaining control of immigration during Brexit negotiations, while tensions between North and South Korea and debates on constitutional changes in Turkey put an index of developing currencies on track for the steepest drop in three weeks.


GOP Splits on Need to Scrap Obamacare Taxes in Swift Repeal
Billy House and Steven T. Dennis, Bloomberg News

Congressional Republicans pushing for a swift Obamacare repeal are sharply divided on whether to scrap Obamacare’s tax provisions at the same time or delay that move until a replacement is ready. Some conservatives say every part of the Affordable Care Act must go immediately — including its tax-revenue streams — because that’s what voters were promised.

Angst grows in GOP over ObamaCare repeal plan
Peter Sullivan, The Hill

Concerns are growing among Republicans about moving forward with their plan to repeal ObamaCare without putting forward a replacement at the same time. Republican congressional leaders are moving quickly to pass an ObamaCare repeal bill, but want to delay when it takes effect.

UnitedHealth Group to Buy Outpatient Surgery Chain for $2.3 Billion
Reed Abelson, The New York Times

UnitedHealth Group, one of the largest and most diversified health insurance companies in the United States, said on Monday that it planned to buy Surgical Care Affiliates, a chain of outpatient surgery centers, for about $2.3 billion. The deal is expected to close in the first half of 2017.

Obamacare repeal’s doomsday scenario
Paul Demko and Adam Cancryn, Politico

Hospital and health plan leaders talk in almost apocalyptic terms about what might lie ahead if Republicans abolish Obamacare without a blueprint for its replacement. Their doomsday scenario: Millions of people could lose their health care coverage, hospitals could hemorrhage cash and shocks to the $3 trillion-a-year health system could send ripples through the entire economy.

Mitch McConnell Vows New GOP Health Plan Soon
Ian Talley, The Wall Street Journal

Congress will quickly devise a new health-insurance system after moving to repeal the Obama administration’s signature health-care law in coming days, Senate Majority Leader Mitch McConnell said Sunday, despite growing questions within the Republican Party over the GOP’s strategy.

Conway, Priebus won’t promise immediate repeal-and-replace
Kevin Robillard, Politico

Kellyanne Conway and Reince Priebus, top advisers to Donald Trump, said Sunday that the president-elect is still considering his options when it comes to the speed of replacing Obamacare. Republican leaders in Congress have been discussing a repeal of Obamacare that would take effect two years or more after the vote to repeal to give them time to craft a replacement plan so that millions of Americans would not suddenly lose coverage.

Corker Concerned About Repealing Obamacare Taxes Without Replacement
Niels Lesniewski, Roll Call

Sen. Bob Corker says Republicans need to be wary of a potential “box canyon” if they repeal Obamacare without a replacement in the queue. The Tennessee Republican said Friday morning that he wants his colleagues to pay more attention to the fiscal issues with the effort to repeal Obamacare.

Obamacare Lite looms as alternative for GOP
Harris Meyer, Modern Healthcare

Now comes the reality. It was a lot easier to campaign against the Affordable Care Act than to come up with a viable alternative. With that dawning realization, health policy experts associated with both political parties are asking if President-elect Donald Trump and congressional GOP leaders might decide it’s politically smarter to reach a deal with Democrats this year to refashion and rebrand the ACA, rather than erasing it and trying to create a new system from scratch.

Obama Health Care Legacy: Coverage, Conflict and Questions
Ricardo Alonso-Zaldivar, The Associated Press

Although his signature law is in jeopardy, President Barack Obama’s work reshaping health care in America is certain to endure in the broad public support for many of its underlying principles, along with conflicts over how to secure them. The belief that people with medical problems should be able to get health insurance is no longer challenged.

State GOP Wary as Republicans Push Repeal of Health Law
Bill Barrow and Thomas Beaumont, The Associated Press

Congressional Republicans’ drive to repeal the 2010 health care law has financial and political repercussions for GOP leaders in the states and gives Democrats potential openings as they struggle to reclaim power lost during President Barack Obama’s tenure. Some Republican governors, in particular, are wary about what their Washington colleagues might do with Obama’s signature law, exposing a fissure in a party that has consolidated control in the nation’s capital and dozens of statehouses around the country in accompaniment with President-elect Donald Trump’s victory in November.

North Carolina’s Dem Governor Formally Begins Effort To Expand Medicaid
Gary D. Robertson, Talking Points Memo

North Carolina’s new Democratic governor has formally started his effort to expand Medicaid to more of the working poor in the state, even as Republicans in Washington bear down on repealing the federal health care law that offers this increased coverage. Gov. Roy Cooper’s office said he sent a letter to federal regulators Friday.


Cleveland Clinic to censure doctor who promoted anti-vaccine claims
Casey Ross, Stat

A Cleveland Clinic doctor who wrote a column laced with anti-vaccine rhetoric appeared to retract his commentary Sunday, but will face disciplinary action for publishing it without authorization, the health system said. Dr. Daniel Neides, whose column spouted a widely discredited theory that vaccines are linked to autism — and whose comments sparked an online uproar — issued a brief statement through a Cleveland Clinic spokeswoman.

Pharma, Biotech and Devices

Biotech Starts Year With a Look Ahead
Charley Grant, The Wall Street Journal

In biotech, it is how you start the year that counts. Investors will get a good look at how 2017 is shaping up starting Monday when the 35th annual J.P. Morgan Healthcare Conference kicks off in San Francisco.

Parkinson’s Therapy Gets Fresh Look From Device Makers
Denise Roland, The Wall Street Journal

Deep brain stimulation, an established therapy that modifies the brain’s circuitry to treat symptoms of Parkinson’s disease and other movement disorders, is attracting fresh attention from medical-device makers who believe it is underused. St. Jude Medical Inc. recently introduced a new DBS system in the U.S., and Boston Scientific Corp. is planning its own entry late next year.

Drug spending for some Medicare enrollees has tripled since 2010
Virgil Dickson, Modern Healthcare

Drug spending for some Medicare beneficiaries has increased at an alarming rate, a new federal report finds. Federal payments for Medicare Part D catastrophic coverage exceeded $33 billion in 2015, which is more than triple the amount paid in 2010, according to an HHS Office of Inspector General report released Thursday.

Abbott-St. Jude merger gives providers what they want: fewer vendors
Adam Rubenfire, Modern Healthcare

The now-completed merger of medical device giants Abbott Laboratories and St. Jude Medical will help hospitals streamline their procurement efforts, but vendor consolidation could also lead to higher supply costs. Suburban Chicago-based Abbott Laboratories’ $25 billion purchase of St. Paul, Minn.-based St. Jude Medical closed Wednesday.

Health IT

Theranos to Lay Off 41% of Workforce, Company Says
Caroline Chen, Bloomberg News

Blood-testing startup Theranos Inc. will fire about 41 percent of its employees after months of regulatory setbacks, lawsuits and scrutiny, saying it is paring down to focus on a new product. The Silicon Valley company will eliminate 155 positions, leaving 220 employees who will work on the new product, a tabletop blood testing product called the miniLab.

Physicians, patients at odds over value of health data
Gienna Shaw, Fierce Healthcare

It’s a big disconnect: The vast majority of physicians say healthcare data is overwhelming, redundant and doesn’t make a difference in care quality. But most patients say their primary care physician’s office should store any personal health data they ask them to.

A Message from the College of American Pathologists:

Pathologists are physicians who provide a diagnosis of cancer. Getting that right is absolutely critical. Watch as Dr. Jiang navigates the high stakes of diagnosis.

Opinions, Editorials and Perspectives

The Misunderstood Beauty of Patents
Peter Pitts, Morning Consult

Patents save lives and enhance the value of medicines. As Abraham Lincoln said, “Patents add the fuel of interest to the passion of genius.” Yet some misguided members of Congress (such as Sens. Elizabeth Warren and Bernie Sanders) still believe the innovator pharmaceutical industry is getting a free ride on government-sponsored research and development and call for aggressive use of the Bayh-Dole Act to use “march in” control prices on government inventions.

Republicans don’t want to hurt ‘real America.’ By repealing Obamacare, they will.
E.J. Dionne Jr., The Washington Post

Let’s try to get this straight. Donald Trump campaigned as the champion of lower-paid working people who deserve better than they have. Republicans have spent the Obama presidency complaining about high deficits and promising to cut them.

There’s Danger for Democrats, Too, in Obamacare Repeal
Patricia Murphy, Roll Call

“So the dog finally caught the car.” That seemed to be the consensus in Washington Wednesday after Vice President-elect Mike Pence and congressional Republicans declared with confidence that they will begin to repeal Obamacare immediately, but struggled to say what Americans could expect as a replacement for the president’s signature health care law, or when.

A Message from the College of American Pathologists:

Pathology is an integral part of surgery. Pathologists provide answers to key questions: Is a lesion benign or malignant? Has it spread? Is more testing needed? Watch as Dr. Atkinson supports Kathy and her care team from biopsy to diagnosis.

Research Reports

Full Repeal of Obamacare Would Hasten Medicare’s Insolvency
Center for a Responsible Federal Budget

Earlier this week, we released a report estimating the cost full repeal of the Affordable Care Act (ACA), also known as Obamacare, and the savings from various partial repeal options. But in addition to the impact on the unified budget deficit, ACA repeal could increase deficits facing the Medicare Hospital Insurance (HI) Trust Fund, which funds Part A of Medicare, and accelerate its insolvency.

Supply-Side Drug Policy in the Presence of Substitutes: Evidence from the Introduction of Abuse-Deterrent Opioids
Abby Alpert et al., National Bureau of Economic Research

Overdose deaths from prescription opioid pain relievers nearly quadrupled between 1999 and 2010, making this the worst drug overdose epidemic in U.S. history. In response, numerous supply-side interventions have aimed to limit access to opioids.