Health Brief: Health Care Failure Takes a Political Toll on Trump, GOP Lawmakers


Government Brief

  • President Donald Trump’s disapproval rating sits at 53 percent — tying an all-time high — following Senate Republicans’ failure to pass legislation overhauling the Affordable Care Act. Forty-four percent of voters also say they’d vote for a Democrat for Congress if the election were held today, compared to 37 percent of voters who said they’d back a Republican candidate. (Morning Consult)
  • While the White House tries to revive the Obamacare repeal push, Republicans in Congress are now working with Democrats on legislation they hope to pass by mid-September to shore up the law’s insurance markets, including extending cost-sharing subsidies that Trump has threatened to stop making to insurers. (The New York Times)
  • Sen. Bernie Sanders (I-Vt.) plans to launch a campaign for single-payer health care, starting with a six-figure digital ad buy urging voters to endorse his “Medicare for All” legislation ahead of the Senate’s August recess. (The Washington Post)

Business Brief

  • Major insurers in Idaho, West Virginia, South Carolina, Iowa and Wyoming are seeking to hike premiums by averages as high as 30 percent or more next year to account for uncertain conditions in the exchanges. (The Wall Street Journal)
  • A U.S. Appeals Court ruled to allow Democratic state attorneys general to defend the cost-sharing reduction payments to insurers that Trump has threatened to cut off. (Reuters)
  • A growing number of medical devices are being used to treat pain, in what could be a promising alternative to opioids. (MIT Technology Review)

Chart Review

Events Calendar (All Times Local)

Wednesday
Brookings Institution event on procedure and politics in Congress 10 a.m.
Senate HELP Committee votes on health care nominations 11 a.m.
Thursday
Senate Finance Committee considers assistant HHS nominee Basset 10 a.m.
Friday
No events scheduled
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Key finding from investigation led by former FBI Director Louis Freeh:

Former law enforcement, FDA, DEA and FBI officials agree “Drug importation proposals would worsen the opioid crisis.” Full report: http://onphr.ma/2f4zYgm

General

Health Care Failure Takes a Political Toll on Trump, GOP Lawmakers
Cameron Easley, Morning Consult 

Senate Republicans’ failure last week to pass legislation overhauling Obamacare is leaving a mark on the party writ large, with President Donald Trump’s disapproval rating tying an all-time high and Congress’ majority party losing considerable ground to Democrats. In the new Morning Consult/POLITICO survey, 53 percent of registered voters said they disapproved of how Trump is doing his job.

Republicans in Congress Bypass Trump to Shore Up Health Law
Robert Pear and Thomas Kaplan, The New York Times

Congressional Republicans moved on Tuesday to defuse President Trump’s threat to cut off critical payments to health insurance companies, maneuvering around the president toward bipartisan legislation to shore up insurance markets under the Affordable Care Act. Senator Lamar Alexander of Tennessee, the influential chairman of the Senate Health, Education, Labor and Pensions Committee, announced that his panel would begin work in early September on legislation to “stabilize and strengthen the individual health insurance market” for 2018.

Sanders preps month-long campaign for single-payer health care, with legislation to follow
David Weigel, The Washington Post

Sen. Bernie Sanders is ramping up his campaign for single-payer health care, starting with digital ads that ask voters to endorse his planned “Medicare for All” legislation ahead of the Senate’s August recess. The six-figure buy, paid for by Sanders’s 2018 Senate reelection campaign, will direct readers to his website, where they can sign on to his bill.

Heller under fire over Obamacare gymnastics
Seung Min Kim, Politico

Dean Heller can’t win on Obamacare. He’s inflamed the left and right throughout the debate on repealing the law. And now the Nevada Republican is handing critics more ammunition by signing onto a new overhaul of Obamacare that has piqued the interest of the White House but nonetheless has little momentum.

Senate OKs bills to address VA budget crisis, claims backlog
Hope Yen, The Associated Press

The Senate approved a pair of bills Tuesday taking aim at urgent problems at the Department of Veterans Affairs, clearing a $3.9 billion emergency spending package to fix a looming budget crisis and adopting new measures to pare down a rapidly growing backlog of veterans’ disability claims. Both bills passed by unanimous vote.

In Trump era, lobbyists boldly take credit for writing a bill to protect their industry
Kimberly Kindy, The Washington Post

For two years, lobbyists for doctors and their insurers met regularly around a conference table a few blocks from the Capitol to draft an overhaul of the nation’s medical malpractice laws. The resulting legislation proposed strict limits on damages for some plaintiffs and sharply lower fees for their attorneys.

F.D.A. Has 6 Inspectors for 3 Million Shipments of Cosmetics
Eric Lipton, The New York Times

The Food and Drug Administration has warned Congress that it is frequently finding contamination, illegal ingredients and other problems in the soaring quantities of imported cosmetics, and that it has only “limited resources” to inspect the shipments. The warning was part of a letter sent in late June to a House Democrat who is pushing Congress to enact legislation giving the F.D.A. greater powers and resources to regulate cosmetics.

Surgeon general nominee, asked about gun violence, treads carefully
Andrew Joseph, Stat News

At a hearing Tuesday for five of President Trump’s nominees at the Department of Health and Human Services, a long contentious issue briefly flared: the public health threat posed by gun violence. Sen. Chris Murphy (D-Conn.) asked Dr. Jerome Adams, Trump’s nominee for surgeon general, what the surgeon general can do to stem gun violence.

Commodity Dip, Euro Gains Hit Stocks; Gold Drops: Markets Wrap
Robert Brand, Bloomberg

Mining and oil shares weighed on Europe’s benchmark equity index as crude fell for a second day and most industrial metals traded lower. The surging euro added a further headwind.

Payers

Some Insurers Seek ACA Premium Increases of 30% and Higher
Anna Wilde Mathews and Louise Radnofsky, The Wall Street Journal

Major health insurers in some states are seeking increases as high as 30% or more for premiums on 2018 Affordable Care Act plans, according to new federal data that provide the broadest view so far of the turmoil across exchanges as companies try to anticipate Trump administration policies. Big insurers in Idaho, West Virginia, South Carolina, Iowa and Wyoming are seeking to raise premiums by averages close to 30% or more, according to preliminary rate requests published Tuesday by the U.S. Department of Health and Human Services.

Court Allows Democratic States to Defend Obamacare Payments
Lawrence Hurley, Reuters

A U.S. appeals court on Tuesday allowed Democratic state attorneys general to defend subsidy payments to insurance companies under the Obamacare healthcare law, a critical part of funding for the statute that President Donald Trump has threatened to cut off. The U.S. Court of Appeals for the District of Columbia Circuit granted a motion filed by the 16 attorneys general, led by California’s Xavier Becerra and New York’s Eric Schneiderman.

Insurers outline actions HHS can take to bolster marketplaces without Congress
Virgil Dickson, Modern Healthcare

With attempts to stabilize the individual market through legislation at an impasse, major insurance companies, including Centene, Cigna and the Blue Cross and Blue Shield Association, say there are things that can be done by HHS administratively to bolster the insurance marketplaces. Payers are still most interested in getting assurances that cost-sharing reductions will continue and the individual mandate will be enforced, but given the political controversy surrounding those requests, they’ve also outlined other requests that won’t require congressional action.

Providers

Medical boards ring up big margins by charging doctors high exam fees
Max Blau, Stat News

After the grueling slog of medical school, residency, and fellowship, Dr. Brian Drolet was ready to start paying down his debt. Then the hand surgeon faced another $5,660 in board certification fees.

Pharma, Biotech and Devices

These New Devices Promise to Fight Pain without Opioids
Emily Mullin, MIT Technology Review

Terri Bryant was working at a cheese factory in 2000 when she injured the delicate, rubbery discs between her spinal bones. That was the start of her chronic pain. Two years later, she had back surgery and started regularly taking fentanyl, a powerful prescription opioid medication. Her pain persisted even after a second surgery in 2009.

Drug Puts A $750,000 ‘Price Tag On Life’
Julie Appleby, Kaiser Health News

Jana Gundy and Amanda Chaffin live within two hours of each other in Oklahoma. Each has a child with the same devastating disease, one that robs them of muscle strength, affecting their ability to sit, stand or even breathe.

FDA approves leukemia treatment developed by Celgene, Agios
Tamara Mathias and Natalie Grover, Reuters

The U.S. Food and Drug Administration (FDA) on Tuesday approved Celgene Corp and Agios Pharmaceuticals Inc’s oral treatment for acute myeloid leukemia (AML) patients with a rare genetic mutation. The drug, Idhifa, will have a monthly list price of $24,872, Celgene said in an email, noting that the median time on therapy for patients was 4.3 months in the trial to secure the FDA’s approval.

Health IT

Health IT groups weigh in on ONC’s interoperability measurement framework
Evan Sweeney, Fierce Healthcare

The nation’s leading health IT groups offered a range of responses to the Proposed Interoperability Standards Measurement Framework published by the Office of the National Coordinator for Health IT in May. Broadly, most groups expressed some trepidation that any new standards would cause undue burden to providers, and urged the ONC to focus efforts on measurement areas that will have the biggest impact.

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. Proposals to allow the importation of drugs into the U.S. would expose Americans to unregulated and potentially dangerous drugs that have not been inspected by Canadian or U.S. officials. These proposals would lead to potentially dangerous outcomes for patients and increase the burden on law enforcement to prevent unregulated medicines from harming Americans. Get the facts at http://onphr.ma/2u12plT

Opinions, Editorials and Perspectives

Medicare Proposal to Better Align Payments Deserves Broad Support
Randy Broun, Morning Consult 

When it comes to health care services, many Americans assume that the government pays for health care the same way consumers pay for products in the retail setting. A consumer buying a bag of chips at Grocery Store A would expect to pay a comparable price for that exact same bag of chips at Grocery Story B three blocks away. In most cases, this would be true.

How Republicans can fix Obamacare now
Lanhee J. Chen and Tevi Troy, The Washington Post

The failure of Senate Republicans to pass even their “skinny” repeal bill is a serious disappointment to critics of the Affordable Care Act. Despite campaign rhetoric suggesting otherwise, “repeal and replace” of the ACA is something Republicans are apparently unable and likely unwilling to do. The only silver lining for conservatives is that the failure has demonstrated what the political market will bear when it comes to changes to the law.

ObamaCare for Congress
The Editorial Board, The Wall Street Journal

President Trump likes to govern by Twitter threat, which often backfires, to put it mildly. But he’s onto something with his recent suggestion that Members of Congress should have to live under the health-care law they imposed on Americans.

Maine’s Two Senators Let Us Down
Paul R. LePage, The Wall Street Journal

When it comes to providing affordable health care to the people of Maine, Sens. Susan Collins and Angus King are worse than out of touch—they are downright dangerous. After Maine expanded Medicaid to childless adults in 2002 under then-Gov. King, the program nearly bankrupted our state.

Taking the Addiction Out of Smoking
Robert N. Proctor, The New York Times

A lightning bolt struck the tobacco world last Friday when the Food and Drug Administration announced a plan aimed at reducing the nicotine in cigarettes to a nonaddictive level. Within an hour, the value of global tobacco stocks plummeted — and for good reason.

Research Reports

Trump Move Would Boost Premiums, Raise Federal Costs, Destabilize Insurance Market
Sarah Lueck, Center on Budget Policy and Priorities

In threatening to stop making federal cost-sharing reduction payments (CSRs) to health insurers providing marketplace coverage, President Trump falsely claimed that they constitute an insurer “bailout.” Actually, the federal government must make these payments to compensate insurers for reducing deductibles and copayments for low- and moderate-income marketplace consumers, as the Affordable Care Act (ACA) requires.