Health Brief: Hickenlooper, Kasich Could Present ACA Stabilization Plan Today


Government Brief

  • Govs. John Hickenlooper (D-Colo.) and John Kasich (R-Ohio) could present their bipartisan proposal to shore up the health insurance markets as soon as today. The plan will likely request more flexibility for states and to loosen the employer mandate that requires companies with 50 or more full-time employees to provide health insurance. (The Denver Post)
  • Despite President Donald Trump’s repeated threats to undermine the Affordable Care Act, an administration official said the administration wants to stabilize the law’s exchanges, but did not say whether it would promote enrollment this fall or continue making key insurer payments known as cost-sharing reductions. The official spoke on the condition of anonymity to approximately 20 journalists. (The New York Times)
  • Freshman Sen. Kamala Harris (D-Calif.) said she intends to co-sponsor Sen. Bernie Sanders’ (I-Vt.) “Medicare for all” legislation. Harris’ support is a boost for progressives who are trying to unite the Democratic Party behind single-payer health care. (Politico)

Business Brief

  • Missouri Attorney General Josh Hawley expanded his investigation into opioid drug makers, sending subpoenas to seven companies seeking information on how they market their painkillers. Officials in more than 20 states are probing opioid drug makers over allegations that the way they market their products has contributed to the nation’s addiction crisis. (Bloomberg)
  • Novartis AG said its groundbreaking cancer-fighting gene therapy, which was just approved by the Food and Drug Administration, would cost $475,000 for a course of treatment. While the price could seem staggering to patients, it is far less than the potential $750,000 a dose some analysts expected. (Stat News)
  • A customer is seeking to dismiss a lawsuit accusing CVS Health Corp. of working with pharmacy benefits managers to charge insured patients more for some generic medications than those who pay cash. A CVS spokesman previously called the accusations baseless. (The Associated Press)

Chart Review

Events Calendar (All Times Local)

Thursday
Paralyzed Veterans of America Annual Summit 7:15 a.m.
Friday
No events scheduled
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General

Hickenlooper’s next major test is his national health care proposal. Can he win over both parties?
John Frank, The Denver Post

The Hickenlooper-Kasich coalition is expected to present their ideas Thursday, and the duo promised substantive policy initiatives that can win support from Democrats and Republicans. It’s a difficult task, given the inability of the Republican-led Congress to advance a plan earlier this year to repeal former President Barack Obama’s signature health care law, sometimes called Obamacare.

Harris to co-sponsor Sanders’ single-payer bill
Carla Marinucci, Politico

California’s junior senator, Kamala Harris, on Wednesday departed from the position held by the state’s senior senator, Dianne Feinstein, and announced her intention to co-sponsor Senator Bernie Sanders’ “Medicare for All’’ bill. To the delight of a hometown crowd at a packed town hall meeting Wednesday in Oakland — where she was raised — Harris announced for the first time that she intended to co-sponsor “Medicare for All,’’ the single-payer health care bill which has the strong support of progressives and groups including National Nurses United, saying it was “the right thing to do.”

Murkowski, key Republican vote on health care, says a new Senate bill will be bipartisan and target costs
Alex DeMarban, Alaska Dispatch News

One of the three Republican senators who cast a deciding vote against repealing “Obamacare” — Alaska’s Lisa Murkowski — said Tuesday that she and other lawmakers are discussing plans to create a bipartisan replacement measure that seeks to stabilize the individual insurance market and lower health care costs. “It can’t be just a partisan bill,” Murkowski told a luncheon of the Anchorage Downtown Rotary Club on Tuesday.

Fentanyl drives another record year of Ohio overdose deaths
Andrew Welsh-Huggins, The Associated Press

An average of 11 people died each day of drug overdoses last year in Ohio, officials said Wednesday as they reported yet another grim milestone in the state’s addictions epidemic. A record 4,050 people died of drug overdoses in 2016, with fatalities driven in large part by the emergence of stronger drugs like the synthetic painkiller fentanyl, the Health Department said.

LePage Tries To Block Medicaid Expansion In Maine By Labeling It ‘Welfare’
Alice Ollstein, Talking Points Memo

Is Medicaid “insurance” or is it “welfare”? The battle taking place in Maine right now over this semantic question could determine whether the state becomes the first in the nation to adopt Obamacare’s Medicaid expansion by popular vote.

Stocks Advance on Growth Outlook; Dollar Steady: Markets Wrap
Robert Brand, Bloomberg

European shares gained a second day after after data underscored the resilience of the American and Chinese economies, and billionaire investor Warren Buffett said he still prefers stocks to bonds. The dollar was steady as Treasury yields rose a second day.

Payers

Trump Administration Wants to Stabilize Health Markets but Won’t Say How
Robert Pear, The New York Times

A Trump administration official said Wednesday that the administration wanted to stabilize health insurance markets, but refused to say if the government would promote enrollment this fall under the Affordable Care Act or pay for the activities of counselors who help people sign up for coverage. The official also declined to say whether the administration would continue paying subsidies to insurance companies to compensate them for reducing deductibles and other out-of-pocket costs for low-income people.

What Tennessee’s insurance commissioner wants on ACA reform
David Nather, Axios

Senate HELP Committee chairman Lamar Alexander will pay a lot of attention to what’s happening in his home state of Tennessee when he moves ahead on an Affordable Care Act stabilization bill. Here’s what he’s likely to hear from Tennessee insurance commissioner Julie McPeak, who’s scheduled to testify at one of the hearings on the bill next week.

Providers

Providers feel the pain of slow Medicaid mental services rule rollout
Virgil Dickson, Modern Healthcare

David Ramsey’s hospitals and emergency departments in West Virginia see the effects of the opioid epidemic every day. Medicaid beneficiaries battling addiction and psychiatric disorders crowd into his emergency departments even though the CMS has launched a nationwide policy to pay for substance-abuse treatment and stays at inpatient psychiatric facilities.

Laughing gas makes a comeback as painkiller in ambulances
Lisa Rathke, The Associated Press

Normally used in dentist’s offices and hospitals, nitrous oxide — yes, laughing gas — is starting to turn up again in ambulances in some rural areas where medical workers with clearance to provide more traditional painkillers often aren’t on board. It gives advanced emergency medical technicians, who are a step down from higher-level paramedics, a way to help relieve patients’ pain and anxiety on what can sometimes be long trips to a hospital.

Pharma, Biotech and Devices

More Opioid Makers Get Subpoenas From Missouri Attorney General
Chris Dolmetsch, Bloomberg

Missouri Attorney General Josh Hawley expanded his probe into the promotion of opioids by pharmaceutical companies, sending subpoenas to seven more drugmakers seeking information about how they market the painkillers. Allergan Plc, Depomed Inc., Insys Therapeutics Inc., Mallinckrodt Plc, Mylan NV, Pfizer Inc. and Teva Pharmaceutical Industries Ltd. were sent subpoenas from Hawley, a Republican.

Pioneering cancer drug, just approved, to cost $475,000 — and analysts say it’s a bargain
Damian Garde, Stat News

The Food and Drug Administration on Wednesday approved a futuristic new approach to treating cancer, clearing a Novartis therapy that has produced unprecedented results in patients with a rare and deadly cancer. The price tag: $475,000 for a course of treatment.

CVS customer seeks dismissal of recent drug prices lawsuit
The Associated Press

A CVS customer wants to end a short-lived, federal lawsuit that hit the drugstore chain in a sensitive area: The prices it charges for prescriptions. The customer accused CVS Health Corp. of conspiring with pharmacy benefits managers to charge insured patients more for some generic medicines than people who pay cash.

Health IT

EHR vendors, provider groups want more details on the definition of information blocking
Evan Sweeney, Fierce Healthcare

A group of health IT and provider organizations want federal officials to issue a proposed rule clarifying the definition of information blocking and the subsequent approach from enforcement officials. Led by Health IT Now, the group of 13 stakeholders, including the American Academy of Family Physicians, the American Medical Informatics Association (AMIA) and several prominent EHR vendors, recommended that the Department of Health and Human Services clarify its definition of information blocking, which is prohibited under the 21st Century Cures Act.

Opinions, Editorials and Perspectives

The ACA markets are a narrow problem. They should be treated that way.
Drew Altman, Axios

When Congress returns next week, the health debate will shift from trying to pass sweeping legislation to stabilizing the non-group insurance market. This will be a different debate about a thorny but smaller problem.

Congress, keep hands off employer sponsored plans in healthcare fights
James Gelfand, The Hill

Lawmakers are back in town and soon the Senate Health, Education, Labor and Pensions (HELP) Committee will once again take up the beast that is healthcare. Some will be tempted to merely throw more money and the semblance of flexibility into a broken system — we urge them to reject this Band-Aid, and to instead implement real reforms.

I’m Winning My Battle With Smartphone Addiction
Leonid Bershidsky, Bloomberg

Most of the research on phone addiction and deprivation is done on students. It’s not just the “kids these days,” though.

My son has autism. Discrimination almost cost him his life.
Sunshine Bodey, The Washington Post

Five years ago, when my son Lief was 9, he fell ill with a virus. The virus attacked his heart and flooded it with fluid.

Research Reports

Medicaid Waivers Should Further Program Objectives, Not Impose Barriers to Coverage and Care
Judith Solomon and Jessica Schubel, Center on Budget and Policy Priorities

In response to a letter from Health and Human Services (HHS) Secretary Tom Price and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma inviting states to propose Medicaid program changes that HHS has rejected in the past, numerous states now have damaging “waiver” proposals in the approval pipeline or under consideration. These include requests to condition Medicaid eligibility on work and work-related activities or drug screening and testing, impose premiums on people with incomes below the poverty line, limit how long people can remain enrolled in Medicaid coverage, and lock people out of coverage if they don’t submit renewal paperwork on time or don’t report changes in employment or income within ten days.

Briefings

Health Brief: GOP Senators Ask CBO to Fast-Track ACA Overhaul Review

Senate Republican leaders have asked the Congressional Budget Office to fast-track consideration of a plan from Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) to overhaul the Affordable Care Act. The CBO is reportedly in the process of analyzing the cost and coverage impact of the plan, as Republicans face pressure to make one last attempt at undoing the ACA before GOP senators’ ability to pass legislation with a simple majority expires on Sept. 30.

Health Brief: Week in Review & What’s Ahead

HELP Committee Chairman Lamar Alexander (R-Tenn.) hopes to reach a deal with Democrats on a plan to shore up the ACA exchanges early this week. A final agreement, if reached, is likely to extend key insurer payments, known as cost-sharing reductions, and include reforms to make it easier for states to establish reinsurance programs. Some Republicans are also pushing to give states more flexibility over required benefits in Obamacare plans, a proposal that is controversial with Democrats.

Health Brief: Some Moderate House Democrats Seek ACA Stabilization

While progressives this week rallied behind Sen. Bernie Sanders’ (I-Vt.) single-payer health care bill, a group of moderate House Democrats in the New Democrat Coalition aligned themselves with the Senate Health, Education, Labor and Pensions Committee’s bipartisan push to stabilize the Affordable Care Act exchanges, which Committee Chairman Lamar Alexander (R-Tenn.) aims to reach a final deal on by early next week.

Health Brief: Deal Reached to Extend CHIP Funding

Senate Finance Committee leaders reached a deal on a five-year reauthorization of the Children’s Health Insurance Program, in a win for children’s health advocates who are seeking longer-term funding certainty for the program, which will expire at the end of the month without congressional action. The deal also gradually phases out the enhanced federal share of funding for state CHIP programs, which was increased under the Affordable Care Act by 23 percentage points.

Health Brief: Some Navigators Shut Down Ahead of ACA Enrollment Period

Several navigator organizations, including one that received the largest federal grant for Obamacare enrollment activities in 2016, are suspending operations ahead of the 2018 open enrollment season because they haven’t received contracts for funding from the Department of Health and Human Services, which could cause enrollment to plummet. The Trump administration announced plans last month to cut funding for navigator groups by about 40 percent, but health officials haven’t said whether the grants would end altogether.

Health Brief: Teva Names New CEO

H. Lundbeck A/S’s Kaare Schultz was named as Teva Pharmaceutical Industries Ltd.’s new chief executive officer, ending a seven-month search by the world’s largest generic drug maker to find a new leader. Schultz could face pressure to split the company into two businesses, one focusing on patented specialty drugs and the other on cheap copycat medicines

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