Health Brief: House May Need to Vote on AHCA Again

Washington Brief

  • There is a chance that House Republicans will have to vote again on their health care bill, which was barely passed by the chamber earlier this month. Speaker Paul Ryan has not yet sent the bill to the Senate because parts of it may have to be redone, depending on how the Congressional Budget Office estimates its effects. (Bloomberg News)
  • Senate Republicans are scrambling to find a short-term fix to stabilize the Obamacare insurance markets before next year, but Democrats have made it clear they won’t work with them unless they drop their repeal effort. (The Hill)
  • More than a dozen Democratic attorneys general filed a motion to intervene in the appeal of a lawsuit targeting Obamacare’s cost-sharing reduction payments, which have become a focal point for how President Donald Trump plans to treat the 2010 law. (Reuters)

Business Brief

  • At a recent meeting, CMS Administrator Seema Verma stunned insurance executives by suggesting the administration would fund the cost-sharing reduction payments if they back the House GOP’s Obamacare replacement bill. (The Los Angeles Times)
  • Shares of Athenahealth soared by more than 17 percent after activist investor Paul Singer disclosed that he has a 9 percent stake in the electronic health record company. (Axios)
  • A House panel advanced the FDA user fee reauthorization bill after adopting an amendment aimed at curbing abusive pricing on drugs that lack generic competition. The so-called “bad actor” provision is not included in the Senate version of the bill. (Modern Healthcare)

Chart Review

Events Calendar (All Times Local)

Friday
NIHCM webinar on coverage for high-need patients 2:30 p.m.

 

General

House May Need to Vote Again on GOP Obamacare Repeal Bill
Billy House, Bloomberg News

House Republicans barely managed to pass their Obamacare repeal bill earlier this month, and they now face the possibility of having to vote again on their controversial health measure. House Speaker Paul Ryan hasn’t yet sent the bill to the Senate because there’s a chance that parts of it may need to be redone, depending on how the Congressional Budget Office estimates its effects.

Abortion poses hurdle for Senate healthcare bill
Rachel Roubein, The Hill

Abortion has emerged as a potential stumbling block for Senate Republicans as they seek to craft an ObamaCare repeal-and-replace bill that can garner 51 votes. Senators are fretting that a provision in the House healthcare bill that bars financial assistance from being used to buy plans covering abortion will be stripped out under the Senate’s rules of reconciliation.

Obamacare Helped Americans Detect Cancer Earlier
Michelle Cortez, Bloomberg News

The number of Americans whose cancers were diagnosed at the earliest stage, when it’s most likely to be cured, increased after Obamacare went into effect and more citizens had access to health insurance, a new study found. While the effect was small, the study found that a higher proportion of new breast, lung and colorectal tumors were detected at stage 1 in 2014 compared with a year earlier.

‘An embarrassment’: U.S. health care far from the top in global study
Ariana Eunjung Cha, The Washington Post

Americans grumble all the time about the quality of our health-care system, but when we’re dealing with serious issues, such as injuries from an auto accident or cancer, we often count our blessings that we live in a wealthy country that has well-trained doctors with access to the latest medical technology. Yet those factors don’t always correlate with staying alive.

Dems ask to meet with Ivanka Trump on women’s healthcare issues
Jessie Hellmann, The Hill

Female Democratic lawmakers are asking to meet with Ivanka Trump this month to talk about women’s health issues, such as access to contraception and maternity care. Trump, who works on women’s issues in her father’s administration, has been silent during the passage of the American Health Care Act (AHCA), which President Trump supports, the lawmakers said in a letter Thursday.

Scientists to test whether Zika can kill brain cancer cells
Kate Kelland, Reuters

Scientists in Britain plan to harness the Zika virus to try to kill brain tumor cells in experiments that they say could lead to new ways to fight an aggressive type of cancer. The research will focus on glioblastoma, the most common form of brain cancer, which has a five-year survival rate of barely 5 percent.

Stocks Steady After Volatile Week; Crude Rises: Markets Wrap
Benjamin Purvis et al., Bloomberg News

Global equities showed signs of stabilizing at the end of a turbulent week in which investors confronted political crises in Washington and Brazil. Oil headed for a second weekly gain as OPEC members supported Saudi Arabian and Russian pledges to extend supply cuts.

Payers

Senate GOP short on ideas for stabilizing ObamaCare markets
Nathaniel Weixel, The Hill

Senate Republicans are floating a short-term fix to stabilize the ObamaCare insurance markets before next year. Health insurance plans across the country need to decide by next month whether they will continue to operate in the ObamaCare exchanges, creating an immediate deadline for Congress.

Democratic attorneys general seek to intervene in Obamacare case
Dan Levine et al., Reuters

More than a dozen Democratic attorneys general on Thursday sought to intervene to defend a key part of the Obamacare healthcare law – subsidy payments to insurance companies – which is under threat in a court case. The 16 attorneys general, led by California Attorney General Xavier Becerra and New York Attorney General Eric Schneiderman, filed a motion to intervene in the case pending in the U.S. Court of Appeals for the District of Columbia Circuit.

Health insurers plan big Obamacare rate hikes — and they blame Trump
Noam N. Levey, The Los Angeles Times

Health insurers across the country are making plans to dramatically raise Obamacare premiums or exit marketplaces amid growing exasperation with the Trump administration’s erratic management, inconsistent guidance and seeming lack of understanding of basic healthcare issues. At the same time, state insurance regulators — both Democrat and Republican — have increasingly concluded they cannot count on the Trump administration to help them ensure that consumers will have access to a health plan next year.

Republicans Lock Onto Insurance Troubles in Push to Topple Health Law
Stephanie Armour et al., The Wall Street Journal

Republicans are seizing on early signs of premium increases and diminishing insurer participation on next year’s insurance exchanges as proof the Affordable Care Act is floundering and must be overturned, pitting them against Democrats who say the GOP repeal effort itself is to blame. The finger-pointing is taking on new urgency as Republican lawmakers cite the ACA’s problems to drum up support for their legislation to topple the law, often called Obamacare.

New Senate bill aims to boost Medicaid addiction treatment access
Maria Castellucci, Modern Healthcare

A bipartisan group of senators on Wednesday introduced a bill that would allow more substance abuse treatment center to receive Medicaid payments. The legislation would enable treatment facilities with up to 40 beds to be reimbursed by Medicaid for 60 consecutive days of inpatient services.

Senate Panel Approves Bill Revamping Medicare for Chronically Ill Patients
Jon Reid, Morning Consult 

The Senate Finance Committee on Thursday unanimously advanced legislation aimed at improving care for people with chronic illnesses, part of a bipartisan effort that has advanced even as Republicans and Democrats fight over the future of the Affordable Care Act. The bill, which is backed by the American Heart Association and dozens of other industry groups, would revamp how Medicare works for patients who have chronic medical conditions.

Aetna targets dentist ‘superprescribers’ in latest opioid initiative
Shelby Livingston, Modern Healthcare

After a root canal or wisdom tooth removal, it’s not unusual for a patient to walk away from the dentist’s chair with a prescription for Vicodin or Percocet, even though ibuprofen would easily relieve the pain. Dentists are among the highest prescribers of highly-addictive prescription opioids—a driving factor in the worsening opioid epidemic.

Providers

California Bill Addresses Safety Concerns At Dialysis Clinics
Anna Gorman, Kaiser Health News

Saying they are concerned about safety in California’s dialysis clinics, a coalition of nurses, technicians, patients and union representatives is backing legislation that would require more staffing and oversight. The bill, introduced by Sen. Ricardo Lara (D-Bell Gardens), would establish minimum staffing ratios, mandate a longer transition time between appointments and require annual inspections of the state’s 562 licensed dialysis clinics.

Pharma, Biotech and Devices

House committee adds pharma ‘bad actor’ provision to FDA user fee bill
Mara Lee, Modern Healthcare

A group of House lawmakers on Thursday approved the FDA user fee reauthorization bill and added a bipartisan amendment aiming to curb abusive drug pricing on pharmaceuticals without generic competition. The amendment and the bill, both passed unanimously out of the Health subcommittee of the House Energy and Commerce Committee.

How the FDA Approved a $300,000-a-Year Drug Its Own Experts Didn’t Believe Worked
Susan Pulliam and Brody Mullins, The Wall Street Journal

Jennifer McNary, a stay-at-home mother, was desperate to find a medicine that might spare her two sons an early death from a rare form of muscular dystrophy.
Chris Garabedian, the chief executive of a pharmaceutical firm, was desperate to find a profitable drug that would reverse his company’s slow fall.

How a drug ad made its way into ‘General Hospital’
Damian Garde, Stat News

Anna Devane has survived assassination plots, severe frostbite, and a boat explosion that left her with amnesia. Now, resigned to a hospital bed with inexplicable fatigue, she’s facing perhaps her most fearsome adversary.

Health IT

Activist investor Paul Singer goes after Athenahealth
Bob Herman, Axios

Shares of the electronic health record company Athenahealth soared by more than 17% this morning after Paul Singer, the activist investor who runs the hedge fund Elliott Associates, bought more than 9% of Athenahealth’s stock, according to a Securities and Exchange Commission filing. Athenahealth has about $1 billion of revenue and sells most of its cloud-based technology to doctors and small hospitals.

A Message from America’s Biopharmaceutical Companies:

Come with us to a new world. Where 140,000 biopharmaceutical researchers GOBOLDLY into the unknown to discover treatments and cures unimaginable ten years ago. Watch the new video at www.GoBoldly.com.

Opinions, Editorials and Perspectives

Despite What You’ve Read, Many Small Businesses Support Obamacare
John Arensmeyer, Morning Consult 

Small business owners are not some sort of single-minded monolith, but they are often treated that way. Stories pop up frequently with bold, broad-stroked claims like “small business optimism is soaring,” “small businesses get hefty tax cut in Trump plan” and “the president changed, so has small business’ confidence.”

The Best Replacement for Obamacare Is Medicaid
Michael S. Sparer, The New York Times

In defending their efforts to repeal the Affordable Care Act, Republican leaders in Congress argue that the insurance marketplaces created by the law are failing. They aren’t completely wrong. Trouble began with faulty websites during the rollout in 2013. Since then, enrollment continues to be below expectations.

Trump Extorted Insurers to Make Them Support Health-Care Bill
Jonathan Chait, New York Magazine

One of the most plausible predictions of the kinds of long-term damage Donald Trump might do to the United States was written by Matthew Yglesias a week after the election. He described a scenario in which Trump used government power to coerce business to support him and his agenda.

Trumpcare Is Already Hurting Trump Country
The Editorial Board, The New York Times

The mere threat that Obamacare will be dismantled or radically changed — either by Congress or by President Trump himself — has persuaded several big insurance companies to stop selling policies or significantly raise premiums. The practical effect is that some lower-income and middle-class families may have no good options for insurance and will have to spend more on health care.

A Message from America’s Biopharmaceutical Companies:

Welcome to the future of medicine. Where breakthrough science is replacing chemotherapy with immunotherapy. Where we can attack the causes of disease, not just the symptoms. Where medicines once designed to fit all are now designed to fit you. Learn more at www.GoBoldly.com.

Research Reports

AHCA Will Remove Low-Cost Sharing Guarantees for Low-Income Individuals
Chris Sloan, Avalere

New research from Avalere finds that under the American Health Care Act (AHCA), low-income individuals who purchase insurance on an exchange would lose access to cost sharing subsidies that help make accessing healthcare affordable. Currently, these cost sharing reduction (CSR) subsidies reduce deductibles by up to 93 percent and maximum out-of-pockets (MOOPs) by up to 85 percent.

Briefings

Health Brief: White House Says It Will Make August CSR Payments

The Trump administration said it would make key payments to insurers this month, despite threats from President Donald Trump to terminate them after Senate Republicans failed to pass a repeal of the Affordable Care Act. Governors and Democrats have been urging Trump to continue the payments because insurers have said they would hike premiums or exit the exchanges without them.

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