Health Brief: House Panel Advances CHIP Reauthorization on Party-Line Vote

Government Brief

  • The House Energy and Commerce Committee voted along party lines to approve a bill that would extend funding for the Children’s Health Insurance Program. On the other side of the Capitol, Senate Republicans and Democrats are working to come up with an agreement on how to finance the program before considering the measure on the Senate floor. (The New York Times)
  • States are increasingly concerned that Congress will not renew CHIP quickly enough to avoid budget shortfalls or before some programs take steps to cap enrollment or shut down by year’s end. While CHIP has broad bipartisan support, congressional negotiations are bogged down over how to offset funding for the program, and final legislative action on Capitol Hill is unlikely until late October at the earliest. (The Wall Street Journal)
  • The Senate voted 57-38 to confirm President Donald Trump’s pick to fill the No. 2 post at the Department of Health and Human Services, with seven Democrats and Sen. Angus King (I-Maine) backing the nomination. Eric Hargan is a Chicago-based lawyer who served in the George W. Bush administration. (The Hill)

Business Brief

  • Cigna announced that it would stop covering OxyContin in its employer plans starting next year, as the health insurer takes steps to meet its goal of a 25 percent reduction in customer opioid use by 2019. Cigna said it would continue to cover a competing oxycodone alternative, but will impose a financial penalty on the drug’s manufacturer if the average daily dosage for Cigna’s customers exceeds a certain threshold. (CNBC)
  • The Food and Drug Administration approved Mylan NV’s generic version of rival Teva’s multiple sclerosis treatment, Copaxone. Mylan shares surged 18 percent while Teva’s slumped after the approval, which came earlier than both companies expected and a day after the FDA issued measures to speed the approval of generic versions of complex drugs. (Reuters)
  • Economic interests have forced the American Medical Association to back away from its support for the idea of allowing the federal government to negotiate lower drug prices, according to comments by AMA President-elect Barbara McAneny at a meeting of the group’s Relative Value Scale Update Committee. McAneny said supporting the drug negotiation policy would cause the AMA to lose credibility in its fight against price-fixing for physicians. (Axios)

Chart Review

Events Calendar (All Times Local)

Senate HELP Committee hearing on the opioid crisis 10 a.m.
No events scheduled

Getting medicines to those affected by hurricanes

America’s biopharmaceutical companies are partnering with disaster response organizations to address medical gaps in the areas impacted by the hurricanes.


Senate confirms No. 2 spot at HHS, days after Price resigns
Rachel Roubein, The Hill

The Senate confirmed Eric Hargan to fill the No. 2 position in the Department of Health and Human Services (HHS) just days after Tom Price resigned as HHS secretary. The 57-to-38 vote on Wednesday was largely along party lines.

Embattled GOP Rep. Tim Murphy to retire
Rachael Bade, et al., Politico

Rep. Tim Murphy of Pennsylvania announced Wednesday that he will retire at the end of his term, after allegations that the married Republican lawmaker, who opposes abortion rights, asked his mistress to terminate a pregnancy. Murphy admitted several weeks ago to an affair with forensic psychologist Shannon Edwards — news that came to light during the woman’s divorce proceedings with her husband.

In Puerto Rico, Health Concerns Grow Amid Lack of Clean Water, Medical Care
Daniela Hernandez, The Wall Street Journal

In the aftermath of Hurricane Maria, many Puerto Ricans are grappling with growing health concerns due to a lack of reliable access to medical care, supplies and clean water. Maggie Reuteman, a volunteer registered nurse with the Red Cross in Puerto Rico, said some patients on oxygen are rationing their supply, fearing they won’t get more in time.

Nevada’s mental health care system was already in dire straits. The carnage in Las Vegas will strain it more
Rebecca Robbins, Stat News

The volunteer psychologists and counselors have been pouring into this grieving city, so fast that a state official says the supply far exceeds the demand for crisis counseling. But a worrisome question looms: What happens when the volunteers go home?

Sterling Down, Spanish Stocks Rebound on Catalonia: Markets Wrap
Eddie Van Der Walt, Bloomberg

The euro traded little changed, Spanish stocks rebounded and the nation successfully sold bonds as Economy Minister Luis de Guindos poured cold water on Catalonia’s bid for independence. The pound fell as political noise swirled around U.K. Prime Minister May’s leadership in the wake of her Conservative Party conference speech.


Bill to Rescue Children’s Health Program Hits Snag in House
Robert Pear, The New York Times

Legislation to rescue the Children’s Health Insurance Program sailed through a Senate committee on Wednesday, but touched off a partisan conflict in the House, diminishing hopes that the popular program would be quickly refinanced. Funding for the program expired on Sunday, and state officials said they would soon start notifying families that children could lose coverage if Congress did not provide additional money.

States Worry Federal Funding for Children’s Health Program Won’t Come in Time
Michelle Hackman, The Wall Street Journal

As Congress struggles to reauthorize the broadly popular Children’s Health Insurance Program, states are increasingly concerned lawmakers won’t act quickly enough to help them avoid budget shortfalls and possibly a shutdown of some state programs by year’s end. House and Senate committees both approved packages Wednesday to renew spending on CHIP, days after Congress allowed the funding to expire over the weekend.

Federal employee health insurance premiums to rise by 6.1 percent
Joe Davidson, The Washington Post

Health insurance premiums paid by federal employees and retirees will increase 6.1 percent on average in 2018, the Office of Personnel Management (OPM) announced Wednesday. Open season, when individuals can shop around and choose health insurance plans, runs from Nov. 13 through Dec. 11 for the Federal Employees Health Benefits Program.

ACA premiums blame game may turn against Republicans
Caitlin Owens, Axios

For years, Democrats have been on the receiving end of political attacks about rising Affordable Care Act premiums. But the roles are about to be reversed — and it’s not clear whether Republicans will be able to avoid the blame. Why it matters: Not only has the GOP failed to fulfill a key campaign promise, but it’s also going to get slammed for allowing things to get worse for voters.

Obamacare sign-up challenge: proving the law is not dead
Yasmeen Abutaleb, Reuters

More than two thousand miles away from the healthcare debate in Washington, President Donald Trump’s threats to let Obamacare collapse are sowing confusion about its fate and dampening 2018 enrollment expectations. The uncertainty here in Arizona, echoed in interviews across the country, shows that even though they have not been able to repeal former President Barack Obama’s signature healthcare law, the Republican effort to undermine it is gaining traction.

Insurers are slow to approve pricey new cholesterol drugs
Cheryl Platzman Weinstock, Reuters

During the first year an expensive class of new cholesterol-lowering drugs was on the market, only one in three patients with a prescription actually received the therapy due to lack of insurance approval and high copays, according to a study sponsored by a manufacturer of one such drug. The drugs, known as PCSK9 inhibitors, are intended for use by adults whose “bad” low-density lipoprotein (LDL) cholesterol levels remain dangerously high even though they’re taking maximal doses of traditional cholesterol-lowering medications.


Why the AMA doesn’t support federal drug price negotiation
Bob Herman, Axios

The American Medical Association used to support the idea of the federal government negotiating lower prices for prescription drugs. But economic self-interests have forced the physician lobbying group to flip-flop on that policy, according to comments made by a top AMA leader to a roomful of doctors Wednesday.

Four HCA hospitals to pay $8.6M over alleged ambulance kickback scheme
Erica Teichert, Modern Healthcare

Four Houston-area HCA hospitals have agreed to pay $8.6 million to settle allegations that they received kickbacks from several ambulance companies in exchange for Medicare and Medicaid business referrals, federal officials said Wednesday. Bayshore Medical Center, Clear Lake Regional Medical Center, West Houston Medical Center and East Houston Regional Medical Center all allegedly made arrangements with unnamed ambulance companies to provide patients with free or heavily discounted transportation.

House Democrats plead for right of residents to sue nursing homes
Rachel Roubein, The Hill

In the wake of nursing home deaths cause by Hurricane Irma, House Democrats are asking the Centers for Medicare and Medicaid Services to let nursing home residents take facilities to court over allegations such as abuse. Over the summer, CMS announced it intended to change the rule under President Obama that banned nursing homes accepting Medicare or Medicaid funds from requiring a third party to settle disputes.

Pharma, Biotech and Devices

Cigna won’t cover OxyContin prescriptions for 2018, as health insurer targets opioid abuse
Dan Mangan, CNBC

Major insurer Cigna — which is engaged in an effort to reduce abuse of prescription painkillers — announced Wednesday that it will effectively stop covering the cost of use of the opioid OxyContin by customers of its employer-based health plans beginning in January. At the same time, Cigna announced a contract to continue covering a competing oxycodone alternative to OxyContin, which will impose a financial penalty on that drug’s maker if too much of the drug ends up being used by the insurer’s customers.

Mylan surges, Teva slumps after FDA approves Copaxone copy
Michael Erman and Divya Grover, Reuters

Mylan NV’s long-awaited U.S. approval for its generic version of rival Teva’s blockbuster multiple sclerosis treatment Copaxone drove Mylan’s shares up around 18 percent on Wednesday while Teva shares plunged. The approval late on Tuesday by the U.S. Food and Drug Administration came earlier than both companies had expected.

Health IT

IBM to Congress: Watson will transform health care, so keep your hands off our supercomputer
Casey Ross and Ike Swetlitz, Stat News

To the public, IBM trumpets its Watson supercomputer as the next big thing in medicine, a new kind of machine that melds human expertise with digital speed to give patients personalized treatment advice. Meanwhile, in the halls of Congress, company executives have been delivering a blunter message: We will revolutionize patient care, so please get out of the way.

A Message from PhRMA:

For those impacted by the devastation and flooding caused by Hurricanes Harvey, Irma and Maria, resources are available for patients to access medicines. America’s biopharmaceutical companies are coordinating with local and federal agencies to meet medical needs in the areas impacted by the hurricanes.

Opinions, Editorials and Perspectives

Let’s Keep the ACA Market Stable — the Same Way Republicans Have in the Past
Bobby Clark, Morning Consult

Compromise is hard. It’s harder in the United States Senate, especially when you are faced with people trying to constantly undermine your efforts.

U.S. Health Care Reform Can’t Wait for Quality Measures to Be Perfect
Brian J. Marcotte et al., Harvard Business Review

There’s a debate in the United States about whether the current measures of health care quality are adequate to support the movement away from fee-for-service toward value-based payment. Some providers advocate slowing or even halting payment reform efforts because they don’t believe that quality can be adequately measured to determine fair payment.

I’m a doctor. I want you to live and thrive. So I want semiautomatic guns banned.
Adam Gaffney, The Washington Post

There comes a moment, soon after an appalling mass shooting, when many horrified people cry out in exasperation: Explain, please, why is it that anybody in America needs an automatic weapon? By this they mean the rapidly firing weapons that are at the center of many of today’s gun control debates.

Research Reports

Safety and Immunogenicity of an Anti–Zika Virus DNA Vaccine — Preliminary Report
Pablo Tebas et al., The New England Journal of Medicine

Although Zika virus (ZIKV) infection is typically self-limiting, other associated complications such as congenital birth defects and the Guillain–Barré syndrome are well described. There are no approved vaccines against ZIKV infection.