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Health Brief: Judge Blocks Anthem-Cigna Merger

Washington Brief

  • The Senate voted to limit debate on Rep. Tom Price’s (R-Ga.) nomination to lead the Department of Health and Human Services and is set to take a final vote today or sometime Friday morning. Senators are expected to vote along party lines to approve Price. (Axios)
  • Rep. Elijah Cummings (D-Md.) is set to meet with President Donald Trump next week to discuss drug prices. The ranking democrat on the House Oversight Committee has been outspoken on high drug prices. (Politico)
  • Sen. Mike Lee (R-Utah) slammed a proposal from House colleagues to include parts of an Obamacare replacement in legislation to repeal the law. (Roll Call)

Business Brief

  • A federal judge blocked a $54 billion Anthem-Cigna merger, saying the proposed deal would limit competition. It follows a similar decision by another federal judge to block a deal between Aetna and Humana. (The Washington Post)
  • Health care trade groups are changing how they talk about the Affordable Care Act to emphasize what they consider to be the law’s benefits, which they hope will be maintained in a replacement measure. (The Wall Street Journal)
  • Pharmacy benefit managers are taking hits from pharmacies and pharmaceutical companies as part of the reason for high drug prices. Pharmaceutical Care Management Association, the industry’s lobbying group, is circulating a plan this week. (Bloomberg News)

Correction
An earlier version of this brief incorrectly stated the value of the Anthem-Cigna merger.

Chart Review

Events Calendar (All Times Local)

Thursday
Brookings Institution event on Obamacare markets 9 a.m.
Friday
NIHCM Webinar on Engaging Medicaid Patients 1 p.m.

 

General

More than 350 organizations write Trump to endorse current vaccines’ safety
Lena H. Sun, The Washington Post

More than 350 organizations, including leading U.S. medical, advocacy and professional organizations, have sent a letter to President Trump expressing their “unequivocal support for the safety of vaccines.” The effort, organized by the American Academy of Pediatrics, reflects the growing alarm among a wide array of groups over Trump’s embrace of discredited claims about vaccine safety.

Obama’s Drug Czar: The Opioid Crisis Must Continue To Be A Federal Priority
Shefali Luthra, Kaiser Health News

The GOP is working to repeal and replace the 2010 health law, known for insuring more than 20 million people. And the change could affect another health concern: the nation’s opioid abuse problem.

Manchin a no on Tom Price, setting up likely party-line vote
Caitlin Owens, Axios

Democratic Sen. Joe Manchin will oppose Rep. Tom Price’s nomination as secretary of the Department of Health and Human Services, meaning Price is likely to be confirmed with only Republican votes. The Senate has a procedural vote on Price’s confirmation tonight, setting up a final vote that’s likely to come sometime Friday morning.

Europe Stocks Extend Asia Momentum as Bonds Climb: Markets Wrap
Jeff Sutherland and Samuel Potter, Bloomberg News

Positive momentum from Asian stocks carried through into Europe after good earnings from Societe Generale SA offered financial shares some relief. Most sovereign bonds also edged higher following Wednesday’s rally in Treasuries.

Payers

Conservatives in Congress call for Obamacare repeal ‘in the next few months’
David Weigel, The Washington Post

A trio of House and Senate conservatives told reporters Wednesday that full repeal of the Affordable Care Act needs to happen in the spring, contradicting President Trump’s recent comments that repeal might come as late as 2018. “Repeal needs to get done in the next few months so we can look forward,” said Sen. Mike Lee (R-Utah).

Health Law’s Unexpected Backers
Michelle Hackman, The Wall Street Journal

When the Affordable Care Act was debated in 2010, the country’s biggest gynecologists’ group spoke out against it, saying it wouldn’t help doctors get paid more fairly or avoid frivolous malpractice lawsuits. Today, the American Congress of Obstetricians and Gynecologists is fighting efforts to fully repeal the law, pushing especially to keep a ban on charging women higher health insurance premiums than men.

Republicans working with CBO on details of ObamaCare bill
Peter Sullivan, The Hill

House Republicans have been working with the Congressional Budget Office on parts of an ObamaCare replacement that they could include in a repeal bill this spring, lobbyists and aides tell The Hill. They have been working with the CBO, Congress’s nonpartisan budget scorekeeper, on the details of tax credits, high-risk pool funding, and changes to Medicaid that could be included in a repeal bill that Republicans hope to pass by the end of March.

GOP swimming in Obamacare replacements, but no consensus
Burgess Everett and Jennifer Haberkorn, Politico

Republican leaders want to get their Obamacare repeal effort back on track. There’s a big problem, though: They’re neck-deep in competing plans to replace the law.

Sen. Mike Lee: House Proposal to Replace Obamacare a ‘Horrible Idea’
Erin Mershon, Roll Call

Utah Republican Sen. Mike Lee on Wednesday criticized a House proposal to include provisions that would “replace” the 2010 health care law in a repeal measure, calling it “a horrible idea.”

GOP faces limited options on Medicaid
Nathaniel Weixel and Rachel Roubein, The Hill Extra

Changing Medicaid is one of the touchiest fights within the GOP effort to replace ObamaCare, and could become even more toxic if Republicans decide to bring children’s health insurance into the mix. Among the options under discussion to reform the state-federal health insurance program for the needy is tacking the provisions onto a separate funding renewal for the Children’s Health Insurance Program, according to several lobbyists familiar with the negotiations.

Humana announces 69 percent drop in Obamacare customers
Robert King, Washington Examiner

A major insurer on Wednesday reported a huge drop in the number of Obamacare customers it has. Humana reported in its latest fourth quarter 2016 earnings Wednesday that total enrollment in the individual market, which includes Obamacare’s exchanges, declined by 69 percent in January 2017 compared to the month before.

Trump Administration Weighs Health Insurance ‘Stabilization’
Ricardo Alonso-Zaldivar, The Associated Press

Worried about the nearly 20 million people who buy their own health insurance policies, the Trump administration and congressional Republicans are weighing how to stabilize a wobbly market, government and industry officials say. The goal is to soothe jittery insurance companies that may bolt next year, while reassuring consumers anxious about the future.

Judge blocks $54 billion Anthem-Cigna health insurance merger
Carolyn Y. Johnson, Morning Consult

A federal judge blocked the $54 billion merger between health insurance giants Anthem and Cigna on Wednesday, saying the deal would increase prices and reduce competition.

U.S. Health Insurance Mergers Killed as Companies Plot Moves
Zachary Tracer et al., Bloomberg News

After 18 months of courtship and court cases, two massive deals that would have reshaped the U.S. health insurance industry have both been declared dead, blocked by judges who said they’d do unacceptable harm to competition in the industry. Now, the companies are right back where they started. Anthem Inc.’s $48 billion deal to buy Cigna Corp. was blocked by a federal judge late Wednesday, weeks after another judge halted Aetna Inc.’s bid for Humana Inc.

The financial impact of UnitedHealth’s Obamacare exit
Bob Herman, Axios

UnitedHealth Group’s retreat from the Obamacare exchanges will reduce its premium revenue by $4 billion this year, the health insurance conglomerate said in an annual securities filing Wednesday.

With Price confirmation looming, Georgia lawmakers seek to cap Medicaid funding
Virgil Dickson, Modern Healthcare

The confirmation of U.S. Rep. Tom Price as the next HHS secretary is expected any day now. That’s empowered Republican lawmakers in his home state of Georgia to make become the first in the nation to seek a per-capita cap waiver for Medicaid.

Patient groups fear Obamacare repeal could undo protections for sickest Americans
Lev Facher, Stat

As Republicans confront the thorny realities of repealing and replacing the Affordable Care Act, groups representing patients with the most serious diseases fear those plans could return the US health care system to one in which sick people are not guaranteed health insurance. It comes down to the individual mandate, the law’s most unpopular provision, which required every American to buy insurance or face a penalty.

Providers

Last Cuban Doctor Defectors Arrive in U.S. After Policy Change
Adriana Gomez Licon, The Associated Press

Yoandri Pavot applied just in time for a visa under a recently scrapped U.S. policy that had long welcomed doctors from Cuba who defected while on assignment in third countries. Pavot and other Cuban doctors arriving this week in Miami under the now canceled policy called the Cuban Medical Professionals Parole said they’re relieved to be arriving despite uncertain times for immigrants under the Trump administration.

New Federal Rules Will Require Home Health Agencies To Do Much More For Patients
Judith Graham, Kaiser Health News

Home health agencies will be required to become more responsive to patients and their caregivers under the first major overhaul of rules governing these organizations in almost 30 years. The federal regulations, published last month, specify the conditions under which 12,600 home health agencies can participate in Medicare and Medicaid, serving more than 5 million seniors and younger adults with disabilities through these government programs.

Pharma, Biotech and Devices

Democrat Cummings to talk drug prices with Trump at White House
K
yle Cheney, Politico

Rep. Elijah Cummings (D-Md.) is preparing to meet with President Donald Trump at the White House to find common ground on efforts to combat surging prescription drug costs. Cummings, who told POLITICO the meeting is tentatively scheduled for next week, would be one of the first Democratic House members to huddle with Trump since he was inaugurated.

Big Pharma Is Pointing Fingers, and Hoping Trump Will Listen
Zachary Tracer et al., Bloomberg News

In the fast-moving Washington game of who’s to blame for high U.S. drug prices, an often-overlooked industry is readying its defenses against pharmaceutical companies that fault other parts of the health sector for the costs faced by patients. Known as pharmacy benefits managers, or PBMs, the industry includes giants such as Express Scripts Holding Co. and CVS Health Corp., which negotiate prices with drugmakers, work with pharmacies and help set the co-pays patients pay out of pocket.

Weak Reporting System Let Risky Surgical Device Stay in Use
Denise Grady, The New York Times

Doctors and hospitals failed to tell the Food and Drug Administration about cases in which cancer was spread around inside women’s bodies by a surgical tool used to operate on the uterus, according to a report issued on Wednesday by the Government Accountability Office. Scattering cancer cells worsens the disease and decreases a patient’s chances of long-term survival.

Appeals Court Allows Sanofi, Regeneron to Continue Selling Cholesterol Drug
Jonathan D. Rockoff, The Wall Street Journal

A U.S. federal appeals court said Wednesday that Sanofi SA and partner Regeneron Pharmaceuticals Inc. can keep selling their cholesterol drug while they challenge a patent-infringement ruling by a lower court that threatened to halt sales. The decision, by the U.S. Court of Appeals for the Federal Circuit, gives the two companies a temporary reprieve from a trial court’s ruling last month finding their drug Praluent violated patents held by rival Amgen Inc.

Health IT

Report Cites Deficiencies at Theranos Lab
Christopher Weaver, The Wall Street Journal

Theranos Inc.’s lab in Arizona failed to ensure some patients who got potentially inaccurate diabetes test results were notified, according to a federal inspection report obtained through a public-records request. The embattled Silicon Valley company also performed patient blood-coagulation tests on a machine its staff configured improperly, according to the report and the company’s response to regulators.

VA admits past IT failures, turns to commercial solutions
Evan Sweeney, Fierce Healthcare

Officials with the Department of Veterans Affairs repeatedly told lawmakers that the agency is moving on from its failed approach of building in-house IT systems, and is instead seeking commercial, off-the-shelf options to improve scheduling, EHR interoperability, and billing and claims processing. In a hearing before the House Committee on Veterans’ Affairs on Tuesday, Rob Thomas, acting assistant secretary for information technology and CIO for the Office of Information and Technology at the VA, acknowledged previous failures in the agency’s attempt to modernize IT systems, but noted that it is no longer trying to build systems from the ground up.

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Opinions, Editorials and Perspectives

How to Start Lowering Drug Prices Now
Ted Okon, Morning Consult

President Donald Trump took an important step in the right direction when he recently met with pharmaceutical executives and expressed grave concern about high drug prices. Escalating prices, especially for life-saving cancer therapies, are a serious problem for patients that must be addressed.

What are Republicans going to do about Obamacare? ‘No idea.’
Dana Milbank, The Washington Post

The Obamacare repeal effort was already in unstable condition. Now its status must be downgraded to critical — and completely unserious. After years of Republican yammering about the urgent need to repeal the Affordable Care Act and months of fruitless pursuit of an alternative, President Trump now says he may not unveil a replacement this year at all.

A Message from PhRMA:

It is not a video game. It is not a screen saver. Our latest #GoBoldy ad showcases how breakthrough immunotherapy treatments are destroying cancer cells inside the human body, revolutionizing how scientists fight this deadly disease. Watch now at www.GoBoldly.com

Research Reports

Efforts to Support Consumer Enrollment Decisions Using Total Cost Estimators: Lessons from the Affordable Care Act’s Marketplaces
Justin Giovannelli and Emily Curran, The Commonwealth Fund

Informants strongly supported marketplace adoption of a total cost estimator. Marketplaces that offer an estimator faced a range of design choices and varied significantly in their approaches to resolving them. Interviews suggested a clear need for additional consumer testing and data analysis of tool usage and for sustained outreach to enrollment assisters to encourage greater use of the estimators.