Health Brief: Obama, Pence Head to Hill to Talk ACA

Washington Brief

  • President Barack Obama and congressional Democrats meet this morning to discuss how to defend the Affordable Care Act, while Vice President-elect Mike Pence will meet with Republicans separately to discuss the law’s repeal. Republicans are charging ahead with the process to repeal the ACA, with a first Senate vote on a budget resolution coming as soon as next week. (The Associated Press)
  • Republicans have a path forward to repealing large parts of Obamacare, but questions about how much of the law to repeal — including hundreds of billions of dollars in taxes that some see as a way to pay for a replacement and the law’s expanded Medicaid program — loom over the effort. (The Los Angeles Times)
  • A handful of Republican senators say Congress shouldn’t wait to replace the Affordable Care Act after it’s repealed, but that a replacement plan should be considered ahead of a repeal vote. (Morning Consult)

Business Brief

  • The American Medical Association, the nation’s leading doctor’s group, is urging that any Obamacare replacement plan maintains the coverage gains that 20 million people have seen under the law. (The Hill)
  • Abbott Laboratories is expected to close a $25 billion deal Wednesday to acquire St. Jude Medical, a deal that will extend its reach to almost the entire cardiovascular device market. (Modern Healthcare)
  • West Virginia officials and H.D. Smith Wholesale Drug Co. announced a $3.5 million settlement, addressing allegations that the company failed to properly address a flood of prescription drugs entering the state. (The Associated Press)

Chart Review

The Cost of Full Repeal of the Affordable Care Act
Committee for a Responsible Federal Budget

Events Calendar (All Times Local)

Vice President-elect Pence meets with House Republicans on Obamacare 9 a.m.
President Obama meets With Hill Democrats on Obamacare 9:35 a.m.
No events scheduled
No events scheduled



House GOP names Diane Black interim Budget chair
Ben Weyl and Rachael Bade, Politico

House Republicans named Rep. Diane Black to be interim chairman of the Budget Committee, in a move to keep the GOP agenda moving swiftly while Chairman Tom Price focuses on his nomination to be President-elect Donald Trump’s HHS secretary. House Speaker Paul Ryan offered the proposal at a House GOP conference meeting Monday night, which he said would allow the Budget Committee to get up and running as quickly as possible, while giving Price the ability to fully prepare for a confirmation gantlet in the Senate, according to Ryan spokeswoman AshLee Strong.

U.S. Stocks Start Year With a Pop as Phones, Health Care Rally
Oliver Renick, Bloomberg News

U.S. stocks rose Tuesday for Wall Street’s first session of the new year, helped by a string of robust economic data from China and Europe that sent all but one industry higher on the day. The S&P 500 added 0.9 percent to 2,257.83 at 4 p.m. in New York, the biggest gain in almost a month, as the Dow Jones Industrial Average climbed 119 points to 19,881.76.


GOP Senators Stress Need for ACA Replacement Sooner Rather Than Later
Mary Ellen McIntire, Morning Consult

Senate Republicans introduced the budget resolution that is a first step to repeal Obamacare Tuesday, but there’s growing concern from some GOP Senators about the lack of an immediate replacement plan. Sens. Susan Collins (R-Maine), Bill Cassidy (R-La.) and Rand Paul (R-Ky.) expressed hesitation about repealing the health care law without having a replacement plan ready to go, citing concerns about how the market would react to the swift repeal without an alternative to take its place.

Republicans finally have the power to repeal Obamacare, but they’re still not sure how
Noam N. Levey, The Los Angeles Times

Congressional Republicans, despite pledging to quickly repeal the Affordable Care Act, are struggling with what parts of the law to roll back and how to lock up the votes they will need, particularly in the Senate, to push their ambitious plans. Settling these questions may delay any major repeal vote for months. Just as importantly, a protracted debate could force President-elect Donald Trump and GOP lawmakers to preserve parts of the healthcare law they once swore to eliminate.

Obama, Pence to Capitol as Health Care Overhaul Fight Begins
Alan Fram, The Associated Press

President Barack Obama is traveling to the Capitol to give congressional Democrats advice on how to combat the Republican drive to dismantle his health care overhaul. Vice President-elect Mike Pence is meeting with GOP lawmakers to discuss the best way to send Obama’s cherished law to its graveyard and replace it with – well, something.

Obama to Discuss How to Salvage ACA With Democrats at the Capitol
Byron Tau, The Wall Street Journal

In a bid to salvage a major piece of his political legacy, President Barack Obama on Wednesday will meet with congressional Democrats to discuss ways to counter Republican-led efforts to repeal the Affordable Care Act. Mr. Obama, facing unified Republican control of Congress and the White House when Republican Donald Trump is inaugurated later this month, will meet with House and Senate Democrats at the Capitol in the morning to talk about ways that Democrats can keep in place at least some parts of the divisive health-care law, the signature legislative accomplishment of Democrats during Mr. Obama’s eight years in office.

Desperate Democrats scramble for an Obamacare strategy
Jennifer Haberkorn and Rachana Pradhan, Politico

Democrats don’t have the votes to stop Republicans from gutting Obamacare. So as they watch their signature domestic policy accomplishment about to be dismantled, they’re looking to the ground game that helped pass it seven years ago.

Senate Republicans Start Obamacare Repeal Process
Bridget Bowman, Roll Call

Senate Republicans wasted no time Tuesday setting in motion their plan to repeal President Barack Obama’s signature health care law. GOP senators will be able to strike large portions of the law while avoiding the threat of a Democratic filibuster through a procedural gambit that expedites Senate consideration of the repeal bill.

Senate to vote on Obamacare repeal budget next week
Ben Weyl, Politico

Congressional Republicans took their first step to repeal Obamacare today when the Senate unveiled a bare-bones budget targeting the health law. Floor votes are expected next week, GOP Senate aides tell POLITICO.

House conservatives to roll out Obamacare replacement
Paige Winfield Cunningham, Washington Examiner

A group of House conservatives will recommend their own Obamacare replacement on Wednesday. The Republican Study Committee, led by Rep. Mark Walker of North Carolina, is proposing to replace President Obama’s healthcare law with a system where people can get tax deductions to help buy coverage on their own instead of through an employer.

Vowing To Jettison Obamacare, Republicans Face  Immediate Resistance And Risks
Julie Rovner, Kaiser Health News

The 115th Congress started work Tuesday with Republican majorities in both the House and Senate in agreement on their top priority — to repeal and replace the 2010 health law, the Affordable Care Act. “The Obamacare experience has proven it’s a failure,” House Majority Leader Kevin McCarthy, R-Calif., told reporters at an opening day news conference.

Could delayed replacement save key parts of Obamacare?
Shannon Muchmore, Modern Healthcare

The phrase “repeal and replace” the Affordable Care Act long has been popular among Republicans. But the “replace” part has always been thorny.

Self-employed fear repealing Affordable Care Act will bring back ‘job lock’
Harris Meyer, Modern Healthcare

Joshua Lapp left a full-time job with health benefits in 2014 to launch an urban planning firm with two partners. Columbus, Ohio-based Designing Locally has grown rapidly, with projects all over the county.

Bundled Payments Work, Study Finds, But HHS Nominee No Fan
Rachel Bluth, Kaiser Health News

A recent change in the way Medicare pays for joint replacements is saving millions of dollars annually — and could save billions — without impacting patient care, a new study has found. But the man Donald Trump has picked to be the secretary of Health and Human Services has vocally opposed the new mandatory payment program and is likely to revoke it.

The Parliamentary Trick That Could Obliterate Obamacare
Robert Pear, The New York Times

Republicans hope to repeal major parts of the Affordable Care Act using an expedited procedure known as budget reconciliation. The process is sometimes called arcane, but it has been used often in the past 35 years to write some of the nation’s most important laws.

West Virginia seeks waiver to boost addiction treatment
Virgil Dickson, Modern Healthcare

In an effort aimed at the substance abuse epidemic that’s disproportionately killing its residents, West Virginia is asking the CMS to approve a waiver that would expand treatment for Medicaid enrollees. The state wants to expand the number of community-based and outpatient substance abuse providers, to offer residential treatment and to increase the availability of medication-assisted treatment, which combines the use of medications and behavioral therapy for the treatment of substance abuse disorders.


Doctors group warns against loss of coverage from ObamaCare repeal
Peter Sullivan, The Hill

The country’s leading doctors group is urging Republicans to take steps to ensure that people do not lose their health insurance once ObamaCare is repealed. The American Medical Association (AMA), wrote a letter to congressional leaders on Tuesday calling for the gains in coverage from ObamaCare, which has expanded insurance to 20 million people, to be preserved.

Millennials give providers one shot to gain their business
Adam Rubenfire, Modern Healthcare

Providers keen to attract millennial patients should make sure to impress them the first time around or risk losing them to another provider, according to a recent study. Millennials are paying close attention to office appearance, cost, customer service and the quality of products used during a visit, according to a recent survey conducted by the Health Industry Distributors Association.

In a small town in Texas, a rural hospital thrives against all odds
Charlotte Huff, Stat

To get to the hospital, you drive. And drive. It’s 220 miles northwest from Fort Worth, along a flat landscape with lots of sky and lots of cows and lots of haystacks. Childress Regional Medical Center is not particularly imposing: a one-story brick hospital with an adjacent primary care clinic.

New Nursing Home Rules Offer Residents More Control Of Their Care
Susan Jaffe, Kaiser Health News

About 1.4 million residents of nursing homes across the country now can be more involved in their care under the most wide-ranging revision of federal rules for such facilities in 25 years. The changes reflect a shift toward more “person-centered care,” including requirements for speedy care plans, more flexibility and variety in meals and snacks, greater review of a person’s drug regimen, better security, improved grievance procedures and scrutiny of involuntary discharges.

Pharma, Biotech and Devices

Abbott gets key to $30 billion cardiovascular device market
Adam Rubenfire, Modern Healthcare

Abbott Laboratories’ purchase of St. Jude Medical, which is expected to close tomorrow, will give it access to nearly every area of the $30 billion cardiovascular device market. Suburban Chicago-based Abbott announced it will close the $25 billion deal less than a week after federal regulators approved the purchase on the condition that the companies divest from two businesses that produce certain cardiac devices.

West Virginia Reaches $3.5 Million Settlement with Drug Wholesaler
The Associated Press

West Virginia officials have reached a $3.5 million settlement with a wholesaler accused of flooding the state with millions of prescription pain pills. Attorney General Patrick Morrisey announced the settlement Tuesday with H.D. Smith Wholesale Drug Co.

J&J Judge Slashes $1 Billion Verdict Over Pinnacle Hip Implants
Jef Feeley, Bloomberg News

Johnson & Johnson won a ruling cutting almost in half a $1.04 billion jury award to patients who accused the company of hiding defects in its Pinnacle artificial hips that had to be surgically removed. A judge on Tuesday left undisturbed a jury’s finding that officials of J&J and its DePuy unit failed to properly warn doctors and patients about the artificial hips’ flaws, but found the panel’s punitive-damage awards to six patients were excessive and should be reduced, according to court filings.

Health IT

Intermountain turns to telehealth to better manage antibiotics
Joseph Conn, Modern Healthcare

Healthcare organizations are using telecommunication technology in many innovative ways to help reach goals. The latest involves a tool that allows some rural hospitals to curb excessive or improper use of antibiotics — something that’s a common problem across the healthcare industry.

Opinions, Editorials and Perspectives

The Problems With ‘Repeal And Delay’
Joseph Antos and James Carpetta, HealthAffairs Blog

Republican leaders in Congress and the incoming Trump administration have said that they plan to move quickly to repeal the Affordable Care Act (ACA) in the early weeks of 2017, with a delay in the date of when key aspects of the repeal would become effective until perhaps 2019 or 2020. This is the so-called “repeal and delay” option.

A Bipartisan Reason to Save Obamacare
Tina Rosenberg, The New York Times

Republicans in the House of Representatives have voted some 60 times to repeal or roll back parts of the Affordable Care Act, and in the first days of the 115th Congress, they, along with the G.O.P.-controlled Senate, are threatening to finally fulfill their promise to repeal it. Most endangered are the insurance provisions that have brought coverage to 20 million people.

The pain pill epidemic isn’t going anywhere until we end coal’s dominance
Nick Mullins, The Washington Post

Before going to work as an underground coal miner, I worked for a subcontractor installing large mine-ventilation fans throughout the Appalachian coal fields. My co-workers were a rough sort.

Stand Up for ObamaCare, CEOs
Annie Lamont and Ezekiel J. Emanuel, The Wall Street Journal

America’s CEOs might not admit it in public, but the Affordable Care Act—a k a ObamaCare—has been good for business. Company benefits managers have watched as the double-digit premium increases under President George W. Bush slowed to a crawl.

Research Reports

The Cost of Full Repeal of the Affordable Care Act
Committee for a Responsible Federal Budget

The Affordable Care Act (ACA), also known as “Obamacare,” includes a number of provisions to expand health care coverage, as well as several offsets that raise taxes and slow the growth of Medicare spending. According to our latest estimates, repealing the ACA in its entirety would cost roughly $350 billion through 2027 under conventional scoring and $150 billion using dynamic scoring.

Can Biosimilar Drugs Lower Medicare Part B Drug Spending?
Chuck Shih and Allan Coukell, The Pew Charitable Trusts

The use of biosimilars—biological products that are highly similar to a biologic drug already approved by the Food and Drug Administration (FDA)—has the potential to reduce drug spending in Medicare Part B, which totaled $21.5 billion in 2014. However, savings to Medicare will depend on the extent to which biosimilars have lower prices than biologics—which, unlike conventional drugs, are proteins or other materials derived from living cells— and the rate at which providers adopt them.