Health Brief: Obama, Pence Hill Visits Kick Off ACA Messaging War

Washington Brief

  • Visits from President Barack Obama and Vice President-elect Mike Pence to Capitol Hill Wednesday signaled a messaging war over the Affordable Care Act. Obama urged Democrats not to help Republicans repeal the law, while Pence and GOP leaders say they’re going to provide relief from a failed law. (The Wall Street Journal)
  • There’s growing concern among Senate Republicans about how plans to repeal and replace Obamacare could affect the federal budget, some of which was aired during Wednesday’s meeting with Pence. (Politico)
  • Vice President Joe Biden says he will create an organization focused on a range of cancer-related issues, including the high cost of some cancer treatments (The Washington Post)

Business Brief

  • Drug companies that overcharge hospitals and clinics for drugs through the Medicare 340B program will be subject to fines under a rule finalized Wednesday by the Obama administration. (Modern Healthcare)
  • The ACA’s Medicaid expansion provisions have provided significant new revenue for rural hospitals, which are now concerned those provisions could be repealed. (Kaiser Health News)
  • Hospital stocks jumped Wednesday on renewed promises by Republicans to repeal and replace Obamacare. (Modern Healthcare)

Chart Review

The Shortening American Lifespan
The Commonwealth Fund

Events Calendar (All Times Local)

No events scheduled
Vox interview with President Obama on the Affordable Care Act 11 a.m.



Senate Advances Budget Resolution With Obamacare Repeal
Roll Call

The Senate on Wednesday voted 51-48 to move ahead in debating a fiscal 2017 budget resolution that would include reconciliation instructions repealing the 2010 health care law. The motion to proceed to the resolution required only a simple majority vote. Republican Sen. Rand Paul of Kentucky voted no. The Senate is expected to begin debate on the budget resolution later Wednesday and through Thursday, and work on amendments next week.

Paul, Freedom Caucus to Meet on Fiscal 2017 Budget Resolution
Lindsey McPherson and Bridget Bowman, Roll Call

The House Freedom Caucus will meet with Sen. Rand Paul Thursday morning at the Kentucky Republican’s request to discuss his concerns about the fiscal 2017 budget resolution Republicans are using to set up an expedited process for repealing the 2010 health care law. “We are meeting with Senator Rand Paul tomorrow to discuss his ideas on replacing the Affordable care Act and the timing of repeal and replacement,” Freedom Caucus Chairman Mark Meadows, R-N.C., told Roll Call.

Biden to tackle broad range of cancer issues, including drug prices, after leaving White House
Laurie McGinley, The Washington Post

Vice President Biden, who led the Obama administration’s “cancer moonshot” initiative, will create a nonprofit organization to grapple with a broad range of cancer issues, including the high cost of cancer drugs, he said in an interview Wednesday. “I’m going to begin a national conversation and get Congress and advocacy groups in to make sure these treatments are accessible for everyone, including these vulnerable underserved populations, and that we have a more rational way of paying for them while promoting innovation,” Biden said.

Gov. Kasich Credits Medicaid Expansion For Helping Ohio Fight Drug Abuse Problem
Jo Ingles, Statehouse News Bureau

As Republicans in Congress debate the idea of repealing the Affordable Care Act or Obamacare, Gov. John Kasich is crediting part of that law for helping fight the war on opiates in Ohio. Kasich says the state has spent millions fighting prescription painkillers, opioids and other illegal drugs and has put in place programs that are working.

House panel recommends cutting funding for Planned Parenthood, reigniting old debate
Mike DeBonis, The Washington Post

A House panel formed by Republicans to investigate the procurement of human fetal tissue for medical research has recommended stripping federal funds from Planned Parenthood, heralding a new congressional assault on the nation’s largest provider of abortions and women’s health care. The GOP majority on the Select Investigative Panel included the recommendation in the 471-page final report, which was issued Tuesday on the dissolution of the panel.

U.S. Stocks Rise, Bonds Erase Drop on Fed Minutes: Markets Wrap
Jeremy Herron, Bloomberg News

U.S. stocks rose, Treasuries erased losses and the dollar fell after minutes from the Federal Reserve’s last meeting indicated officials considered gradual rate hikes warranted amid debate on the economic impact from a rising dollar and Donald Trump’s policies. The S&P 500 Index rose a second day as investors heard a more dovish tone from policy makers in the minutes than after the Fed raised rates Dec. 14.


Republicans Want to Kill Obamacare Without the Blame
Peter Coy and Sahil Kapur, Bloomberg News

Republicans have a problem. They’ve vowed to repeal Obamacare, but they don’t want to take the blame when some of the 20 million people who get health insurance under the Affordable Care Act lose it.

GOP’s Health-Law Attack Spurs Messaging Battle
Peter Nicholas et al., The Wall Street Journal

Donald Trump fired off tweets and President Barack Obama trekked to Capitol Hill on Wednesday at the start of a battle aimed at controlling the political messaging as Congress takes its first steps toward dismantling the president’s signature health-care overhaul. The incoming president warned congressional Republicans that they risk a backlash by moving quickly to repeal the law, adding they were better off letting Democrats own what he called “the failed ObamaCare disaster” and allowing the system to “fall of its own weight…”

GOP airs Obamacare divisions in Pence meeting
Jennifer Haberkorn and Burgess Everett, Politico

Republicans are fast-tracking the process of repealing Obamacare, aiming to get it done in several weeks. But they’re not even close to agreement about what comes next — or even when the repeal should take effect.

Trump plans executive actions for ObamaCare repeal
Peter Sullivan, The Hill

House Republicans are planning to get an ObamaCare repeal bill on President-elect Trump’s desk by Feb. 20, while the administration moves forward with executive actions to start unwinding ObamaCare on day one. The Feb. 20 target was put forward by incoming House Budget Committee Chairman Diane Black (R-Tenn.), said Rep. Markwayne Mullin (R-Okla.), leaving a meeting with House Republicans and Vice President-elect Mike Pence on Wednesday.

Some GOP Lawmakers Fear Repealing Obamacare Without A Replacement
Lauren Fox, Talking Points Memo

In a closed-door meeting in the House basement Wednesday with the whip team, a Republican rank-and-file member rose to convey his deep fear that Republicans were making a big mistake by repealing the Affordable Care Act without any concrete plan to replace it with. According to one source in the room, the member rose and got the room’s attention.

Senate Republicans Open Fight Over Obama Health Law
Thomas Kaplan and Glenn Thrush, The New York Times

Congress opened for battle over the Affordable Care Act on Wednesday as Republicans pushed immediately forward to repeal the health care law and President Obama made a rare trip to Capitol Hill to defend it. The bitterness that has long marked the fight intensified as Republicans seized the opportunity to make good on a central campaign promise to get rid of the law, a pledge reinforced on Wednesday by Vice President-elect Mike Pence, who met with House Republicans not far from where the president gathered with Democrats.

House GOP Hails Pence as Obamacare Slayer
John T. Bennett, Roll Call

House Republicans on Wednesday cast Vice President-elect Mike Pence as a conservative white knight uniquely qualified to dismantle the 2010 health care law while shrugging off his decision to embrace the law’s Medicaid expansion while governor of Indiana. Pence huddled in the Capitol with House Republicans on Wednesday about their designs for scrapping President Barack Obama’s signature legislative legacy while Obama rallied House and Senate Democrats to resist those efforts a few hundred feet away in the Capitol Visitor Center.

How Republicans Might Replace Obamacare
Stephanie Armour, The Wall Street Journal

Republicans are preparing to follow through on their vow to repeal the Affordable Care Act, or Obamacare. But it is far from clear what will replace it. Various Republicans have put forward a grab bag of policy ideas about what could take the place of President Barack Obama’s health law, but have yet to reach a consensus.

Obamacare signups increase from last year
Robert King, Washington Examiner

Obamacare signups are surging even as the Republican-controlled Congress has taken formal steps this week to dismantle the healthcare law. The Obama administration said Wednesday that about 8.8 million Americans signed up for Obamacare through, which 38 states and the District of Columbia uses to get access for Obamacare.

Health Overhaul Revisited: The Impact of Some GOP Ideas
Ricardo Alonso-Zaldivar, The Associated Press

Republicans are far from consensus on how they would replace President Barack Obama’s health care law, which reduced the nation’s uninsured rate to a historic low around 9 percent but failed to win broad public support. Dozens of GOP-inspired ideas are being bandied about on Capitol Hill, and it could take months or years to fully understand the costs and benefits of complex changes lawmakers are considering.

In Towns That Lost Most Obamacare Insurers, Rate Increases Still Competitive
Phil Galewitz, Kaiser Health News

People in this city had their pick of four health insurers last year when they shopped for policies during the Affordable Care Act’s open enrollment. This time they have just one: Blue Cross Blue Shield of South Carolina, which had the most Obamacare consumers in Richland County in 2016 due to its low prices.

Gov. Roy Cooper wants to expand Medicaid
Mary Cornatzer, The News and Observer

Gov. Roy Cooper says he wants to expand Medicaid immediately, defying a state law. Talking to a group of business leaders at an economic forum on Wednesday morning, the Democratic governor said he would file an amendment by Friday asking the federal government to amend the state Medicaid plan.

Snyder fights for Medicaid plan in Obamacare repeal
Jonathan Oosting, The Detroit News

Gov. Rick Snyder wants Republican President-elect Donald Trump and the GOP-led Congress to spare Michigan’s unique form of Medicaid expansion as they consider dismantling the Affordable Care Act, calling it a “successful” program that could serve as a national model. Trump has repeatedly vowed to repeal and replace “Obamacare” but has not made clear whether he wants to pull back state funding for expanded Medicaid eligibility. It is a key but costly provision of the 2010 law that has allowed millions of low-income residents to qualify for government-paid health care coverage.


Hospital stocks rally on Republican promises of measured repeal of ACA
Dave Barkholz, Modern Healthcare

Hospital stocks enjoyed a rally on Wall Street Wednesday as Congress promised an orderly transition from the Affordable Care Act. Dallas-based Tenet Healthcare had one of its best days in a year, rising $1.35 per share, or 9%, to close the day at $16.75.

Obamacare Repeal Threatens Rural Hospitals and the Trump Voters Who Depend on Them
Shefali Luthra, Kaiser Health News

Judy Keller, 69, has always relied on Highlands Hospital in Connellsville, Pennsylvania, for medical care, just as her parents did before her. When she walks through the halls, she recognizes faces from the community, including some from her days as a schoolteacher.

Pharma, Biotech and Devices

Alexion Says Senior Management Improperly Pressured Staff to Boost Sales
Jonathan D. Rockoff, The Wall Street Journal

Alexion Pharmaceuticals Inc. said Wednesday that senior management pressured staff to get customers to order its flagship drug earlier than needed to meet financial targets. The finding, reported in a securities filing, followed an investigation by members of Alexion’s board of directors into allegations of improper sales practices made by a former employee that had delayed the submission of its most-recent financial report.

Drug companies will be fined for overcharging 340B hospitals
Virgil Dickson, Modern Healthcare

The Obama administration has finalized a rule that imposes fines on drug companies that overcharge hospitals and clinics for medication purchased under the government’s 340B drug discount program. Drug companies must reimburse providers that overpaid for products and they are subject to fines of up to $5,000 per instance if they overcharged “knowingly and intentionally.”

Health IT

Hospital Impact: EHRs, health IT slouch toward 2017
Marla Durben Hirsch, Fierce Healthcare

2016 was a busy year for healthcare information technology in general and EHRs in particular. Electronic health records have maturedin part. Sometimes it seems like the industry takes two steps back for every step forward.

Opinions, Editorials and Perspectives

Repealing Obamacare Puts Rural Hospitals at Risk
Alan Morgan, Morning Consult

Plans are being laid in Washington to repeal the Affordable Care Act as soon as Donald Trump takes the presidential oath of office. Hidden inside the law is a little-known provision unrelated to the health insurance expansion that helps rural hospitals across America stay open.

Republicans Are Courting Disaster on Health Care
The Editorial Board, The New York Times

And so it begins. After six years of posturing and futile votes to repeal the Affordable Care Act, Republicans in the Senate have started a process to erase the most important provisions of the health reform law with a simple majority. Millions of Americans are at risk of losing their coverage.

How Democrats can defeat the repeal of Obamacare
Paul Waldman, The Washington Post

It was no small feat for Republicans to suffer an embarrassing public defeat on the very first day of the new Congress, but they managed to do it by first voting to gut the Office of Congressional Ethics, then reversing themselves within hours after a public outcry and a spate of bad press. This is likely to be a Democratic talking point for a long time to come (“The first thing Republicans did was try to destroy the ethics office!”).

The Health Care Plan Trump Voters Really Want
Drew Altman, The New York Times

This week Republicans in Congress began their effort to repeal and potentially replace the Affordable Care Act. But after listening to working-class supporters of Donald J. Trump — people who are enrolled in the very health care marketplaces created by the law — one comes away feeling that the Washington debate is sadly disconnected from the concerns of working people.

The Politics of TrumpCare
The Editorial Board, The Wall Street Journal

President Obama and Vice President-elect Mike Pence both paid a visit to Capitol Hill Wednesday, in the first formal engagement over the future of the Affordable Care Act. Republicans finally have the power to repeal, but the question is whether they have the grit to replace ObamaCare.

Research Reports

The Shortening American Lifespan
David Squires, The Commonwealth Fund

New data released by the Centers for Disease Control and Prevention (CDC) this month showed that Americans’ life expectancy fell from 2014 to 2015, from 78.9 years to 78.8 years. Though this may sound like a trivial change, declines in life expectancy are rare in the developed world outside of periods of war or national crisis.