Health Brief: Obamacare Has More Support Than GOP Alternative, Poll Shows

Washington Brief

  • Fifty percent of registered voters approve of the Affordable Care Act, while 38 percent approve of the House GOP legislation that would replace the 2010 law, according to a new poll. (Morning Consult)
  • Twenty Republican senators representing states that expanded Medicaid will likely be the deciding factor in determining the fate of the chamber’s health care legislation. (The Washington Post)
  • The Senate voted 57-42 to confirm Scott Gottlieb to lead the Food and Drug Administration. Gottlieb is a veteran of the George W. Bush administration whose nomination was welcomed by industry groups. (Stat News)

Business Brief

  • BlueCross BlueShield of Tennessee will sell Obamacare health plans next year in the Knoxville region, an area that had been at risk of having no insurer offering exchange plans in 2018. (The Wall Street Journal)
  • Twenty-two companies are no longer members of the Pharmaceutical Research and Manufacturers of America after the trade group adopted new rules requiring members to spend at least $200 million a year on research and development, and that their R&D spending comprise at least 10 percent of global sales. (Bloomberg News)
  • French drugmaker Sanofi will adjust U.S. drug price increases to below the health care inflation rate, a move that will limit price hikes this year to 5.4 percent. (Reuters)

Chart Review

Events Calendar (All Times Local)

Senate HELP Committee marks up FDA Reauthorization Act 10 a.m.
Consumer Healthcare Products Association Regulatory Science and Quality Conference 8 a.m.
AEI discussion on practice regulation and health care reform 12 p.m.
Consumer Healthcare Products Association Regulatory Science and Quality Conference 8 a.m.
National Economists Club luncheon on the ACA and AHCA 12 p.m.



Obamacare Has More Support Than GOP Alternative, Poll Finds
Mary Ellen McIntire, Morning Consult 

More American voters approve of the Affordable Care Act now than they ever did under the previous administration, which enacted the law — even as support is slipping for the GOP alternative that Republicans are now shepherding through Congress. A new Morning Consult/POLITICO poll shows that 50 percent of voters strongly or somewhat approve of Obamacare, while 42 percent disapprove of the 2010 health law.

Senate Republicans face their own divisions in push for health-care overhaul
Robert Costa and Sean Sullivan, The Washington Post

Sen. Ted Cruz, a defiant loner whose feuds with Republican Party leaders have made him a conservative favorite, suddenly felt an itch to collaborate. It was late March, just after the dramatic collapse of House Republicans’ initial attempt to pass a sweeping overhaul of the nation’s health-care system.

4 deal-breakers that could blow up a Senate Obamacare repeal bill
Adam Cancryn, Politico

The Senate’s fresh attempt to dismantle Obamacare is already running into its first roadblock — the growing list of demands from GOP lawmakers eager to leave their own mark on the legislation. Just days into the chamber’s health care debate, centrists and self-styled mavericks are testing the party’s razor-thin margin for victory and setting the stage for a series of high-profile negotiations.

Sen. Hatch: ‘The public wants every dime they can be given’
Ted Barrett, CNN

Utah Republican Sen. Orrin Hatch warned Tuesday that efforts to repeal and replace the Affordable Care Act in the Senate might be complicated because once the public “is on the dole, they’ll take every dime they can.” The comment by one of the key Senate architects of the ongoing rewrite of the massive health care law, suggests Republicans are skeptical Americans will be unwilling to give up benefits provided for under the Affordable Care Act, also known as Obamacare.

GOP Rep. Denham claims health care bill was ‘bipartisan’
David Siders, Politico

Rep. Jeff Denham, facing ire in his California district over House Republicans’ health care vote last week, claimed on Tuesday that the bill was the product of a “bipartisan” process, despite the fact that no Democrats supported it. Asked if he had read the bill at a community meeting in this tiny agricultural town, Denham said he read it all.

Iowa Rep. Rod Blum Quits Interview Over Town Hall Questions
Thomas Beaumont, The Associated Press

Iowa Rep. Rod Blum stormed out of a TV interview when pressed about why he screens those who attend his public meetings. He then held a town hall, where he was booed and jeered by constituents angry over his vote to repeal the 2010 federal health care law.

Stocks Edge Lower as Dollar Stalls; Oil Advances: Markets Wrap
Robert Brand, Bloomberg News

European shares slipped with U.S. index futures and the dollar’s rally faltered after Donald Trump fired FBI Director James Comey. Oil climbed following an industry report that showed American stockpiles declining for a fifth week.


Insurer Steps In to Sell Plans on Health-Law Exchange in Tennessee
Anna Wilde Matthews and Louise Radnofsky, The Wall Street Journal

BlueCross BlueShield of Tennessee will offer Affordable Care Act marketplace plans in the Knoxville region of Tennessee next year, filling a potential gap left when Humana Inc. announced it would pull out of all of the exchanges where it does business. The 16-county region had been at risk of having no insurer offering exchange plans in 2018, and the situation had gained attention as part of the political fight over the future of the ACA.

Trump administration backs off penalizing exchange plans for not auditing risk-adjustment program
Virgil Dickson, Modern Healthcare

The Trump administration won’t penalize insurers for failing to verify the number of severely ill patients they’ve enrolled through the insurance exchanges. The Affordable Care Act established a risk-adjustment program that’s aimed at preventing insurers from cherry-picking the healthiest members.

Obamacare Taxes Aren’t Necessarily Going Away, GOP Senators Say
Sahil Kapur, Bloomberg News

Republican senators said it’s unclear whether their chamber will repeal all of the taxes imposed under Obamacare as they set aside the health-care bill passed by the House and prepare to write their own from scratch. “That’s hard to say right now. We just have to see,” said Senate Finance Chairman Orrin Hatch, the Utah Republican whose panel oversees health-care and tax policy. “It’s going to be negotiated.”

Who will decide what the Senate’s health bill looks like? Follow the Medicaid-state senators.
Paul Kane, The Washington Post 

The Senate has broken into a series of “working groups” to begin writing its own version of legislation to replace the Affordable Care Act. There’s the leadership-driven group, a group of moderates and there was talk about a more conservative group before it was mostly absorbed into the leadership group.

Early splits appear as Senate Republicans confront Medicaid choice
Peter Sullivan, The Hill

Republican senators hailing from states that took ObamaCare’s Medicaid expansion are taking different tacks on defending the program as much of their party looks to end it. Sen. Rob Portman (R-Ohio) told reporters Tuesday that he supports rolling back the Medicaid expansion by ending the extra federal money for it, as long as there is a “soft landing.”

Medicaid Expansion Transformed a Community—Now the Bill Is Coming Due
Melanie Evans and Andrea Fuller, The Wall Street Journal

The Republican Party’s revamp of the U.S. health-care system is heading toward a showdown over Medicaid. This region, a patch of red in a largely blue state, saw more changes than most from the 2010 Affordable Care Act’s expansion of the health-insurance program for low-income people.


Cleveland State, MetroHealth partner in effort to educate nurses
Lydia Coutre, Modern Healthcare

Cleveland State University will offer bachelor’s and master’s of science degrees in nursing for registered nurses through a new partnership with MetroHealth. The blended-delivery approach will include some classes taught at MetroHealth, and in-person and online coursework taught by Cleveland State professors.

Pharma, Biotech and Devices

Pharma Lobby Ousts 22 Drugmakers Amid U.S. Pricing Debate
Jared S Hopkins and Cristin Flanagan, Bloomberg News

The pharmaceutical industry’s powerful Washington trade association fell in size by almost two dozen companies after revising membership rules amid the debate over U.S. drug prices. Pharmaceutical Research and Manufacturers of America, or PhRMA, will require that members spend at least $200 million a year on research and development and that their R&D spending is at least 10 percent of global sales.

Sanofi pegs U.S. drug price rises to below healthcare inflation
Ben Hirschler, Reuters

French drugmaker Sanofi has pledged to peg U.S. drug price rises to below healthcare inflation in a move that limits increases for any product this year to 5.4 percent, unless there are exceptional circumstances. The price promise goes one step beyond action taken by a number of other large pharmaceutical companies that have undertaken to keep 2017 price increases below 10 percent.

Scott Gottlieb wins confirmation as FDA commissioner
Sheila Kaplan, Stat News

Dr. Scott Gottlieb is headed back to the Food and Drug Administration. By a vote of 57 to 42, the Senate on Tuesday confirmed Gottlieb, a former FDA deputy commissioner, as the agency’s next chief.

Trump wants faster FDA action, but 1 in 3 drugs have safety issues after approval
Sydney Lupkin, Kaiser Health News

President Trump wants the Food and Drug Administration to approve drugs faster, but researchers at the Yale School of Medicine found that nearly a third of medications that reached the market from 2001 through 2010 had major safety issues years after they became widely available to patients. Seventy-one of these 222 drugs were withdrawn, required a “black box” warning about serious side effects, or warranted a safety announcement about new risks to the public, Yale professor Dr. Joseph Ross and his colleagues reported in JAMA on Tuesday.

Senate Health Committee to hold hearing on drug prices
Nathaniel Weixel, The Hill

A Senate committee plans to hold a hearing on U.S. prescription drug prices. Sen. Lamar Alexander (R-Tenn.), chairman of the Senate Health, Education, Labor and Pensions Committee, in a letter Tuesday said the panel will schedule a hearing “in the near future” on the issue.

Health IT

Google offshoot Verily loses top scientist leading its mental health project
Charles Piller, Stat News

Verily Life Sciences, the high-profile Google offshoot, has lost the scientist who led its search for better ways to prevent, detect, and treat mental illness — the latest in a string of top executives who have left the company after a short tenure. Dr. Thomas Insel, former head of the National Institute of Mental Health, joined the Silicon Valley startup with fanfare in December 2015.

A Message from PhRMA:

You don’t always pay full price for doctor or hospital visits. So why is a visit to the pharmacy different? Unlike care received at an in-network hospital or physician’s office, patients with high deductibles or coinsurance pay cost sharing based on the list price of a medicine, even if their insurer receives a steep discount. Insurers should share more of the rebates they receive with patients. Get the facts at

Opinions, Editorials and Perspectives

When the Drug Industry Puts Patients First
Steve Miller, Morning Consult 

Egregious price hikes in the drug industry in recent years have led to justified public outrage. Fueling the indignation has been a widespread sense that the public is defenseless, that little or nothing can be done to protect the vulnerable from runaway drug costs.

Why I voted for the American Health Care Act
Mark Sanford, The Post and Courier

I voted Thursday for the American Health Care Act, and given the intensity of feelings and thoughts surrounding this bill, I wanted to explain my reasoning. Despite all the hyperbole, ultimately the vote came down to one simple question: do we kill the bill and stop the debate from advancing to the Senate — or not?

Now what? Hurdles for CBO and the governors
Steven Brill, Axios

Now that the House has acted (and left town), the Congressional Budget Office has to find a useful way to estimate what will happen with the state waivers in the health care bill — more useful than the way it has tried to predict state decisions in the past. And we need a better sense of what the governors are planning to do.

The Pre-Existing Lie
Rich Lowry, The National Review

If you’ve only followed coverage of the Republican health-care bill loosely in the media, you might believe that House Republicans, after much effort, passed legislation to deny people with pre-existing conditions health insurance. The issue of pre-existing conditions has dominated the debate over the GOP health-care bill out of all proportion to the relatively modest provision in the legislation, which is being distorted — often willfully, sometimes ignorantly — into a threat to all that is good and true in America.

The ‘Republicans Are Doomed’ Gambit
The Editorial Board, The Wall Street Journal

Barack Obama emerged from his short-lived political retirement on Sunday to call on Members of Congress to show the “political courage” to preserve ObamaCare. But wait.

Another measles outbreak that didn’t have to happen
The Editorial Board, The Washington Post

What can an advanced nation, with high-level medical care, say to the Somali American community of Minnesota, where an outbreak of measles, highly infectious and potentially deadly, is racing ahead because many people failed to get their children vaccinated, fearing a link to autism? This is what must be said: The fears are wrong, vaccinations save lives and this community must overcome distrust in order to overcome disease.

A Message from PhRMA:

DID YOU KNOW more than 1/3 of the list price for brand medicines is rebated back to payers and the supply chain? Yet, unlike care received at an in-network hospital or physician’s office, patients with high deductibles or coinsurance pay cost sharing based on a medicine’s list price, even if their insurer receives a steep discount. Patients share the costs of medicines, so they should share the savings. Learn more at

Research Reports

Postmarket Safety Events Among Novel Therapeutics Approved by the US Food and Drug Administration Between 2001 and 2010
Nicholas S. Downing et al., JAMA

Among 222 novel therapeutics approved by the FDA from 2001 through 2010, 32% were affected by a postmarket safety event. Biologics, psychiatric therapeutics, and accelerated and near–regulatory deadline approval were statistically significantly associated with higher rates of events, highlighting the need for continuous monitoring of the safety of novel therapeutics throughout their life cycle.