Health Brief: Poll Finds GOP Plan to Encourage Health Coverage Unpopular With Voters

Washington Brief

  • Sixty-four percent of voters oppose the House plan to force adults to pay a 30-percent higher premium to their insurance company if they have a gap in coverage for more than two months. (Morning Consult)
  • Republican senators told Trump administration officials they would like to see substantial changes to the House health care bill following a harsh judgement by the Congressional Budget Office.  (The New York Times)
  • The CBO score and conservative opposition has moderate House Republicans alarmed at the prospect of voting for a bill that could be dead on arrival in the Senate. (CNN)

Business Brief

  • A Food and Drug Administration panel determined that the benefits of Endo International Plc’s long-acting opioid painkiller no longer outweigh its risks. (Reuters)
  • The generic drug industry supports the FDA speeding up generic drug approvals, even though it presents a risk to pricing power on existing drugs. (The Wall Street Journal)
  • CMS Administrator Seema Verma’s consulting firm, SVC Inc., is being acquired by Health Management Associates following her confirmation on Monday. (Modern Healthcare)

Chart Review

Events Calendar (All Times Local)

American College of Emergency Physicians Leadership and Advocacy Conference 7:30 a.m.
The Atlantic Policy Briefing on Biosimilars 8 a.m.
Center for American Progress Event on Women’s Reproductive Health 11 a.m.
Senate Aging Committee Hearing on Families in the Opioid Crisis 2:30 p.m.
Roll Call Live Discussion on Health Care 8 a.m.
House Budget Committee Markup of Reconciliation Bill 10 a.m.
Heritage Foundation Event on Tobacco Control in E-Cigarettes 12 p.m.
RAND Corporation Briefing on the ACA Future 12 p.m.



G.O.P. Senators Suggest Changes for Health Care Bill Offered by House
Jennifer Steinhauer and Thomas Kaplan, The New York Times

A day after a harsh judgment by the Congressional Budget Office on the House plan to repeal the Affordable Care Act, nervous Senate Republicans on Tuesday suggested changes to the bill. They told Trump administration officials — including the health secretary, Tom Price — that they wanted to see lower insurance costs for poorer, older Americans and an increase in funding for states with high populations of hard-to-insure people.

Hill moderates take issue with GOP health care plan
Lauren Fox and MJ Lee, CNN

A devastating analysis from the Congressional Budget Office on the House GOP bill to repeal Obamacare has rattled moderates Republicans in the House, who are uneasy about the prospects of voting for a proposal that increasingly appears dead on arrival in the Senate. Republican Rep. Leonard Lance, a moderate from New Jersey who Democrats believe will be vulnerable in 2018, told CNN that he believes the House GOP bill will fail in the Senate.

Health Management Associates to buy CMS chief’s consulting business
Modern Healthcare

Health Management Associates will acquire SVC, a consulting firm that is owned by Seema Verma, who Monday was confirmed by the Senate as the head of the CMS. Verma had vowed to divest her company in order to address conflicts of interest that stemmed from the multimillion-dollar contracts she received as president and founder of SVC working with states to design Medicaid expansion plans.

Trump loyalists sound alarm over ‘RyanCare,’ endangering health bill
Robert Costa and Philip Rucker, The Washington Post 

A simmering rebellion of conservative populists loyal to President Trump is further endangering the GOP health-care push, with a chorus of influential voices suspicious of the proposal warning the president to abandon it. From headlines at Breitbart to chatter on Fox News Channel and right-wing talk radio, as well as among friends who have Trump’s ear, the message has been blunt: The plan being advanced by congressional Republican leaders is deeply flawed — and, at worst, a political trap.

After CBO Report, Democrats See an Opening on Health Care
Janet Hook, The Wall Street Journal

Democrats, after playing defense on health care for nearly a decade, are trying to turn the issue to their political advantage, targeting in particular lawmakers who have gone on record voting for a GOP plan to replace the Affordable Care Act. Republicans on the House Ways and Means Committee and the Energy and Commerce Committee, racing to advance the legislation, voted to approve the bill last week—before the Congressional Budget Office had analyzed its impact and found that the bill would leave 24 million more Americans without health insurance.

Health Bill’s CBO Score Raises Alarms for Wary Senators
Mary Ellen McIntire, Morning Consult 

A Congressional Budget Office analysis of a Republican health care bill to repeal and replace the Affordable Care Act is fueling additional Senate skepticism of the measure. The bill already cleared its first hurdle in the House, advancing through the Ways and Means and Energy and Commerce committees last week, but many senators — who have been wary of the legislation since it was released last week — are already warning that it may be better to press pause.

Daines joins top Montana Dems in criticizing Obamacare replacement
The Associated Press

Montana’s Republican U.S. senator joined the state’s top Democrats in criticizing the Republican health care plan Monday after a nonpartisan analysis showed the legislation would lead to millions losing their coverage and insurance premiums continuing to rise over the next several years. The Congressional Budget Office report said 14 million Americans would lose health care coverage next year under the Republican legislation, and 24 million by 2026.

Citing ‘too many’ left uninsured, Miami Republican opposes GOP health plan
Patricia Mazzei, The Miami Herald

Miami Republican Rep. Ileana Ros-Lehtinen plans to vote against the House GOP plan to replace the Affordable Care Act, becoming the first Florida Republican to reject the legislation outright. “After studying the impact of this proposed legislation on my district and speaking with many of my constituents, I have decided to vote no on the bill as currently written,” she said in a statement to the Miami Herald. “The bill’s consequences for South Florida are clear: too many of my constituents will lose insurance and there will be less funds to help the poor and elderly with their healthcare.”

CBO Estimates ‘Several Thousand’ More Births if Planned Parenthood Funds Cut
Daniel Nasaw, The Wall Street Journal

By stripping federal funding from clinics affiliated with women’s health organization Planned Parenthood, the House Republican health-care plan would reduce poor people’s access to birth-control services and likely result in more pregnancies, according to a nonpartisan report by the Congressional Budget Office. The CBO’s findings give weight to critics of the bill who have said it would reduce women’s access to health care.

Europe Stocks, Oil Rise as Bonds Steady Before Fed: Markets Wrap
Benjamin Purvis and Samuel Potter, Bloomberg News

Crude prices were once again a dominant story in markets, with oil’s rebound helping underpin European stocks as investors wait for Wednesday’s expected U.S. interest rate increase. The British pound pared a rebound and metals climbed.


Poll: GOP Plan to Encourage Health Coverage Unpopular With Voters
Mary Ellen McIntire, Morning Consult 

U.S. voters largely disapprove of a measure in the Republican health care bill meant to encourage people to maintain health insurance coverage, a new Morning Consult/POLITICO poll shows. The poll finds nearly two-thirds of voters (64 percent) don’t think the bill should include a provision making adults pay a 30 percent higher premium if they postpone buying health insurance for more than two months.

GOP Bill Would Make Comparing Health Plan Prices More Difficult
Jon Reid, Morning Consult 

Central to Republican leaders’ pitch for their Affordable Care Act replacement plan is giving people more choices when it comes to shopping for health insurance. But a little-noticed provision in their legislation could actually make it harder for Americans to compare health plans by price, according to the Congressional Budget Office.

Thune proposal would means-test tax credits in House bill
Caitlin Owens, Axios

Sen. John Thune, the third-highest ranking member of the Senate, is working on a proposal to partially means test the tax credits in the House Obamacare repeal and replacement bill. In a sit-down with Axios, Thune said he wants to avoid “creating a new middle class entitlement,” which the current House bill could do by spreading the federal assistance too far up the income scale.

Humana selling bonds to raise $1 billion
Chris Larson, Louisville Business First

Humana is looking to raise $1 billion through the sale of bonds, according to a filing with the U.S. Securities and Exchange Commission released Tuesday. The filing states that Humana Inc. (NYSE: HUM) seeks to raise $1 billion in senior debt notes in two tranches, or groups: one for $600 million that will mature in 2027 with a coupon, or interest rate, of 3.95 percent and another for $400 million that will mature in 2027 with a coupon of 4.8 percent.


How a mistake at a tiny Massachusetts hospital disrupted Medicare payments nationally
Bob Herman, Axios

The so-called “Bay State boondoggle” is back. The hospital payment policy, based on a provision then-Sen. John Kerry slipped into Obamacare, makes Massachusetts hospitals look bad. And it’s sure to create more in-fighting among hospitals — especially since it has continued to create a chain reaction that affected hospital payments around the country.

AMA launches website urging civic action against AHCA
Emily Rappleye, Becker’s Hospital Review

The American Medical Association is launching an effort aimed at getting the provider community involved in healthcare reform on the Hill. The physician association Monday rolled out an interactive website,, which provides a way for clinicians and patients to contact Congress members via email, phone and social media.

Pharma, Biotech and Devices

Risks of Endo’s opioid painkiller outweigh benefits: FDA panel
Natalie Grover, Reuters

The benefits of Endo International Plc’s long-acting opioid painkiller no longer outweigh its risks, an independent panel to the U.S. Food and Drug Administration (FDA) concluded on Tuesday. Endo’s shares closed down about 4 percent and were down about 1.7 percent in extended trading.

Generic Drugmakers Can Live With a Speedier FDA
Charley Grant, The Wall Street Journal

Rather than a bonanza, a faster U.S. Food and Drug Administration would be a double-edged sword for battered generic drug stocks. Fortunately, there are some glimmers of hope for investors in the sector.

Health IT

Health IT coalition seeks scrutiny of ONC’s regulatory role
Rachel Z. Arndt, Modern Healthcare 

Health IT Now is asking Congress and the Trump administration to examine the role the Office of the National Coordinator for Health Information Technology plays in regulating health IT and how that role relates to other regulatory agencies. Not-for-profit advocacy group Health IT Now wrote in a letter Monday to HHS Secretary Tom Price that the coalition worries that recent ONC actions could raise costs and slow product development by going beyond what the Health Information Technology for Economic and Clinical Health Act allows the ONC to do.

A Message from PhRMA:

More than a third of the initial list price of brand medicines is rebated back to insurance companies, PBMs and the government, or retained by the supply chain. And the gap between list and net prices is growing every year.

Opinions, Editorials and Perspectives

An End to PBM Pick-Pocketing
B. Douglas Hoey, Morning Consult 

Usually when your pocket has been picked, you discover the loss pretty quickly. But many of America’s more than 22,000 independent community pharmacies are finding their reimbursements for prescription drugs reduced well after the patient hands over the co-pay and leaves with their medicine.

The Health Bill’s Fiscal Bonus
The Editorial Board, The Wall Street Journal

The furor over the Congressional Budget Office’s report on the House GOP health bill is concentrated on predictions about insurance coverage, which suits Democrats fine. Lost amid the panic is that CBO shows the bill is a far-reaching advance for the market principles and limited government that conservatives usually favor.

Republicans should really read the CBO report
The Editorial Board, The Washington Post 

“IT’S JUST not believable,” Health and Human Services Secretary Tom Price said Monday, after the Congressional Budget Office (CBO) projected the GOP’s Obamacare repeal-and-replace bill would result in 24 million more Americans without coverage. Here’s what is not believable: Mr. Price’s prediction that “our plan will cover more individuals at a lower cost and give them the choices that they want for the coverage,” a claim that expert after expert has deemed a fantasy.

The House GOP Leadership’s Health Care Bill Is ObamaCare-Lite — Or Worse
Michael F. Cannon, Cato Institute 

During the presidential campaign, Donald Trump promised legislation that “fully repeals ObamaCare.” Monday night, the Republican leadership of the House of Representatives released legislation it claims would repeal and replace ObamaCare.

The Rhode Island Model Can Save Medicaid
Gary D. Alexander, The National Review 

As Congress attempts to reform our health-care system yet again, discussions about how to manage and pay for Medicaid are on the front burner. With one in four Americans enrolled in what’s now the largest “unearned” public-welfare program in history, curbing the program’s growth is a fiscal imperative.

A Message from PhRMA:

Share of gross (based on list price) medicine spending kept by brand biopharmaceutical companies is falling. After accounting for discounts and rebates, brand biopharmaceutical companies retained just 63 percent of total list price spending on brand medicines. The rest was rebated back to PBMs, health plans and the government, or retained by other stakeholders in the biopharmaceutical supply chain. Read the first-of-its-kind study here.

Research Reports

Kaiser Health Tracking Poll: ACA, Replacement Plans, Women’s Health
Ashley Kirzinger et al., The Kaiser Family Foundation

The latest Kaiser Health Tracking Poll examines the public’s early attitudes towards the House Republican plan to replace the Affordable Care Act and finds that more expect the new plan will make things worse rather than better when it comes to the number of people with coverage and costs for those buying insurance on their own. Republicans are more optimistic, with nearly half expecting the plan to decrease costs and one-third saying it will increase the number of people covered.