Health Brief: House GOP Leaders To Share Obamacare Plans

Washington Brief

  • House Republican leaders will brief rank-and-file GOP lawmakers in a closed-door session this morning about elements of their plan to repeal and replace the Affordable Care Act. (The Washington Post)
  • Seema Verma, President Donald Trump’s pick to head the Centers for Medicare and Medicaid Services, maintained a web of business arrangements while her firm made millions from consulting agreements to revamp state Medicaid programs, which experts say could present conflicts of interests. Verma is slated to testify at her confirmation hearing this morning. (The Associated Press)
  • CMS actuaries project the average rate of national health spending to rise 5.6 percent between 2016 and 2025. (Morning Consult)

Business Brief

  • The Trump administration introduced a number of insurer-friendly rules aimed at bolstering the insurance marketplaces while Republicans try to come up with an Obamacare replacement. (The New York Times)
  • Some small businesses that were once opposed to being required to provide health insurance to their full-time workers say they would continue to offer employer coverage if the Obamacare mandate is repealed. (The Wall Street Journal)
  • Molina Healthcare posted a fourth-quarter loss that’s attributed to it overestimating the medical costs for its enrollees by $120 million. The result of having healthier enrollees forced Molina to pay $325 million into an Obamacare program called risk adjustment. (Axios)

Chart Review

Events Calendar (All Times Local)

Families USA Health Action 2017 8:30 a.m.
House Judiciary subcommittee hearing on competitive health insurance Reform Act of 2017 10 a.m.
CAHC event on ACA replacement and subsidy portability 10 a.m.
Senate Finance Committee confirmation hearing on Seema Verma’s nomination to lead CMS 10 a.m.
Families USA Health Action 2017 7:30 a.m.



House GOP leaders will elaborate on their Obamacare plans
Kelsey Snell, et al., The Washington Post 

House Republican leaders plan to unveil on Thursday elements of their plan to repeal and largely replace portions of the Affordable Care Act. House Majority Leader Kevin McCarthy (R-Calif.) told reporters Wednesday that committee leaders will brief GOP lawmakers on some specific proposals at a closed-door meeting scheduled for Thursday morning.

A bleak week for Obamacare
Paul Demko, Politico

Obamacare’s health insurance markets are flirting with financial disaster — and that’s before Republicans have had a chance to lay their hands on the law they’ve vowed for seven years to repeal. The insurance markets, which have been bleeding money, have taken one hit after another this week, beginning with news that Humana would become the first major insurer to pull out of the market completely next year.

Price huddles with Senate GOP on ObamaCare
Peter Sullivan, The Hill

Senate Republicans met with Secretary of Health and Human Services Tom Price for lunch Wednesday, but lawmakers said that the discussion did not get into the details of an Obamacare replacement plan. President Trump said last month that his administration would put forward a replacement plan shortly after Price was confirmed, which happened last week.

Price delays rule meant to encourage sharing of substance abuse treatment records
Joseph Conn, Modern Healthcare

HHS Secretary Tom Price wants more public input before enforcing a rule that loosened privacy standards around substance abuse treatment records. The Obama administration issued the rule just weeks before President Barack Obama left office.

AARP takes aim at piece of GOP Obamacare replacement
Alayna Treene, Axios

AARP is launching a campaign against Congress’ proposed State Age Rating Flexibility Act, what it’s calling an “age tax,” that lets health insurance companies make premiums five times more expensive for older adults, up from the current three times. The group argues that the new legislation — which is expected to be a big part of the Obamacare debate — will unfairly hurt middle class families in order to “line the pockets” of big insurance companies.

Robert F. Kennedy Jr. says he expects Trump vaccine panel will move forward
Dylan Scott, Stat News

Prominent vaccine skeptic Robert F. Kennedy Jr. said Wednesday that he expects the Trump administration to move forward with a vaccine safety commission and that President Trump pledged that he was “not going to back down” if the drug industry objected to the commission. Kennedy said he had spoken with presidential aides three times since his January meeting with Trump.

No Limits
Sarah Kliff, Vox

Timmy Morrison was delivered by emergency C-section, weighing in at 3 pounds, 9 ounces. Doctors put him under anesthesia within a week and into surgery within a month. He arrived seven weeks premature — but, in a way, just at the right time.

Equity Rally Falters as Traders Turn to Havens: Markets Wrap
Eddie Van Der Walt and Blaise Robinson, Bloomberg News

Investor appetite for risk abated as European shares dropped on concern the longest rally since July 2015 went too far, while havens including the yen, bonds and gold advanced. An index of Europe’s 600 biggest shares fell for the first time in eight days. Nestle SA lost the most since November after saying it will target lower growth.


White House Proposes New Rules to Steady Insurance Markets Under Health Law
Robert Pear, The New York Times

The Trump administration proposed new rules on Wednesday to stabilize health insurance markets roiled by efforts to repeal the Affordable Care Act, by big increases in premiums and by the exodus of major insurers. The move came a day after Humana announced that, starting next year, it would completely withdraw from the public marketplaces created by former President Barack Obama’s signature domestic achievement.

CMS Projects Slower Health Spending Growth Over Next Decade Under ACA
Mary Ellen McIntire, Morning Consult 

Actuaries at the Centers for Medicare and Medicaid Services project the average rate of national health spending will grow 5.6 percent between 2016 and 2025, down slightly from their projections last year. Economic growth, medical prices and an aging population are all factors driving up spending, according to data published Wednesday in the journal Health Affairs.

Pick for Medicare post faces questions on Indiana contracts
Brian Slodysko and Carla K. Johnson, The Associated Press

President Donald Trump’s pick to oversee Medicare and Medicaid advised Vice President Mike Pence on health care issues while he was Indiana’s governor, a post she maintained amid a web of business arrangements — including one that ethics experts say conflicted with her public duties. A review by The Associated Press found Seema Verma and her small Indianapolis-based firm made millions through consulting agreements with at least nine states while also working under contract for Hewlett Packard.

Obamacare causes unexpected losses for Molina Healthcare
Bob Herman, Axios

Molina Healthcare’s stock tumbled after hours Wednesday after the health insurer posted a fourth-quarter loss that was attributed to parts of Obamacare — a big problem for one of the health insurers that has had success in the program. However, the company didn’t lose money because it had sicker-than-expected enrollees.

Small Businesses Change Tune on Health-Insurance Coverage
Ruth Simon, The Wall Street Journal

When Congress enacted the Affordable Care Act in 2010, some small firms worried that the cost of covering their workers would drive them out of business. But many of them now say they plan to keep offering health-insurance coverage, even if the requirement that they do so is eliminated.

Arizona judges question GOP arguments about blocking Brewer’s Medicaid expansion
Ken Alltucker, The Arizona Republic

A three-judge Arizona Court of Appeals panel repeatedly questioned arguments raised Tuesday by attorneys for Republican lawmakers challenging the state’s 2013 Medicaid expansion. Three dozen lawmakers filed their lawsuit contesting the legislation shortly after it was passed.

Judge rules for Oregon health plan in suit similar to Highmark’s
Steve Twedt, The Pittsburgh Post-Gazette

A federal claims judge has ordered the federal government to pay an Oregon health plan $214 million that he says was promised under the Affordable Care Act, an argument similar to the one Pittsburgh-based insurer Highmark has made in a suit seeking $223 million. In a Feb. 9 ruling, Judge Thomas Wheeler in the U.S. Court of Federal Claims granted summary judgement to Moda Health Plan Inc. of Portland, saying the government unlawfully withheld the payments.

Kansas still studying fiscal effect of expanding Medicaid
Allison Kite, The Associated Press

Kansas officials and advocates of expanding the state’s Medicaid program are at odds over what the expansion would cost, delaying a legislative committee’s vote on the idea. House Health and Human Services Committee Chairman Daniel Hawkins said Tuesday that the vote count on the panel is “neck and neck” on a bill expanding the state’s Medicaid program, known as KanCare.


2016 was a tough year for Cleveland Clinic finances
Lydia Coutre, Crain’s Cleveland Business

Rather than the nearly 50% drop in operating income the Cleveland Clinic stomached in 2016, president and CEO Dr. Toby Cosgrove instead focused on quality metrics, education, research and innovation during his annual State of the Clinic address on Wednesday morning, Feb. 15. Cosgrove began his address by congratulating staff for national rankings and quality improvements, as well as highlighting the Clinic’s opportunity to work with the current administration as it shapes the future of health care policy.

Travel Ban Spotlights U.S. Dependence On Foreign-Born Doctors
Lauren Silverman, KERA

Patients in Alexandria, La., were the friendliest people Dr. Muhammad Tauseef ever treated. They’d drive long distances to see him, and often brought gifts.

Pharma, Biotech and Devices

Generic drug lobby rebrands itself as drug-pricing politics intensify
Dylan Scott, Stat News

The Generic Pharmaceutical Association is no more. Meet the Association for Accessible Medicines.

PhRMA questions legality of Gov’s drug price control plan
Claire Hughes, The Times Union

The pharmaceutical industry does not like Gov. Andrew Cuomo’s proposals to control drug prices. The Pharmaceutical Research and Manufacturers Association this week launched a campaign to encourage New York state lawmakers to reject the plan, which would cap prescription drug costs for both Medicaid and private insurers. PhRMA claims the price control proposals threaten New York jobs and innovations — and may be illegal.

Health IT

GAO: EHRs, health insurance marketplaces among federal cybersecurity weaknesses
Evan Sweeney, FierceHealthcare

The Government Accountability Office once again called on the federal government to strengthen its cybersecurity capabilities across several platforms, with particular emphasis on hospital medical records and state-based insurance marketplaces. The GAO issued several broad cybersecurity recommendations in a report released Tuesday, calling on federal agencies to strengthen oversight and IT capabilities, improve cyber detection and response, expand training efforts and protect personally identifiable information.

A Message from the Coalition for Affordable Prescription Drugs:

Federal programs, state governments, employers, unions and others partner with PBMs to address rising prescription drug costs, keep patients healthy and deliver value for the health system. Visit for more.

Opinions, Editorials and Perspectives

A Rough 24 Hours for Obamacare
Megan McArdle, Bloomberg News

The last 24 hours have been one long string of bad news for Obamacare. Tuesday, the insurer Humana announced that it would be pulling out of the exchanges for next year.

Seema Verma’s Medicaid overhaul should not be the national model
Laura Hermer, Stat News

Medicaid is not a “workfare” program. It’s our nation’s primary method of covering health care for low-income Americans.

A Message from the Coalition for Affordable Prescription Drugs:

Federal programs, state governments, employers, unions and others partner with PBMs to address rising prescription drug costs, keep patients healthy and deliver value for the health system. Visit for more.

Research Reports

Trump Administration’s New Health Rule Would Reduce Tax Credits, Raise Costs, For Millions of Moderate-Income Families
Aviva Aron-Dine and Edwin Park, The Center on Budget and Policy Priorities

The Trump Administration’s new proposed rule on health care would raise premiums, out-of-pocket costs, or both for millions of moderate-income families. If finalized as proposed, the rule would reduce the amount of health care that marketplace plans have to cover.