Health Brief: Reductions in Number of Uninsured Stalled in 2016

Washington Brief

  • After five consecutive years of coverage gains, the number of uninsured Americans in 2016 was unchanged from the year before, according to a new government report that underscores the stakes as Republicans try to roll back the Affordable Care Act. (The Associated Press)
  • Newly installed Food and Drug Administration Commissioner Scott Gottlieb is reorganizing the federal inspection process to have regulators oversee specific product areas, such as pharmaceuticals and medical devices, rather than U.S. geographic regions. (Bloomberg News)
  • Some moderate Senate Democrats and Republicans attended a meeting to discuss whether there is a bipartisan path forward on health care. The meeting produced no firm conclusions, but members hope to meet again. (Axios)

Business Brief

  • A whistle-blower asserts that UnitedHealth Group and other big insurance companies have been systematically bilking Medicare Advantage for years by making patients look sicker than they were, which led to bigger reimbursements. (The New York Times)
  • Thermo Fisher is buying Pantheon, a Dutch manufacturer of drugs for clinical trials, for $5.2 billion as it seeks to expand its offerings of biopharma services. Thermo Fisher is the world’s largest maker of scientific instruments. (Reuters)
  • The Trump administration plans to let small businesses bypass the Affordable Care Act’s online marketplace to get health insurance for their employees. The change is expected to have little practical impact but shows the administration’s movement on its pledge to scale back parts of the 2010 law. (The Wall Street Journal)

Chart Review

Events Calendar (All Times Local)

Avik Roy briefing on new report about distortion in U.S. prescription drug market 9:30 am.
Senate Finance Committee hearing on improving Medicare for patients with chronic conditions 10 a.m.
NIH Director Collins testifies before House Appropriations subcommittee 10 a.m.
House Energy and Commerce subcommittee hearing on public health 10:15 a.m.
House Ways and Means subcommittee hearing on Medicare 2 p.m.
No events scheduled



Bipartisan group of senators meets to talk health care
Caitlin Owens, Axios

A small group of Republican and Democratic senators met Monday night to discuss whether there’s any path forward together on health care. While there was no firm conclusion, members emerged hopeful they’ll meet again.

Cruz, Paul want to go ‘nuclear’ on Obamacare repeal
Jennifer Haberkorn and Seung Min Kim, Politico

Conservative GOP Sens. Ted Cruz and Rand Paul are pushing to test the limits of how much of Obamacare can be repealed under Senate rules, setting up a potential “nuclear” showdown. The firebrands want to overturn long-standing precedent for what can be done under reconciliation, the fast-track budget process the GOP is using to dismantle the Affordable Care Act.

Lone GOP outside group offers cover for GOP healthcare vote
Cristina Marcos, The Hill

A GOP outside group allied with Speaker Paul Ryan (R-Wis.) is investing further in its effort to provide cover for House Republicans supporting the legislation to reform ObamaCare. American Action Network is to date the only major outside group defending the GOP’s healthcare plan on the airwaves.

Trump to Expand Funding Ban Tied to Abortion Overseas
Gardiner Harris and Somini Sengupta, The New York Times

The Trump administration said on Monday it would vastly expand the so-called global gag rule that withholds American aid from health organizations worldwide that provide or even discuss abortion in family planning. The new policy could disrupt hundreds of clinics in Africa and around the world that fight AIDS and malaria.

Texas Seeks Medicaid Money It Gave Up Over Planned Parenthood Ban
Abby Goodnough, The New York Times

Four years after Texas gave up millions of dollars in federal Medicaid funds so it could ban Planned Parenthood from participating in a family planning program for low-income women, the state is asking the Trump administration for the money back. The request presents an important early test for the administration of President Trump, who recently appointed an anti-abortion official to oversee federal family planning programs.

Euro Soars Amid Trump Concerns; Oil Extends Gain: Markets Wrap
Samuel Potter et al., Bloomberg News

The dollar weakened for a fifth day and the euro surged to the highest since November after a report U.S. President Donald Trump revealed classified information to Russia’s top diplomat. Crude extended gains as confidence grew that output cuts will be extended.


Gov’t report: Efforts to reduce US uninsured stalled in 2016
Ricardo Alonso-Zaldivar, The Associated Press

After five consecutive years of coverage gains, progress toward reducing the number of uninsured Americans stalled in 2016, according to a government report that underscores the stakes as Republicans try to roll back Barack Obama’s law. The Centers for Disease Control and Prevention estimated that 28.6 million people were uninsured last year, unchanged from 2015.

White House Closes a Health-Care Enrollment Option
Michelle Hackman, The Wall Street Journal

The Trump administration said Monday that it would no longer make enrollment for small-business plans available on, a change that carries little practical impact but signals the administration’s movement on a pledge to scale back parts of the Affordable Care Act. Under the ACA, employers with as many as 50 workers could sign up for small-group plans through the Small Business Health Options Program, often called SHOP, where some employers could qualify for tax credits to lower premiums.

A Whistle-Blower Tells of Health Insurers Bilking Medicare
Mary Williams Walsh, The New York Times

When Medicare was facing an impossible $13 trillion funding gap, Congress opted for a bold fix: It handed over part of the program to insurance companies, expecting them to provide better care at a lower cost. The new program was named Medicare Advantage.

Medicaid Expansion, Reversed by House, Is Back on Table in Senate
Robert Pear, The New York Times

Senate negotiators, meeting stiff resistance to the House’s plans to sharply reduce the scope and reach of Medicaid, are discussing a compromise that would maintain the program’s expansion under the Affordable Care Act but subject that larger version of Medicaid to new spending limits. With 62 senators, including 20 Republicans, coming from states that have expanded Medicaid under the Affordable Care Act, the House’s American Health Care Act almost certainly cannot pass the Senate.

Tennessee’s insurance chief seeks elusive answers in Washington
Holly Fletcher, The Tennessean

Tennessee’s top health insurance official is expressing frustration over what she describes as a lack of answers from Washington and the Trump administration, as the state braces for a new round of insurance rate filings. The future of a type of health insurance subsidy called cost-sharing reductions (CSR) is causing distress for insurers across the country, and Tennessee Insurance Commissioner Julie Mix McPeak says she can’t pinpoint the agency that will make the decision.

Preexisting Conditions And Continuous Coverage: Key Elements Of GOP Bill
Michelle Andrews, Kaiser Health News

Before he was diagnosed with head and neck cancer in 2015, Anthony Kinsey often went without health insurance. He is a contract lawyer working for staffing agencies on short-term projects in the Washington, D.C., area, and sometimes the 90-day waiting period for coverage through a staffing agency proved longer than the duration of his project, if coverage was offered at all.


New Research on Strokes Extends Window for Treatment
Thomas M. Burton, The Wall Street Journal

Leading medical researchers have found that treating many severe-stroke patients as long as 24 hours after a devastating stroke can restore a relatively normal life to some people whose brains had been viewed as badly injured. In results presented Tuesday in Prague at the European Stroke Organization conference, the research neurologists said that pulling a clot from major arteries to the brain can carry powerful effects many hours later than conventional wisdom had dictated.

The Bug Problem in Nursing Homes
Lucette Lagnado, The Wall Street Journal

There’s a bug problem in some nursing homes, and it’s not what you think. Residents of long-term care facilities are vulnerable to drug-resistant infections known as superbugs and can easily spread the deadly germs to others.

Pharma, Biotech and Devices

New FDA Commissioner Gottlieb Reorganizing Inspection Staff
Anna Edney, Bloomberg News

Federal inspectors who ensure the safety of the nation’s food and medical products will begin specializing in certain areas, as new Food and Drug Administration commissioner Scott Gottlieb enters his first full week at the agency. Workers in the FDA’s Office of Regulatory Affairs will begin focusing on overseeing specific product areas — such as pharmaceuticals or medical devices — rather than activities in their U.S. geographic regions, Gottlieb said Monday in a memo obtained by Bloomberg News.

Thermo Fisher to buy Patheon for $5.2 billion to expand biopharma services
Bill Berkrot and Natalie Grover, Reuters

Thermo Fisher Scientific Inc (TMO.N) said on Monday it would buy Patheon NV (PTHN.N), a Dutch manufacturer of drugs for clinical trials, for $5.2 billion as it seeks to complement its offerings in production and services for the biopharma industry. The offer price of $35 per share represents a premium of about 35 percent to Patheon’s Friday close.

New York county sues Purdue, J&J over opioid marketing
Nate Raymond, Reuters

A county in New York state has sued Purdue Pharma LP, Johnson & Johnson (JNJ.N) and other drugmakers, accusing them of engaging in fraudulent marketing that played down the risks of prescription opioid painkillers, leading to a drug epidemic. The lawsuit, which also named units of Teva Pharmaceutical Industries Ltd (TEVA.TA) and Endo International Plc (ENDP.O) as defendants, was announced on Monday by Orange County, New York, which is located in the southeastern part of the state.

Overwrought Marketing? Ads, Not Research, Create Some Pharma Best-Sellers
Julie Appleby, Kaiser Health News

An overhead light drawing attention to his face, actor Danny Glover starts to cry, dropping his head into one hand — then, he abruptly switches over to deep belly laughs, before resuming a straight face. “When I act, if I do this it’s totally in my control,” he says, getting to the point: “But for someone with pseudobulbar affect, choosing to cry or laugh may not be your decision.”

Trump taking aim at drug pricing
Peter Sullivan, The Hill

The Trump administration is working on actions it can take without Congress to fight high drug prices, according to people who have attended listening sessions officials are holding on the issue. It is unclear what exactly the administration will do or how consequential the measures will actually be.

SoFi President Nino Fanlo to Leave Firm for Biotech Startup
Peter Rudegeair, The Wall Street Journal

The No. 2 executive at online lender Social Finance Inc. is exiting the company to take a senior job at a biotechnology startup. Nino Fanlo, SoFi’s president and chief financial officer, is leaving the firm at the end of the month to take over as finance chief at Human Longevity Inc., a four-year-old genomics company, the two companies said.

Health IT

International Cyberattack Affects Some Corners of U.S. Health Care, Including Medical Devices
Melanie Evans, The Wall Street Journal

The international cyberattack that swept the globe has had some impact on the U.S. health-care system, as hospital systems scramble to prevent its further spread. On a conference call with health-care organizations Monday, U.S. federal officials said several medical devices had been infected with the ransomware that proliferated across dozens of countries, but declined to identify the devices, according to a person on the call.

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Opinions, Editorials and Perspectives

Why Are the Children Crying?
David Beier and Walt Rose, Morning Consult 

Nearly 1 out of every 10 Americans (30 million out of 321 million) is a child on Medicaid. These innocent and vulnerable deserve the best — but to hear the political debate about health care, they seem invisible.

How Republicans Stopped Pretending and Started Getting Real
Michael A. Needham and Jacob Reses, Politico

“Republicans need to become a governing party.” It’s a mantra we’ve been hearing for years, usually in response to speed bumps in the legislative process caused by internecine warfare within the House Republican conference, and always carrying the implication that some Republicans’ problem is that they only know how to say “no.”

I was arrested for asking Tom Price a question. I was just doing my job.
Dan Heyman, The Washington Post

For someone like me who is constantly checking email on my phone, one odd thing about getting put in jail is how suddenly you’re almost totally cut off. I was arrested last week after asking Health and Human Services Secretary Tom Price a question about the American Health Care Act while he walked toward a meeting in the West Virginia State Capitol.

Trump and Christie’s First Steps to Solving the Opioid Crisis
Josh Bloom and Alex Berezow, The Wall Street Journal

President Trump has tapped New Jersey Gov. Chris Christie to tackle America’s opioid crisis—a complicated task to say the least. Because the root cause of rising addiction and overdose is still unclear, any government response must be flexible and nuanced.

A Good Start on Health Care, But We’re Not Done
Diane Black, RealClearPolitics

You asked for it, you got it. For seven years, everywhere I go, people tell me stories about how Obamacare’s heavy hand has cost them money and hurt their health care.

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Research Reports

Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2016
Robin A. Cohen, National Center for Health Statistics

This report from the National Center for Health Statistics (NCHS) presents selected estimates of health insurance coverage for the civilian noninstitutionalized U.S. population based on data from the 2016 National Health Interview Survey (NHIS), along with comparable estimates from previous calendar years. Estimates for 2016 are based on data for 97,459 persons.