Health Brief: Republicans Won’t Promise ACA Replacement Will Cover All

Washington Brief

  • Republican leaders won’t promise that their forthcoming alternative to the Affordable Care Act will cover the 20 million people who have gained coverage under the law, even though a top Trump adviser this week pledged that newly-covered Americans would maintain coverage. (The Hill)
  • Sen. Tom Cotton (R-Ark.) is the latest GOP senator to express reservations about repealing Obamacare without having replacement legislation, as a small but growing group of Republicans raising concerns about the plan to do so this week. (Bloomberg News)
  • The conservative House Freedom Caucus will decide next week if it will take an official position on a budget resolution meant to repeal Obamacare. Some members say they are ready to support the measure, even though it would increase the deficit, in order to repeal the health care law. (The Washington Post)

Business Brief

  • The likely repeal of the Affordable Care Act means that judges are making decisions about two pending health insurance mergers under a different policy landscape from when the mergers were proposed. (Modern Healthcare)
  • Mylan, the manufacturer of EpiPens, wants to create its own pharmacy and sell directly to public places, such as restaurants and sports venues. The company is planning a lobbying push to create laws that would allow them to do so. (Bloomberg News)
  • Families USA, a group that’s been influential in drafting health care policy, including the Affordable Care Act, named Frederick Isasi, previously a director at the National Governor’s Association, its next executive director. The group’s outgoing leader, Ron Pollack, has pledged to fight for the Affordable Care Act. (Modern Healthcare)

Chart Review

Events Calendar (All Times Local)

Friday
Vox interview with President Obama on the Affordable Care Act 11 a.m.

 

General

Conservatives ready to support $1 trillion hole in the budget
Kelsey Snell and David Weigel, The Washington Post

Some of the most conservative members of Congress say they are ready to vote for a budget that would — at least on paper — balloon the deficit to more than $1 trillion by the end of the decade, all for the sake of eventually repealing the Affordable Care Act. In a dramatic reversal, many members of the hard-line House Freedom Caucus said Thursday they are prepared later this month to support a budget measure that would explode the deficit and increase the public debt to more than $29.1 trillion by 2026, figures contained in the budget resolution itself.

Planned Parenthood would lose funding as part of Obamacare repeal, Ryan says
Mike DeBonis, The Washington Post

Republicans plan to strip Planned Parenthood of hundreds of millions of dollars in federal funding as part of their rapid push to repeal President Obama’s health-care overhaul, House Speaker Paul D. Ryan said Thursday. Ryan said a defunding measure would appear in a special fast-track bill that is expected to pass Congress as soon as next month.

What Trump’s new health policy aide says about abortion and birth control
Dylan Scott, Stat

Senate rejects effort to force 60 votes for Obamacare repeal
Robert King, The Washington Examiner

The Senate narrowly rejected Democrats’ attempts to force Republicans to get 60 votes to repeal Obamacare rather than a simple majority. The Senate voted 52-48 along party lines to reject an amendment by Sen. Tim Kaine, D-Va., and other Democrats to a budget resolution bill that is the first step toward repealing Obamacare.

Families USA names Frederick Isasi executive director
Maria Castellucci, Modern Healthcare

Families USA has selected Frederick Isasi, a director at the bipartisan National Governors Association, to serve as its new executive director. Isasi succeeds Ron Pollack, who announced last May he would step down from the consumer advocacy group he co-founded 36 years ago.

State Medicaid directors say 15-day inpatient limits may endanger some patients with mental illness
Virgil Dickson, Modern Healthcare

State Medicaid agencies want the CMS to extend the length of stay for inpatient psychiatric services, saying some patients with substance abuse disorders or severe depression need more time to get well. They worry the length of stay could affect treatment options.

Trump Defense Nominee James Mattis Resigns From Theranos Board
Christopher Weaver, The Wall Street Journal

The retired Marine Corps general President-elect Donald Trump has picked to lead the Defense Department resigned from the board of embattled Theranos Inc., people familiar with the matter said. The move distances Gen. James Mattis from a blood-testing startup embroiled in scandal ahead of his confirmation hearings.

Snapshots of an Epidemic: A Look at the Opioid Crisis Across the Country
The New York Times

Opioid addiction is America’s 50-state epidemic. It courses along Interstate highways in the form of cheap smuggled heroin, and flows out of “pill mill” clinics where pain medicine is handed out like candy.

Dollar Retreats as Treasuries Jump With Gold: Markets Wrap
Jeremy Herron, Bloomberg News

The dollar fell and Treasuries rallied with gold as asset moves sparked by Donald Trump’s election showed signs of faltering ahead of Friday’s U.S. jobs report. The greenback weakened a second day after reaching a 14-year high, as China moved to stem capital outflows and investors reconsidered Federal Reserve rate intentions.

Payers

GOP won’t promise ObamaCare fix will cover all
Peter Sullivan, The Hill

Republican leaders are refusing to commit to their ObamaCare replacement plan covering as many people as President Obama’s health law. Congressional Republicans are quickly moving forward to pass a repeal of ObamaCare and say a replacement plan will come later this year.

Senate GOP Jitters Grow on Obamacare Repeal With No Replacement
Steven T. Dennis and Sahil Kapur, Bloomberg News

Republican plans to repeal Obamacare without detailing a replacement are hitting resistance from at least three GOP senators, which would be enough to scuttle the strategy party leaders devised to deliver quickly on a central promise from President-elect Donald Trump. Only one of the senators — Rand Paul of Kentucky — has so far said he plans to vote against the procedural gambit that sets up Obamacare repeal, citing unrelated budget concerns.

Republicans Face Pressure for Push to Repeal Affordable Care Act
Stephanie Armour and Michelle Hackman, The Wall Street Journal

Senate Majority Leader Mitch McConnell on Thursday reiterated the need to move swiftly to repeal and replace the Affordable Care Act, as Republicans face growing questions about the turmoil that might ensue and the viability of crafting a replacement.  “We all know how harmful this failed, partisan experiment has been for those we represent,” Mr. McConnell said.

Americans don’t want to scrap Obamacare without something to replace it, new poll shows
Noam N. Levey, The Los Angeles Times

The vast majority of Americans do not support Republican plans to repeal the Affordable Care Act without enacting a replacement, a new nationwide poll finds. Nearly half the country does not want the law, commonly called Obamacare, to be repealed at all.

Trump Takes on Democrats and Health Law in New Twitter Blitz
Julie Hirschfeld Davis, The New York Times

President-elect Donald J. Trump lashed out at Democrats on Thursday over their efforts to preserve President Obama’s health care coverage law, insulting their top legislative leader and denouncing the measure as a “lie” as he called for a less expensive and more effective system. “The Democrats, lead by head clown Chuck Schumer, know how bad ObamaCare is and what a mess they are in,” Mr. Trump wrote in the first of three early-morning posts on Twitter.

Dems vow fight over ObamaCare benefits for women
Mike Lillis, The Hill

House Minority Leader Nancy Pelosi (D-Calif.) and House Democrats are warning GOP leaders they’ve got a fight on their hands if they try to roll back women’s healthcare benefits under ObamaCare. Democrats have little power in the minority to prevent Republicans from repealing President Obama’s signature healthcare reform law, including a host of provisions guaranteeing prenatal and contraception coverage for women.

GOP governors face uphill battle to spare Medicaid expansion from repeal
Virgil Dickson, Modern Healthcare

An effort by Republican governors of Medicaid expansion states to convince congressional Republicans that the Affordable Care Act’s Medicaid expansion is worth keeping is unlikely to influence their drive to repeal the ACA and that coverage expansion, GOP experts say. Instead, congressional Republicans are expected to push to convert Medicaid to a capped program of federal contributions to the states, which would give state officials much greater leeway to set eligibility and benefits, said Jon Gilmore, a Republican strategist in Arkansas.

Post-ACA landscape raises stakes in megamerger cases
Shelby Livingston, Modern Healthcare

The near-certain possibility that the Affordable Care Act will be bulldozed and replaced by the incoming administration means the nation’s largest insurers are consolidating amidst a very different landscape than the one they viewed when they first proposed some of the industry’s largest tie-ups ever. And that raises the stakes in the U.S. Justice Department’s antitrust cases against the Aetna-Humana and Anthem-Cigna mergers, which would take the country’s five largest insurers to three.

Exhibit A for Republican Obamacare repeal challenge: people with HIV
Julie Steenhuysen, Reuters

Scientists have shown conclusively that treatment not only improves the health of people infected with HIV, it also stops transmission of the virus that causes AIDS. That public health issue is just one of the challenges Republicans face as they attempt to overhaul the Affordable Care Act, a law that brought health insurance coverage to some 20 million people – including tens of thousands of Americans living with HIV.

Medicare Failed To Recover Up To $125 Million In  Overpayments, Records Show
Fred Schulte, Kaiser Health News

Six years ago, federal health officials were confident they could save taxpayers hundreds of millions of dollars annually by auditing private Medicare Advantage insurance plans that allegedly overcharged the government for medical services. An initial round of audits found that Medicare had potentially overpaid five of the health plans $128 million in 2007 alone, according to confidential government documents released recently in response to a public records request and lawsuit.

Providers

Georgia lawmakers are debating a hospital “bed tax” that could cost them millions
Max Blau, Stat

GOP lawmakers in Georgia are facing a tough question when they reconvene Monday: Should the state continue to do what nearly every other state in the US does — tax its hospitals? Georgia collects what’s known as a hospital provider fee, also known as a “bed tax,” that’s set to expire halfway through 2017.

Pharma, Biotech and Devices

Mylan’s EpiPen Sales Plan: Schools Today, Everywhere Tomorrow
Jared S. Hopkins and Robert Langreth, Bloomberg News

Mylan NV made a fortune, and stirred controversy, while getting EpiPen allergy shots stocked in schools across America. Now the drugmaker wants to sell EpiPens to restaurants, sports venues and potentially even Boy Scout troops — by setting up its own pharmacy to cut out middlemen and lobbying for new laws that could expand sales of its biggest product.

U.S. judge blocks Sanofi, Regeneron from selling cholesterol drug
Brendan Pierson, Reuters

A federal judge on Thursday blocked Sanofi SA and Regeneron Pharmaceuticals Inc from selling their cholesterol drug Praluent, a victory for Amgen Inc, which had accused them of infringing its patents. U.S. District Judge Sue Robinson in Delaware ordered that the ban not take effect for 30 days to give Sanofi and Regeneron time to appeal.

J&J, Actelion approach Swiss takeover board over deal structure: paper
Joshua Franklin, Reuters

Johnson & Johnson and Actelion have asked Switzerland’s takeover board about the viability of a complicated takeover deal the U.S. healthcare company is discussing with the Swiss biotech firm, newspaper Tages-Anzeiger reported on Friday, without saying how it got the information. The two companies asked about the proposal under which Johnson & Johnson would acquire Actelion while separating its commercialized portfolio from its research and development assets, a deal structure first reported by Reuters last week.

Health IT

Patients don’t trust health information technology
Gienna Shaw, Fierce Healthcare

More than 50% of consumers are skeptical about the benefits of healthcare information technologies, including patient portals, mobile apps and electronic health records. And fully 70% of Americans distrust health technology, up sharply from just 10% in 2014.

Opinions, Editorials and Perspectives

Repealing the ACA without a Replacement — The Risks to American Health Care
Barack Obama, New England Journal of Medicine

Health care policy often shifts when the country’s leadership changes. That was true when I took office, and it will likely be true with President-elect Donald Trump.

Trump’s health-care plan has already been tried. It was a disaster.
Jim McDermott, The Washington Post

As the new Congress begins its work this week, President-elect Donald Trump continues to call for repeal of the Affordable Care Act. However, rather than propose wholesale repeal — as many on the right would prefer — he is seeking to maintain some of the law’s most popular provisions.

What’s the Rush to Kill Obamacare?
The Editorial Board, Bloomberg View

For seven years, Republicans have yearned to dismantle the Affordable Care Act. Now that they have the chance, they seem wholly unprepared to do it right.

Let Opioid Users Inject in Hospitals
Tim Lahey, The New York Times

“How am I feeling, Doc?” my new patient answered. “I’m feeling like a caged dog.” Hospitalized for a heart-valve infection resulting from injection drug use, my patient had purple hair and arms covered with hand-drawn tattoos.

Make Obamacare great again — call it Trumpcare
Catherine Rampell, The Washington Post

Believe it or not, Americans like Obamacare. They just don’t know they like Obamacare. That is, the law known as “Obamacare” and “the Affordable Care Act” is relatively unpopular.

Research Reports

Kaiser Health Tracking Poll: Health Care Priorities for 2017
Ashley Kirzinger et al., Kaiser Health News

The latest Kaiser Health Tracking Poll finds that health care is among the top issues, with the economy and jobs and immigration, Americans want President-elect Donald Trump and the next Congress to address in 2017. When asked about a series of health care priorities for President-elect Trump and the next Congress to act on, repealing the ACA falls behind other health care priorities including lowering the amount individuals pay for health care, lowering the cost of prescription drugs, and dealing with the prescription painkiller addiction epidemic.

Briefings

Health Brief: Week in Review & What’s Ahead

Speaker Paul Ryan (R-Wis.) pulled legislation to repeal and replace the Affordable Care Act on Friday afternoon after GOP leaders and the White House failed to cobble together enough support from the conservative and moderate wings of their party. In an astounding moment, the Wisconsin Republican conceded that Obamacare, which Republicans have campaigned on repealing since its inception, would remain the law of the land for the “foreseeable future.”

Health Brief: GOP Announces Changes to Health Care Bill

House GOP leaders made tweaks to their Obamacare replacement legislation aimed at bolstering Republican support, but many skeptical conservatives remain opposed to the plan. The changes include giving states more flexibility with their Medicaid programs, phasing out Obamacare taxes sooner and increasing tax credits to help older Americans afford health insurance.

Health Brief: Week in Review & What’s Ahead

Speaker Paul Ryan’s Obamacare replacement plan got a boost Friday when leaders of the Republican Study Committee, the largest caucus in the House GOP, announced their support after the White House agreed to an amendment package that would give states the choice to block grant Medicaid rather than receive a per capita cap, and maintain work requirements for some program enrollees.

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