Health Brief: Ryan’s Job Approval Dropped Following ACA Replacement Collapse

Washington Brief

  • More voters disapprove of House Speaker Paul Ryan’s job performance than President Donald Trump, a sign that he has shouldered much of the public blame for the collapse of the GOP’s health care plan. (The Wall Street Journal)
  • Moderate Republicans have faced a greater blowback from constituents over the spring recess than members of the conservative House Freedom Caucus following the GOP health bill’s failure. (Axios)
  • If Republicans move ahead with repealing Obamacare, states would likely rely on a proposed Patient and State Stability Fund to prop up their insurance markets amid massive changes. (The Hill Extra)

Business Brief

  • Insurance industry executives are slated to meet with Centers for Medicare and Medicaid Services Administrator Seema Verma today as deadlines loom for them to file plans for next year’s Obamacare marketplaces. (Bloomberg News)
  • Insurers make it difficult for patients and families to get coverage for needed inpatient and outpatient care for addiction, including medication-assisted treatment, doctors say. (Modern Healthcare)
  • Theranos will not operate a clinical laboratory for two years and pay a $30,000 fine in a settlement with CMS that resolves all legal and regulatory proceedings between the federal agency and the embattled blood diagnostics firm. (The San Francisco Chronicle)

Chart Review

Events Calendar (All Times Local)

Bipartisan Policy Center event on patient treatment options 10 a.m.
No events scheduled
CSIS hosts discussion on future of global health financing 2:30 p.m.
No events scheduled



Poll Suggests Health-Care Fiasco Hurt Paul Ryan’s Standing Among Voters
Kristina Peterson and Rebecca Ballhaus, The Wall Street Journal

House Speaker Paul Ryan has a lower job approval rating than President Donald Trump in a new survey released Monday by the Pew Research Center. Less than a month since the collapse of the House GOP health-care bill, only 29% of those surveyed by Pew approved of Mr. Ryan’s job performance, compared to 39% for Mr. Trump — itself a historically low rating for a new president.

Recess makes Freedom Caucus winners on Trumpcare
Caitlin Owens, Axios

Moderate Republican House members have had a much tougher recess than conservatives when it comes to Trumpcare. Members from purple districts have had to weather angry liberals and disappointed conservatives, while conservatives have largely emerged as heroes.

Mentally ill accessing less U.S. health care
Lisa Rapaport, Reuters

More than 8 million American adults suffer from serious psychological distress, and they’re less likely to access healthcare services than other people, a U.S. study suggests. People with serious psychological distress, which includes any mental illness severe enough to require treatment, are three times more likely to be too poor to afford care and 10 times more likely to be unable to pay for medications, the study found.

In a Dragon’s Blood, Scientists Discover a Potential Antibiotic
Donald G. McNeil Jr., The New York Times

Biochemists may have discovered a type of antibiotic that sounds like something out of a fairy tale: It is based on dragon blood. Scientists from George Mason University recently isolated a substance in the blood of a Komodo dragon that appeared to have powerful germ-killing abilities.

Pound Rises as Election Called; Europe Stocks Drop: Markets Wrap
V Ramakrishnan, Bloomberg News

The pound climbed with bonds as British Prime Minister Theresa May announced an early general election. European stocks declined as traders caught up with a swathe of geopolitical events following the long weekend.


Obamacare’s Insurers Struggle for Stability Amid Trump Threats
Zachary Tracer and Anna Edney, Bloomberg News

Obamacare is stuck in limbo, and insurers and state regulators are struggling to set their plans for what’s increasingly shaping up as a chaotic year for the health-care program. After the failure of Republicans’ first attempt to repeal and replace the Affordable Care Act and President Donald Trump’s subsequent threats to let the program “explode,” more health insurers are threatening to pull out next year, while others may sharply raise the premiums they charge.

Insurers slowly removing barriers to addiction treatment
Shelby Livingston, Modern Healthcare

Psychiatrist Dr. Jerry Halverson had just finished a frustrating phone call with a health insurer. The insurer had refused to authorize a troubled teenager’s inpatient stay at Rogers Memorial Hospital, a behavioral health facility where Halverson serves as medical director.

Insurer UnitedHealth’s quarterly profit, revenue beats
Ankur Banerjee, Reuters

UnitedHealth Group Inc (UNH.N), the largest U.S. health insurer, reported a better-than-expected quarterly revenue and profit, driven by strength in its pharmacy benefit management business. UnitedHealth, which has pulled out of virtually all Obamacare individual markets, is the first health insurer to report its results a month after legislation to overhaul the U.S. healthcare system was pulled by Republican leaders.

GOP eyes insurer fund to save ObamaCare repeal
Rachel Roubein, The Hill Extra

If Republicans move ahead with repealing ObamaCare, a proposed Patient and State Stability Fund would likely be a key component to keeping the fragile insurance market intact amid massive changes. The $100 billion fund, included in the embattled House GOP bill, is the result of months of meetings between congressional staff, insurance commissioners and other officials that began before Republicans took complete control of Washington.

Medicaid expansion may come up again when legislative session resumes
Jonathan Shorman, The Wichita Eagle

Democrats are preparing for another run at Medicaid expansion when lawmakers return, hoping they can offer changes to conservatives to gain their support. But opponents vow to fight, saying there are no modifications that would win them over.

GOP’s New Health Care Rallying Cry: Remember The Maine!
Alice Ollstein, Talking Points Memo 

Just before fleeing Washington for the April recess, Republicans unveiled a new amendment they said would revive their struggling bill to repeal the Affordable Care Act—a policy based on a program in Maine that aims to bring down health insurance premiums by funneling older and sicker people into a separate individual market subsidized by the federal government. Though some lawmakers and staff privately admitted it was merely a stunt to create the appearance of progress on the stalled health care overhaul, others insisted the proposal would breathe new life into the moribund bill.

The Cost of Not Taking Your Medicine
Jane E. Brody, The New York Times

There is an out-of-control epidemic in the United States that costs more and affects more people than any disease Americans currently worry about. It’s called nonadherence to prescribed medications, and it is — potentially, at least — 100 percent preventable by the very individuals it afflicts.


CMS asks for comments on physician-owned hospital regulation
Virgil Dickson, Modern Healthcare

The Trump administration wants to hear comments on restrictions that the Affordable Care Act placed on physician-owned hospitals. On Friday, the CMS issued a proposed rule for inpatient hospitals that contained two requests for information.

A pain in the night and a harrowing drive: A crisis in rural health care puts mothers-to-be on a risky road
Casey Ross, Stat News

The pain started at midnight. Clare Shirley shuffled through the darkness to the bathroom.

Pharma, Biotech and Devices

FDA user fee extension poised to benefit healthcare companies
Alex Kacik, Modern Healthcare

The tentative deal to reauthorize the FDA’s ability to collect user fees could be a boon to many healthcare companies by providing more certainty and efficiency in the product-approval process, healthcare and legal experts said. The bipartisan leaders of the Senate’s and U.S. House of Representatives’ health committees released a draft of the bipartisan Food and Drug Administration Reauthorization Act Friday that would reauthorize the FDA’s four user-fee agreements that renew the agency’s authority to collect user fees from the makers of prescription brand drugs, medical devices, generic drugs and biosimilars, and several crucial programs at the FDA.

Patient groups, backed by pharma, organize to fight Nevada drug pricing bill
Ed Silverman, Stat News

A bill that was recently introduced in Nevada to fight the cost of diabetes medicines is quickly generating vociferous opposition from several patient organizations, some of which receive financial support from the pharmaceutical industry. The groups include the National Organization for Rare Disorders, Caregiver Voices United, the Myositis Association, the International Pain Foundation, RetireSafe, and the Epilepsy Foundation.

Valeant CEO is the healthcare industry’s highest-paid executive . . . IF he meets his numbers
Dave Barkholz, Modern Healthcare

Big executive pay and poor stock-price performance make for a volatile mix. That’s what executives are learning at troubled Valeant Pharmaceuticals International and hospital chain Tenet Healthcare Corp.

Unilife Corp. files for bankruptcy
Rachel Z. Arndt, Modern Healthcare

Medical-device company Unilife Corporation filed for bankruptcy protection last week after laying off more than a third of its 140-person workforce earlier this month. This is the latest in an ongoing series of financial struggles for the York, Penn.-based company, which also laid off more than 40% of its workers in 2016 and sublet some of its office space to save money after struggling to sell, customize and license its technology to pharmaceuticals and biotech companies.

Health IT

Theranos agrees not to operate labs for two years
Catherine Ho, The  San Francisco Chronicle 

Theranos has reached a settlement with the Centers for Medicare and Medicaid Services that resolves all legal and regulatory proceedings between the federal agency and the embattled Palo Alto blood diagnostics firm, the company announced Monday. Theranos has agreed to pay a penalty of $30,000 and cannot operate a clinical laboratory for the next two years.

A Message from the College of American Pathologists:

Pathologists are physicians whose diagnoses drive care decisions made by patients, primary care physicians, and surgeons. Watch as Dr. Jiang navigates the high stakes of diagnosis.

Opinions, Editorials and Perspectives

America Needs an Rx for Its Prescription Drug Prices
Larry Smith and Larry Ellingson, Morning Consult 

When President Donald Trump and Sen. Bernie Sanders, (I-Vt.) see eye to eye on an issue, you know that it is politically volatile. That is the state of the current debate around prescription drug pricing, which has become a cause célèbre for lawmakers across the political spectrum.

The GOP’s problem on health reform is they’ve spent years hiding their real position
Ezra Klein, Vox

The most interesting policy argument in America right now is the debate between conservatives’ real position on health care and their fake position. The fake, but popular, position goes something like this: Conservatives think everyone deserves affordable health insurance, but they disagree with Democrats about how to get everyone covered at the best price.

Sorry, Republicans, but most people support single-payer health care
Catherine Rampell, The Washington Post

Despite the rise of the tea party and unified Republican control of government, one decidedly anti-free-market idea appears ascendant: single-payer health care. And it’s no wonder, given that a record-high share of the population receives government-provided health insurance.

A Message from the College of American Pathologists:

Pathology is an integral part of surgery. Pathologists provide answers to key questions: Is a lesion benign or malignant? Has it spread? Is more testing needed?

Watch as Dr. Atkinson supports Kathy and her care team from biopsy to diagnosis.

Research Reports

CMS Should Build on Current Oversight Efforts by Further Enhancing Collaboration with States
U.S. Government Accountability Office

The Centers for Medicare & Medicaid Services reviews states’ efforts to reduce improper Medicaid payments, and encourages them to use collaborative audits—where CMS contractors and states work together to review the accuracy of payments made. However, some states have reported barriers (such as staff burden) to participating in collaborative audits.