Health Brief: Senate Confirms Price as HHS Secretary

Washington Brief

  • The Senate approved Tom Price, a six-term congressman and fierce critic of the Affordable Care Act, to serve as secretary of Health and Human Services by a vote of 52-47 overnight. (The New York Times)
  • More than 12.2 million people nationwide signed up for Obamacare health coverage this year, as lawmakers and the new administration plot the law’s repeal. Nearly two-thirds of people who signed up for coverage live in states that President Donald Trump won. (The Associated Press)
  • Republican senators from states that expanded Medicaid under Obamacare huddled this week as they try to figure out the next steps for the program while the GOP plans to dismantle the ACA. (The Hill)

Business Brief

  • The U.S. Court of Claims ruled that Moda, an Oregon health insurer, was due $214 million under the Affordable Care Act’s risk corridor program, handing a big win to the insurer. (The Oregonian)
  • A 2004 tax holiday cost the federal government more than $3 billion and didn’t increase U.S. jobs in the pharmaceutical sector. Now, Trump is promising another to try and reach the same goal. (Stat)
  • Anthem says it plans to appeal a federal judge’s decision to block its proposed merger with Cigna, but Cigna hasn’t expressed similar plans. (The Wall Street Journal)

Chart Review

Events Calendar (All Times Local)

Friday
No events scheduled

 

General

Tom Price Is Confirmed as Health Secretary
Robert Pear and Thomas Kaplan, The New York Times

The Senate early Friday approved the nomination of Representative Tom Price to be secretary of health and human services, putting him in charge of President Trump’s efforts to dismantle the Affordable Care Act. By a vote of 52 to 47, the Senate confirmed Mr. Price, Republican of Georgia, after a debate that focused as much on his ethics and investments as on his views on health policy.

Can Price steer GOP through Obamacare repeal battle?
Adam Cancryn, Politico

After surviving a brutal confirmation process, Rep. Tom Price will be asked to pull off the most perilous high-wire act in Washington. If Price is confirmed as HHS Secretary on a party-line vote later today or early tomorrow, as expected, he will assume an almost impossible task: It will be his job not just to unite GOP lawmakers divided over how swiftly to kill Obamacare, but to tamp down backlash from a newly resurgent left and placate a health care industry with hundreds of billions of dollars at stake in the repeal fight.

Dana-Farber will avoid ‘controversial venues’ after Mar-a-Lago fundraiser
Ike Swetlitz, Stat

The Dana-Farber Cancer Institute, which has faced strong criticism for its decision to hold a fundraiser this month at President Trump’s Mar-a-Lago Club, said Thursday that it would avoid “controversial venues” in the future. The hospital’s chief executive, Dr. Laurie Glimcher, said in a statement that its upcoming event, scheduled for Feb. 18, had become a “lightning rod” for some.

WHO director issues thinly veiled rebuke of FDA critics
Helen Branswell, Stat

The director of the World Health Organization issued a thinly veiled rebuke of critics suggesting that the Food and Drug Administration should be overhauled, including several candidates reported to be in consideration to head the agency. Speaking at a conference in Seattle on Wednesday, Dr. Margaret Chan warned against loosening the rules governing the safety and effectiveness data that drug companies must supply to win marketing approval from the FDA.

Bonds Drop on Inflation; Europe Stocks Erase Gains: Markets Wrap
Natasha Doff, Bloomberg News

Bonds fell and the dollar rose against most of its peers as reflation trades came back into focus after a promise by U.S. President Donald Trump to overhaul business taxes. European stocks erased gains as banks declined as political risk plagued the region.

Payers

Anthem to Appeal Decision Against Cigna Deal
Anna Wilde Mathews and Brett Kendall, The Wall Street Journal

Anthem Inc. said it would appeal a federal judge’s decision to block its acquisition of Cigna Corp., but the future of the deal was unclear amid discord between the two partners. Wednesday, U.S. District Judge Amy Berman Jackson said the proposed $48 billion deal between the two health insurers violated federal antitrust law because it would create an unacceptable reduction in the number of companies able to serve large multistate employers that insure their workers.

With Health law in Jeopardy, More Than 12M Still Sign Up
Ricardo Alonso-Zaldivar and Kevin S. Vineys, The Associated Press

More than 12.2 million people have signed up for coverage nationwide this year under the Obama-era health care law even with the uncertainty created by President Donald Trump’s vow to repeal and replace it. A count by The Associated Press shows that many consumers returned to the program despite its problems. Aside from the political turmoil, those difficulties include a spike in premiums, rising deductibles and dwindling choice of insurers.

Republican senators wrestle with changes to Medicaid
Peter Sullivan, The Hill

Republican senators who hail from states that expanded Medicaid are meeting about the future of the program as their party moves ahead with the repeal of ObamaCare. The senators had their first meeting on Wednesday in the office of Sen. Rob Portman (R-Ohio), who is from a state that expanded Medicaid and whose Republican governor, John Kasich, has been a vocal defender of it.

GOP Ramps Up Effort to Transform Medicaid Into Block Grants
Jennifer Levitz and Stephanie Armour, The Wall Street Journal

Congressional Republicans are stepping up efforts to overhaul how Medicaid is funded, a move that could reduce the funds states receive while giving states more control over the roughly $500 billion program. House Republicans this week weighed bills on Medicaid eligibility that are widely seen as their first move toward a broader overhaul.

‘Massive Confusion’ Abounds For Insurers As GOP Wavers On Obamacare Redo
Jay Hancock, Kaiser Health News

Premiums for Obamacare plans sold by New Mexico Health Connections could rise as little as 7 percent next year, says Martin Hickey, the insurance company’s CEO. Or they might soar as much as 40 percent, he said. It all depends on what happens in Washington.

Moda wins big: judge rules government owes Moda $214 million
Jeff Manning, The Oregonian

Moda Health, the Oregon health insurer that has struggled in the era of the Affordable Care Act, finally got some good news Thursday. The U.S. Court of Claims issued a strongly worded opinion that the federal government must pay Moda $214 million it had earlier reneged on.

Republicans in Idaho tried to design a better plan than Obamacare — and failed
Robert Samuels, The Washington Post

Jamie Gluch lumbered into the kitchen and pulled from the freezer a bag of corn, the only affordable analgesic he had for his swollen face. “You going to be okay?” asked his wife, 44-year-old Chelle Gluch. Jamie grunted “I’m all right” and joined the children at their in-home day-care business, who were watching cartoons on the sofa.

The Devil Is In The Details Of Latest GOP Obamacare Repeal Plan
Tierney Sneed, Talking Points Memo

Congressional Republicans are inching closer to cementing an approach to dismantling the Affordable Care Act that reportedly will include some replacement measures in the repeal legislation. The effort marks a victory for the GOP lawmakers who lobbied against repealing the law without a replacement, but it’s by no means the end of the intra-party battles.

Trump administration eyes help for ObamaCare insurers
Lauren Clason, The Hill Extra

The Trump administration is considering a number of changes to steady the ObamaCare insurance markets, but officials will have to get creative without new legislation from Congress. As the Senate prepares to vote to confirm Rep. Tom Price (R-Ga.), President Trump’s nominee to head the Department of Health and Human Services, the agency will soon propose a rule to help insurers facing massive uncertainty as Republicans prepare to gut the health law.

What Made Obamacare Succeed In Some States? Hint: It’s Not Politics
Stephanie O’Neill, Kaiser Health News

Ask anyone about their health care and you are likely to hear about ailments, doctors, maybe costs and insurance hassles. Most people don’t go straight from “my health” to a political debate, and yet that is what our country has been embroiled in for almost a decade.

This Grammys season, music world spotlights protecting the Affordable Care Act
August Brown, The Los Angeles Times

Last April, doctors told David Ponder, a 57-year-old gospel musician living near San Diego, that his heart was going to fail. He had already had quadruple bypass surgery; without a full transplant he and his music would likely die within months.

Zenefits Cuts 45% of Staff as New CEO Pushes Changes
Shelly Hagan, Bloomberg News

Zenefits announced it will cut 45 percent of its workforce as new Chief Executive Officer Jay Fulcher reduces costs in the wake of regulatory scrutiny and management shakeups that collapsed the company’s expansion plans.

Providers

Tom Price belongs to a doctors group with unorthodox views on government and health care
Amy Goldstein, The Washington Post

Tom Price — congressman, orthopedic surgeon, warrior against government intrusion into medical care — was three minutes into a speech condemning the Affordable Care Act when he asked his hotel ballroom audience of physicians whether they all were on the list to get emails from the federal agency overseeing Medicare and Medicaid. “If you’re not, you ought to get on it,” Price said. “Because, you know, everyone needs a good dose of nausea every now and again.”

Hospitals in low-income areas could lose billions in ObamaCare repeal: report
Jessie Hellmann, The Hill

A hospital trade group is warning that if ObamaCare is repealed without a replacement, hospitals across the country would lose billions of dollars in funding. America’s Essential Hospitals (AEH), a trade group that represents hospitals serving low-income communities, released a report Thursday detailing $40.5 billion in potential losses from 2018 through 2026 if congressional Republicans repeal ObamaCare without a comparable replacement.

Pharma, Biotech and Devices

Will pharma use a tax break to create new jobs? That’s not what happened last time
Damian Garde, Stat

Drug makers are promising to create tens of thousands of American jobs if President Donald Trump follows through on his promise to give them a big tax break if they “repatriate” cash they’ve stashed overseas. But that’s not what happened last time pharma got a tax holiday.

Dying Patients Have Pence’s Backing on ‘Right to Try’ Policy
Anna Edney, Bloomberg News

Vice President Mike Pence may have just picked another fight with pharmaceutical companies — one that doesn’t involve drug prices. Pence is pushing for a nationwide law that would give terminally ill patients expanded access to experimental drugs that haven’t been approved yet but have made it through the first of three approval phases.

Dozens Of New Cancer Drugs Do Little To Improve Survival, Frustrating Patients
Liz Szabo, Kaiser Health News

Marlene McCarthy’s breast cancer has grown relentlessly over the past seven years, spreading painfully through her bones and making it impossible to walk without a cane. Although the 73-year-old knows there’s no cure for her disease, she wants researchers to do better.

Health IT

ATA says states’ telemedicine progress a mixed bag
Evan Sweeney, Fierce Healthcare

A handful of states have made progress when it comes to integrating new policies that make it easier for physicians to practice telemedicine and provide broader coverage for patients, but much of the country remains stagnant when it comes to advancing such regulations. The result has been “a mix of strides and stagnation” in telemedicine policies across the country in 2016, according to two new reports from the American Telemedicine Association (ATA).

A Message from PhRMA:

It is not a video game. It is not a screen saver. Our latest #GoBoldy ad showcases how breakthrough immunotherapy treatments are destroying cancer cells inside the human body, revolutionizing how scientists fight this deadly disease. Watch now at www.GoBoldly.com

Opinions, Editorials and Perspectives

Controlling Cost Through Value
Peter Pitts, Morning Consult

The supporters of Oregon bill LC-1285 are calling for pharmaceutical price controls. So, let’s be honest, it doesn’t do that.

The Republican health-care plan the country isn’t debating
Drew Altman, The Washington Post

With the debate about the Affordable Care Act drawing so much scrutiny, a broader Republican agenda to fundamentally change the federal role in health care is flying under the radar. It’s the most important issue in health care we are not debating.

The GOP’s Health-Care Offensive
Kimberly A. Strassel, The Wall Street Journal

When Dave Hoppe recalls his first big health-care fight, one memory stands out. It was the summer of 1994, and Sen. George Mitchell, the Democratic majority leader, had canceled August recess to force a debate over his party’s health-care monster: HillaryCare.

Save the health-care safety net
Henry A. Waxman, USA Today

In the debate about the fate of the Affordable Care Act, one indispensable cog in our nation’s health care system has thus far been ignored — the safety net. These are the community health centers, public hospitals, clinics and programs that never turn anyone away, regardless of the ability to pay.

The opioid epidemic could turn into a pandemic if we’re not careful
Robert Gebelhoff, The Washington Post

The scourge of opioid addiction in the United States was one of the most talked-about issues during the campaign cycle — often panned as a devastating failure of the U.S. medical system. But painting opioid addiction as a uniquely American phenomenon ignores the mounting evidence that opioid abuse is a growing threat beyond our borders.

Obamacare repeal: Blind men and the elephant
Jennifer Rubin, The Washington Post

Vicki Hopper, a constituent of Rep. Tom Price (R-Ga.) from Roswell, Ga., lost her job two years ago but has kept her insurance through the Obamacare exchange. She says the price is “high, but affordable” since the subsidy cuts her payment to $370 per month.

A Message from PhRMA:

It is not a video game. It is not a screen saver. Our latest #GoBoldy ad showcases how breakthrough immunotherapy treatments are destroying cancer cells inside the human body, revolutionizing how scientists fight this deadly disease. Watch now at www.GoBoldly.com

Research Reports

Social Risk Factors and Equity in Medicare Payment
Melinda B. Buntin and John Z. Ayanian, New England Journal of Medicine

Medicare is steadily shifting from volume-based fee-for-service payments to value-based payment models, including accountable care organizations, episode-based bundled payments, and penalties for hospitals with relatively high Medicare readmission rates. These models typically provide financial bonuses or penalties related to the efficiency and quality of care, thereby shifting more financial risk to hospitals, medical groups, and other providers.

Briefings

Health Brief: Week in Review & What’s Ahead

The Senate GOP’s working group on health care is still discussing how to craft a bill to replace the Affordable Care Act, but lawmakers are also focused on a short-term fix to stabilize the individual insurance markets next year. The fix needs to come before June 21, insurers’ deadline for deciding whether to participate in the exchanges for 2018.

Health Brief: House May Need to Vote on AHCA Again

There is a chance that House Republicans will have to vote again on their health care bill, which was barely passed by the chamber earlier this month. Speaker Paul Ryan has not yet sent the bill to the Senate because parts of it may have to be redone, depending on how the Congressional Budget Office estimates its effects.

Health Brief: Week in Review & What’s Ahead

Senate Republican leaders formed a group to craft legislation that would replace the 2010 Affordable Care Act. The 13-man working group, which includes some of the most conservative members of the Senate at the exclusion of more moderate members, has faced criticism for not including women.

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