Health Brief: Senate GOP Working Group Members Balk at Alexander Proposal

Washington Brief

  • Conservative members of the Senate GOP’s official working group on health care balked at a proposal floated by Sen. Lamar Alexander (R-Tenn.) to let states repeal Obamacare insurance regulations if they automatically enroll customers in catastrophic health coverage. (CNN)
  • Meanwhile, a plan being pushed by conservative Sen. Mike Lee (R-Utah) for fast and steep cuts to Medicaid is likely to face opposition from centrist Republicans. (The Wall Street Journal)
  • A rival group of Republicans, led by Sens. Susan Collins (Maine) and Bill Cassidy (La.) have been meeting in a bid to influence the direction of the Senate’s Affordable Care Act replacement bill. (The Hill)

Business Brief

  • Aetna chief executive Mark Bertolini told employees at a private meeting that he is open to having a debate about single-payer health care. His remarks come less than a week after Aetna announced it would pull out of Obamacare in 2018. (Vox)
  • Anthem ended its $48 billion bid to buy Cigna, and is now fighting over whether Cigna deserves a $1.85 billion termination fee for the abandoned deal. (The Associated Press)
  • AstraZeneca shares surged after a trial of immunotherapy drug durvalumab showed it reduced disease progression in lung cancer patients. (Reuters)

Chart Review

Events Calendar (All Times Local)

No events scheduled
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



Behind the scenes, GOP working group runs into a few early obstacles
Lauren Fox and Phil Mattingly, CNN

Negotiations to repeal and replace Obamacare are fully underway now in the US Senate, where Republican lawmakers are grappling with how they can find consensus between their moderate and conservative factions while still managing to get the 50 Republicans they need to gut the Affordable Care Act. It’s tough math and although it is early in the process, so far the GOP’s health care working group — a collection of 13 GOP senators — has already encountered some of the same hurdles that hindered the House’s efforts, which struggled for weeks to collect enough votes to pass.

Rival Senate healthcare group seeks to make waves
Nathaniel Weixel, The Hill

A rival group of Republican senators is seeking leverage to influence the direction of the Senate’s ObamaCare replacement bill. The group, led by Sens. Susan Collins (R-Maine) and Bill Cassidy (R-La.), has been meeting “a couple times a week,” according to Sen. Shelly Moore Capitol (R-W.Va.).

Paul Ryan Still Wants to Re-do Medicare
Rema Rahman, Roll Call

House Speaker Paul D. Ryan said Friday it is possible the fiscal 2018 budget resolution could propose changes to the Medicare program. Speaking on WISN 1130, a conservative radio station in Milwaukee, Ryan said he’s long championed changes to the federal health insurance program for people 65 and older.

Trump Says He Knows About Health Care, But Some Of His Facts Seem Alternative
Julie Rovner, Kaiser Health News

Lost in all the coverage of the firing of FBI Director James Comey last week were a pair of in-depth interviews President Donald Trump gave that included lengthy comments on health care — one with Time magazine and the other with The Economist. He acknowledged to Time interviewers that health care was not an area of expertise in his previous job. “It was just not high on my list,” he said. But he added that “in a short period of time I understood everything there was to know about health care.”

Republicans‘ Latest Health Care Challenge: Selling Their Bill
Simone Pathé, Roll Call

With the Republican health care plan continuing to earn negative headlines and unfavorable poll numbers, House GOP lawmakers returning to Washington this week have a public relations challenge of epic political proportions. They succeeded — barely — at passing their health care bill.

Oil Jumps With Commodity Currencies on Output Deal: Markets Wrap
Samuel Potter and Adam Haigh, Bloomberg News

Crude rallied on the prospect a deal to cut global supply will be extended, leading a broader advance across commodities and spurring the currencies of major exporters. European stocks also felt the benefit, with miners and energy shares gaining.


Senate Conservatives Look to Cut Medicaid
Stephanie Armour and Kristina Peterson, The Wall Street Journal

Conservative Senate Republicans are weighing faster and steeper cuts to Medicaid that could drop millions of people from coverage and mark the biggest changes to the program in its 52-year history. The plan being pushed by lawmakers such as Mike Lee (R., Utah) is likely to face resistance from centrist GOP senators who are already concerned a health-overhaul bill passed by House Republicans would leave too many people uninsured.

Aetna CEO in private meeting: “Single-payer, I think we should have that debate”
Sarah Kliff, Vox

The chief executive of one of the country’s largest health insurance companies says he is open to having a single-payer debate. “Single-payer, I think we should have that debate as a nation,” Aetna chief executive Mark Bertolini said Thursday.

Anthem gives up Cigna bid, vows to fight on over damages
Tom Murphy, The Associated Press

Anthem has ended its soured, $48 billion bid to buy rival Cigna, but the nation’s second-largest health insurer isn’t giving up a fight over whether Cigna deserves a termination fee for the scrapped deal. Anthem said Friday that Cigna sabotaged the merger agreement and caused “massive damages” for Anthem, which provides Blue Cross-Blue Shield coverage in several states.

Schools brace for impact if Congress cuts Medicaid spending
Sally Ho and Carolyn Thompson, The Associated Press

For school districts still getting their financial footing after the Great Recession, the Medicaid changes being advanced as part of the health care overhaul are sounding familiar alarms. Administrators say programming and services even beyond those that receive funding from the state-federal health care program could be at risk should Congress follow through with plans to change the way Medicaid is distributed.

Is it a veto or not? McAuliffe and GOP fight over language blocking Medicaid expansion.
Laura Vozzella, The Washington Post 

Gov. Terry McAuliffe and the Republican legislature have escalated a long-running fight over whether a handful of his vetoes are valid — a battle that could determine whether the Democrat is able to pull off his marquee campaign pledge to expand Medicaid before leaving office in January. McAuliffe on Friday issued an executive order directing state agencies to recognize the state budget as he sees it — including five vetoes he made to various parts of the two-year spending plan.


KentuckyOne to sell its Louisville hospitals to stop losses
Dave Barkholz, Modern Healthcare

Struggling KentuckyOne Health plans to sell its Louisville hospitals to focus on its healthier markets in Lexington and eastern Kentucky, the hospital system announced Friday. KentuckyOne, a division of Catholic Health Initiatives, said it will seek buyers for Jewish Hospital, Frazier Rehab Institute, Sts. Mary & Elizabeth Hospital, Medical Centers Jewish East, South, Southwest and Northeast, Jewish Hospital Shelbyville, Saint Joseph Martin and KentuckyOne Health Medical Group provider practices in Louisville and Martin.

Surgeons plan to use hepatitis-infected hearts to slash wait for a transplant
Karen Weintraub, Stat News

Kiran Shelat was willing to try almost anything to get off dialysis. Every night, the civil engineer was hooked up to a machine for 10 to 12 hours, often suffering excruciating muscle aches.

Houston Hospital Checking To See If Patients’ Cupboards Are Bare
Charlotte Huff, Kaiser Health News

Sherry King had lost her job as a dental assistant and was stretching her food, sometimes going without any fresh fruit or vegetables. But the suburban Houston resident didn’t reach out for any help — even from her own relatives, whom she didn’t want to worry.

Pharma, Biotech and Devices

AstraZeneca shares surge after key drug shows promise in lung cancer trial
Alistair Smout, Reuters

A trial of AstraZeneca’s key immunotherapy drug durvalumab showed it reduced disease progression in lung cancer patients, sending the company’s shares higher and giving it a lead over rivals as it seeks to transform its oncology business. The trial results are an unexpectedly early boost for the product, known commercially as Imfinzi, which the company hopes will become a blockbuster drug with sales in the billions of dollars.

Policymakers Face Pressure to Act on Drug Pricing
Andrew Siddons, Roll Call

A proposal that would open the door for the import of low-cost prescription drugs from Canada was defeated at a Senate markup Thursday, but the proposal is unlikely to be gone for good. Lawmakers from both parties seem to want to demonstrate concern about drug prices to voters.

Health IT

How data restructured Oscar’s approach to marketplace plans—and why that might be bad for the industry in the long run
Evan Sweeney, Fierce Healthcare

After a rocky foray into the insurance marketplace, payer upstart Oscar appears to be finding its groove by using the data it’s collected since it launched in 2014 to optimize provider networks. Oscar’s data-driven approach has been closely watched by the insurance industry, although it hasn’t always been lucrative.

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Come with us to a new world. Where 140,000 biopharmaceutical researchers GOBOLDLY into the unknown to discover treatments and cures unimaginable ten years ago. Watch the new video at

Opinions, Editorials and Perspectives

Congress Needs to Keep Working on Health Reform to Get It Right
Carl Armato, Morning Consult 

Despite the recent House of Representatives vote on the American Health Care Act, there remains a great deal of uncertainty over what will happen in the Senate. As the CEO of a large nonprofit health system, I have one message to lawmakers and our president: Keep working.

No, Medicaid isn’t broken
Drew Altman, Axios

One reason the architects of the American Health Care Act want to cut Medicaid spending and give more responsibility to the states is that they believe that the current program is “broken,” with inadequate access to physicians and out-of-control costs. This is one of those canards that is repeated so often that many people just accept it as true. Mostly, it is not true.

The Health Care Bill’s Insults to Women
The Editorial Board, The New York Times

When Representative John Shimkus questioned, during a debate in March, why men have to pay for prenatal care, it was a sign of things to come. Soon Sean Spicer, the White House press secretary, was joking that older men didn’t need maternity care.

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Welcome to the future of medicine. Where breakthrough science is replacing chemotherapy with immunotherapy. Where we can attack the causes of disease, not just the symptoms. Where medicines once designed to fit all are now designed to fit you. Learn more at

Research Reports

Can at Scale Drug Provision Improve the Health of the Targeted in Sub-Saharan Africa?
Adrienne M. Lucas and Nicholas L. Wilson, The National Bureau of Economic Research

The single largest item in the United States foreign aid health budget is antiretroviral therapy (ART) for the treatment of HIV/AIDS. Many supply- and demand-side factors in sub-Saharan Africa could cause smaller than expected epidemiological effects of this at scale drug provision.