Health Brief: Senate Parliamentarian Says Reconciliation Authority for ACA Repeal Expires Sept. 30


Government Brief

  • The Senate’s parliamentarian ruled that Republicans have until the end of the month to use the legislative process known as reconciliation to pass their current repeal-and-replace effort for the Affordable Care Act. The legislative maneuver would allow GOP senators to dismantle the law with 51 votes, but three Senate Republicans are pushing another plan that would reroute Obamacare’s federal dollars directly to the states, eliminate the individual and employer mandates, and cut and reshape Medicaid. (The Associated Press)
  • As Congress has fought over the Affordable Care Act, state officials across the country have done the heavy lifting for Obamacare enrollees, moving to ease premium hikes and ensure participation on the health insurance exchanges. But after Republicans failed to pass a repeal of Obamacare in July, a key Senate panel has launched a bipartisan push to address a controversial and unsettled issue: guaranteeing funding insurer payments that reduce out-of-pocket costs for some low-income people. (Politico)
  • While the Trump administration recently decided to reduce funding for enrollment promotion under Obamacare, the administration had already taken several steps to undermine the Affordable Care Act. Those steps included criticisms on social media platforms and in press releases, as well as the removal of information on the Department of Health and Human Service’s website that helped consumers learn about the 2010 law. (The New York Times)

Business Brief

  • Novartis Chief Executive Joe Jimenez plans to step down on Feb. 1 and be replaced by the company’s drug development chief Vas Narasimhan. Under Jimenez, who has served as CEO for seven years, the drug maker has shifted from animal health, vaccines and over-the-counter businesses to focus on generally more profitable prescription medicines, particularly in cancer, but has had setbacks as top-selling drugs have lost patent protection. (Reuters)
  • Obamacare supporters are putting together a new campaign to promote enrollment, in an effort to make up for the Trump administration’s decision to slash spending on outreach. The new effort could be announced this week. (Axios)
  • A video showed a Salt Lake City nurse being roughed up and arrested by a police detective for upholding the hospital’s policy of not allowing the police to draw blood from a patient without an arrest, a search warrant or the patient’s consent. The incident is likely to spur hospital administrators to review their policies surrounding police access to patients. (Modern Healthcare)

Chart Review

Events Calendar (All Times Local)

Tuesday
No events scheduled
Wednesday
Senate HELP Committee hearing with insurance commissioners on ACA stabilization 10 a.m.
Senate Appropriations subcommittee markup of HHS spending bill 11 a.m.
Cato Institute event on health insurance effect on mortality 12 p.m.
Thursday
Senate HELP Committee hearing with governors on ACA stabilization 9 a.m.
Senate Finance Committee hearing on reauthorizing CHIP 10 a.m.
Senate Appropriations Committee markup of HHS spending bill 10:30 a.m.
Medicare Payment Advisory Commission September meeting 9:30 a.m.
Friday
Govs. Hickenlooper, Kasich discuss bipartisan ACA plan 9 a.m.
NIHCM webinar on cancer care 1:30 p.m.
Medicare Payment Advisory Commission September meeting 10 a.m.
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General

Obstacles await as Congress resumes health care fight
Alan Fram, The Associated Press

Republican hopes for repealing and replacing former President Barack Obama’s health care law are still twitching in Congress, though barely. Leaders lack the votes to pass something and face a fresh obstacle — the Senate parliamentarian ruled Friday that Republicans only have the ability to dismantle the law with 51 votes until the end of the month.

Senate’s Obamacare fixes would build on heavy lifting by states
Adam Cancryn, Politico

While Congress was busy bickering over repealing the health law, officials in red and blue states worked frantically to soothe anxious insurers, tamp down rate increases and insulate their markets from the ceaseless chaos in Washington. The result is an Obamacare system that’s still vulnerable, but far from the “disaster” President Donald Trump and his top health officials describe.

The Same Agency That Runs Obamacare Is Using Taxpayer Money to Undermine It
Audrey Carlsen and Haeyoun Park, The New York Times

The Trump administration said on Thursday that it would slash spending on advertising and promotion for the Affordable Care Act, but it has already been waging a multipronged campaign against it. Despite several failed efforts by Republican lawmakers to repeal it, the Affordable Care Act remains the law of the land.

ACA allies plot their own enrollment push
Sam Baker, Axios

Supporters of the Affordable Care Act are putting together a new effort to promote enrollment, hoping to make up for at least some of the Trump administration’s cuts to that outreach. The plan is still under wraps for now; an announcement could come as early as this week.

How Trump Can Succeed At Signing Up People For Obamacare — If He Wants To
Jeffrey Young, HuffPost

President Donald Trump and his administration are about to be responsible for managing the next sign-up season on the health insurance exchanges created by the Affordable Care Act, a 2010 law he’s actively trying to repeal and about which he has nothing good to say. President Barack Obama and his team had plenty of trouble running these exchanges, and they actively supported and promoted enrollment for four years.

Stocks Bounce as Traders Refocus on Central Banks: Markets Wrap
Robert Brand, Bloomberg

European stocks bounced after Monday’s losses as traders shifted focus from North Korea to a week packed with central-bank decisions, Federal Reserve speakers and economic data that will help illuminate the path of the global economy. Most industry sectors in the Stoxx Europe 600 Index gained as data from China to the euro area pointed to a resurgent global economy.

Payers

Deadline Looms for Insurers to File Rate Proposals
Anna Wilde Matthews, The Wall Street Journal

A deadline for insurers to file 2018 prices for health insurance sold through Affordable Care Act exchanges arrives Tuesday, but state regulators are still struggling to make decisions about pricing and coverage amid uncertainty in federal health policy. The upshot is confusion in what is typically an orderly, regimented regulatory process for reviewing insurance offerings that will go on sale to consumers on Nov. 1.

State insurance commissioners under pressure in health-care drama
Julie Appleby, Kaiser Health News

With insurance premiums rising amid congressional Republicans’ failed attack on the Affordable Care Act, a group of bureaucrats whom few Americans can identify hold considerable power over consumers’ health plans: state insurance commissioners. Elected in 11 states, appointed in the others, they are central characters in the unfolding drama that is the nation’s health coverage.

Anthem Will Offer Obamacare In Otherwise ‘Bare’ Missouri Counties
Bruce Japsen, Forbes

Anthem said it would offer individual coverage under the Affordable Care Act in “68 counties in Missouri that otherwise would not have health insurance for their residents,” although it is still scaling back from the 85 counties where the insurer sells Obamacare plans this year. The move, announced Friday by the nation’s second-largest health insurer, is in contrast to its decisions to exit the ACA individual market on a larger scale in Virginia, Ohio, Indiana, Nevada and Wisconsin, where Anthem has for years sold coverage under the Blue Cross Blue Shield brand.

Minnesota Finds a Way to Slow Soaring Health Premiums
Robert Pear, The New York Times

Last fall, as consumers in Minnesota were facing health insurance rate increases of 50 percent or more, Gov. Mark Dayton, a Democrat, said the Affordable Care Act was “no longer affordable to increasing numbers of people.” The state’s top insurance regulator said the Minnesota market was “on the verge of collapse.”

Providers

Detective, nurse altercation could spur review of hospital policies
Harris Meyer, Modern Healthcare

In a case that’s gone viral, a Salt Lake City nurse endured a police detective’s rough treatment, handcuffing, and arrest to uphold her hospital’s policy of not allowing police to draw blood from a patient without an arrest, a search warrant, or the patient’s consent. The incident is likely to spur hospital administrators to evaluate their policies surrounding police access to patients, said Jennifer Mensik, a nursing instructor at Arizona State University and vice president of continuing education for OnCourse Learning.

Healthcare hiring cut in half from July to August
Maria Castellucci, Modern Healthcare

Healthcare hiring slowed significantly in August compared to the white-hot average gain of 37,950 jobs added to the industry during the previous two months. The industry produced 20,200 jobs in August, less than half of July’s 40,900 new healthcare jobs added, according to the most recent jobs report released Friday by the Bureau of Labor Statistics.

Pharma, Biotech and Devices

Novartis names drugs chief as CEO to deliver return to growth
John Miller, Reuters

Novartis (NOVN.S) CEO Joe Jimenez will step down on Feb. 1 and hand over to drug development chief Vas Narasimhan to decide the fate of $50 billion in assets and make good on a pledge to return the Swiss company to sales growth. Jimenez, who will have been at the helm for eight years when he retires, has hived off animal health, vaccines and over-the-counter drugs businesses at Novartis to focus on generally more profitable prescription medicines, particularly in cancer.

Health IT

Industry coalition finalizes clinical decision support guidelines aimed at self-regulation
Evan Sweeney, Fierce Healthcare

A coalition of organizations interested in making or using clinical decision support software has finalized voluntary guidelines aimed at self-regulating new technology that uses data and machine learning to assist physicians with more accurate diagnoses. The Clinical Decision Support Coalition, led by Bradley Merrill Thompson, a medical device attorney with Epstein Becker Green, finalized draft guidelines for CDS software released in May after reviewing public comments.

Opinions, Editorials and Perspectives

The Pharmaceutical Industry’s Social Contract With Patients
Joanna Shepherd, Morning Consult 

In recent months, the public outcry over drug prices has been somewhat drowned out by the controversy surrounding efforts to reform the Affordable Care Act. Although the administration is still expected to issue an executive order targeting drug pricing soon, the current lull presents an opportunity to evaluate recent efforts to constrain drug prices.

Navigating ObamaCare
The Editorial Board, The Wall Street Journal

One of the more evidence-free claims on the left is that the Affordable Care Act worked brilliantly before Republicans tried to dismantle it. Witness the claim this week that the Trump Administration is trying to tank the law’s exchanges, which are struggling from lack of consumer choice and affordability, not from a lack of government marketing.

Health care truth GOP must accept: America doesn’t want a free market
Andrew Cline, USA Today

Republicans in Washington have thus far failed to deliver on a signature campaign promise — to repeal Obamacare — despite controlling the House, Senate and White House. After their last flop, the party’s various factions pointed fingers faster than an all-mime production of “Gunfight at the O.K. Corral.”

Opioids Aren’t the Only Pain Drugs to Fear
Jane E. Brody, The New York Times

Last month, a White House panel declared the nation’s epidemic of opioid abuse and deaths “a national public health emergency,” a designation usually assigned to natural disasters. A disaster is indeed what it is, with 142 Americans dying daily from drug overdoses, a fourfold increase since 1999, more than the number of people killed by gun homicides and vehicular crashes combined.

Research Reports

Public Insurance and Psychotropic Prescription Medications for Mental Illness
Johanna Catherine Maclean et al., The National Bureau of Economic Research

Mental illnesses are prevalent in the United States and globally, and cost is a critical barrier to treatment receipt for many afflicted individuals. Affordable insurance coverage can permit access to effective healthcare services and treatment of mental illnesses.

Briefings

Health Brief: GOP Senators Ask CBO to Fast-Track ACA Overhaul Review

Senate Republican leaders have asked the Congressional Budget Office to fast-track consideration of a plan from Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) to overhaul the Affordable Care Act. The CBO is reportedly in the process of analyzing the cost and coverage impact of the plan, as Republicans face pressure to make one last attempt at undoing the ACA before GOP senators’ ability to pass legislation with a simple majority expires on Sept. 30.

Health Brief: Week in Review & What’s Ahead

HELP Committee Chairman Lamar Alexander (R-Tenn.) hopes to reach a deal with Democrats on a plan to shore up the ACA exchanges early this week. A final agreement, if reached, is likely to extend key insurer payments, known as cost-sharing reductions, and include reforms to make it easier for states to establish reinsurance programs. Some Republicans are also pushing to give states more flexibility over required benefits in Obamacare plans, a proposal that is controversial with Democrats.

Health Brief: Some Moderate House Democrats Seek ACA Stabilization

While progressives this week rallied behind Sen. Bernie Sanders’ (I-Vt.) single-payer health care bill, a group of moderate House Democrats in the New Democrat Coalition aligned themselves with the Senate Health, Education, Labor and Pensions Committee’s bipartisan push to stabilize the Affordable Care Act exchanges, which Committee Chairman Lamar Alexander (R-Tenn.) aims to reach a final deal on by early next week.

Health Brief: Deal Reached to Extend CHIP Funding

Senate Finance Committee leaders reached a deal on a five-year reauthorization of the Children’s Health Insurance Program, in a win for children’s health advocates who are seeking longer-term funding certainty for the program, which will expire at the end of the month without congressional action. The deal also gradually phases out the enhanced federal share of funding for state CHIP programs, which was increased under the Affordable Care Act by 23 percentage points.

Health Brief: Some Navigators Shut Down Ahead of ACA Enrollment Period

Several navigator organizations, including one that received the largest federal grant for Obamacare enrollment activities in 2016, are suspending operations ahead of the 2018 open enrollment season because they haven’t received contracts for funding from the Department of Health and Human Services, which could cause enrollment to plummet. The Trump administration announced plans last month to cut funding for navigator groups by about 40 percent, but health officials haven’t said whether the grants would end altogether.

Health Brief: Teva Names New CEO

H. Lundbeck A/S’s Kaare Schultz was named as Teva Pharmaceutical Industries Ltd.’s new chief executive officer, ending a seven-month search by the world’s largest generic drug maker to find a new leader. Schultz could face pressure to split the company into two businesses, one focusing on patented specialty drugs and the other on cheap copycat medicines

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