Health Brief: Senate Set to Vote on Budget Resolution to Repeal ACA

Washington Brief

  • The Senate is set to vote late Wednesday or early Thursday on a budget resolution that would serve as a way to repeal the Affordable Care Act. While the budget won’t be signed into law, it must be approved by both chambers for committees to begin drafting reconciliation legislation. (Politico)
  • Robert F. Kennedy Jr. says President-elect Donald Trump has asked him to chair a commission on vaccine safety, raising concerns of some health professionals since Kennedy has sought to advance a widely discredited theory that vaccines can cause autism. Trump’s team, pushed back on the certainty of the committee, saying he is considering a commission focused on autism. (The Washington Post)
  • Sen. Lamar Alexander (R-Tenn.), who chairs the Health, Education, Labor and Pensions Committee, laid out his ideal approach to repealing and replacing the ACA on the Senate floor Tuesday. Alexander argued for repealing the law once specific plans are in place and for giving states more authority. (Talking Points Memo)

Business Brief

  • The Pharmaceutical Research and Manufacturers of America is launching a major ad campaign meant to tout the industry’s achievements and move past a year in which former pharmaceutical executive Martin Shkreli dominated headlines that followed the industry. (BuzzFeed News)
  • Rural hospitals could face greater financial struggles if the Affordable Care Act is repealed. The law’s Medicaid expansion helped cover many poorer individuals who access health care at such hospitals and created programs to help rural hospitals afford prescription drugs. (Kaiser Health News)
  • GOP lobbyists are prepping for a major push to influence a conservative overhaul of Obamacare, as negotiations on Capitol Hill about a replacement plan are still underway. (The Hill)

Chart Review

Events Calendar (All Times Local)

Brookings Institution event on research and development 10 a.m.
Cato Institute discussion on the 115th Congress’ agenda 10 a.m.
AEI panel discussion on fixing health care 8 a.m.



Healthcare lobbyists prepare for frenzy
Megan R. Wilson, The Hill

Healthcare lobbying is about to shift into overdrive in Washington. With Republicans moving full-speed ahead with the repeal of ObamaCare, lobbyists on K Street are scrambling to come up with ways to influence the result.

Exclusive: House Panel Launches Online Portal for Health Reform Info
Mary Ellen McIntire, Morning Consult

The House Energy and Commerce Committee wants to be a go-to reference for all things related to the Obamacare repeal-and-replacement process, and its launching an online portal Wednesday meant to serve as “health care central” for inquiring minds. The committee, led by Rep. Greg Walden (R-Ore.), is poised to play an important role in GOP efforts to repeal and replace the 2010 health law.

How to Prevent Gun Deaths? Where Experts and the Public Agree
Quoctrung Bui and Margot Sanger-Katz, The New York Times

The mass shooting at the Fort Lauderdale airport in Florida last week shows how much the conversation around gun violence has changed since the presidential election. Five people were killed, and many others were injured; a few months ago, such carnage would have prompted new calls for more restrictions on guns.

Vaccine skeptic Robert Kennedy Jr. says Trump asked him to lead commission on ‘vaccine safety’
Abby Philip et al., The Washington Post

President-elect Donald Trump asked Robert F. Kennedy Jr., a proponent of a widely discredited theory that vaccines cause autism, to chair a new commission on vaccine safety and scientific integrity, Kennedy said Tuesday. The stunning move pushes up against established science, medicine and the government’s position on the issue.

What Trump can — and can’t — do to change vaccine policy
Rebecca Robbins, Stat

Robert F. Kennedy Jr., a prominent doubter of the safety of vaccines, told reporters on Tuesday that he will chair a commission on vaccine safety and scientific integrity as part of Donald Trump’s administration. The president-elect’s spokeswoman issued a statement hours later saying “no decisions have been made” about “forming a committee on Autism.”

In annual speech, bruised Christie lays out plan to attack drug addiction
Katie Jennings and Ryan Hutchins, Politico

Gov. Chris Christie made a national appeal for redemption in his final year in office by devoting much of his State of the State address Tuesday to the issue of drug addiction, laying out a “plan to attack” an epidemic that is “ripping the very fabric of our state apart.” The two-term Republican governor promised to make the issue of addiction a top priority in the coming months “because our state faces a crisis which is more urgent to New Jersey’s families than any other issue we could confront.”

Dollar Gains Before Trump as Oil Rises on OPEC Cut: Markets Wrap
Cecile Gutscher and Emma O’Brien, Bloomberg News

The dollar strengthened and Treasuries edged lower as investors awaited President-elect Donald Trump’s first press conference since July. Oil climbed from the lowest level in a month.


How the GOP plans to repeal Obamacare
Ben Weyl, Politico

The Republican Party’s quest to kill Obamacare is about to get real. Here’s a step-by-step guide to how it will go down in the coming days and weeks — assuming they don’t manage to mess it up or get cold feet.

Key GOP Chair Unveils Most Detailed Plan Yet To Repeal And Replace O’Care
Lauren Fox, Talking Points Memo

A Senate committee chairman with Obamacare jurisdiction offered the most detailed plan we’ve seen since the election to repeal and replace the ACA, on the floor of the Senate Tuesday afternoon. Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander (R-TN), who has long advocated for a “simultaneous” approach to scrapping and replacing the Affordable Care Act, said that Republicans should be focused on repairing Obamacare’s exchanges while building a new system to deliver health care to the American people.

Trump Tells Congress to Repeal Health Care Law ‘Very Quickly’
Maggie Haberman and Robert Pear, The New York Times

President-elect Donald J. Trump demanded on Tuesday that Congress immediately repeal the Affordable Care Act and pass another health law quickly thereafter, issuing a nearly impossible request: replace a health law that took nearly two years to pass with one Republicans would have only weeks to shape. “We have to get to business,” Mr. Trump told The New York Times in a telephone interview.

Trump’s Obamacare remedy spurs more confusion
Jennifer Haberkorn and Adam Cancryn, Politico

Republicans on Capitol Hill are in disarray about how to repeal Obamacare and President-elect Donald Trump’s call on Tuesday to enact a replacement “very quickly” did nothing to clear up the turmoil. Trump told The New York Times that he wants a repeal to happen within days and “the replace will be very quickly or simultaneously, very shortly thereafter.”

Trump, GOP at crossroads on repealing ObamaCare
Peter Sullivan, The Hill

In a significant development, President-elect Donald Trump on Tuesday called on Republicans to pass an ObamaCare replacement within “weeks” after repeal.  Trump’s comments urging his party to act quickly on a replacement come as a growing group of congressional Republicans is expressing serious concerns about moving forward quickly on repeal without having a replacement plan ready, or at the least the outlines of one.

Trump, Hill GOP fret about fallout from repealin Obamacare so Quickly
Kelsey Snell et al., The Washington Post

After years of promising to repeal the Affordable Care Act, a growing number of Republicans are balking at the prospect of doing so quickly without a firm plan to replace it. As the Senate begins voting Wednesday on a path to eliminate the landmark health-care bill, some Republicans are worried about the political fallout and uncertainty of starting to roll back Obamacare without knowing how the process will end.

Two New Reports Challenge GOP Criticism of Health-Care Law
Stephanie Armour, The Wall Street Journal

The double-digit jump in premiums this year on the health law’s exchanges was a one-time correction, and a brisk pace of sign-ups shows the marketplaces are on solid ground, the Obama administration said Tuesday in two reports that challenge Republican’s key criticisms of the Affordable Care Act. The reports, released as congressional Republicans are poised to topple key pillars of the ACA, again put the outgoing administration at odds with the GOP argument that the law is rapidly failing and must be quickly repealed.

Ryan: GOP’s goal is to replace, repeal ObamaCare ‘concurrently’
Scott Wong and Peter Sullivan, The Hill

Speaker Paul Ryan (R-Wis.) said on Tuesday that some elements required to replace ObamaCare could be included in the earlier process to repeal the healthcare law. Ryan, however, didn’t identify specific elements or get into other details of how that process would work.

Obamacare Markets See Growth Despite Premium Hikes
Andrew Siddons, Roll Call

More than 11.5 million people have signed up for individual health insurance coverage using the marketplaces established by the health care overhaul during the current enrollment period, an increase of 286,000 people compared to the same time last year, the Obama administration reported on Tuesday. The total includes 8.7 million who signed up through and 2.8 million who enrolled through state-based marketplaces.

Fewer Americans Paid Obamacare Tax Penalty In 2016
Phil Galewitz, Kaiser Health News

About 6.5 million Americans paid an average penalty of $470 for not having health insurance in 2015 — 20 percent fewer than the year before, according to data released Tuesday by the IRS. The IRS collected $3 billion, IRS Commissioner John Koskinen said in a letter to members of Congress.

Trump Medicare promise causes heartburn for GOP
Scott Wong, The Hill

Time and again on the campaign trail, Donald Trump pledged to his supporters that he wouldn’t gut Medicare as president. Trump’s incoming chief of staff, Reince Priebus, doubled down on that position over the weekend, insisting that his boss wouldn’t “meddle” with Medicare or Social Security.


Even In Trump Country, Rural Hospitals Brace For Damage From Health Law’s Repeal
Shefali Luthra, Kaiser Health News

Judy Keller, 69, has always relied on Highlands Hospital for medical care, just as her parents did before her. When she walks through the halls, she recognizes faces from the community and even from her days working as a school teacher.

Merger May Revitalize California’s Flagging Effort To Pool Medical Records
Chad Terhune, Kaiser Health News

After a sluggish start, the Cal INDEX medical database has agreed to a merger that would create one of the largest repositories of patient records in the country. The nonprofit California Integrated Data Exchange, launched by insurers Blue Shield of California and Anthem Inc. with much fanfare in 2014, announced Tuesday that it intends to merge with the Inland Empire Health Information Exchange.

After scandal, Phoenix VA still troubled by long waits for medical care, investigators say
Lisa Rein, The Washington Post

Almost three years after long waits for medical appointments for veterans exploded into a nationwide scandal, the Phoenix VA hospital at the center of the crisis still is not providing timely care, a watchdog group documented Monday. Special Counsel Carolyn Lerner, whose office represents whistleblowers and investigates their claims, wrote in a letter to President Obama that two independent reviews have confirmed many allegations brought by a doctor at the Phoenix facility.

Pharma, Biotech and Devices

Here’s How Big Pharma Plans To Clean Up After Martin Shkreli
Stephanie M. Lee, BuzzFeed News

Martin Shkreli was everywhere last year. After hiking the price of an antiparasitic pill from $13.50 to $750 as the then-CEO of Turing Pharmaceuticals, the unapologetic, indicted, and widely reviled “pharma bro” helped ensure that the issue of skyrocketing drug prices made news almost daily. No wonder Stephen Ubl, who runs the pharma industry’s lobbying group, said that moving on from Shkreli and doing damage control are the top priorities for drug makers in 2017.

California judge outlines next steps for coordinated Essure cases
Elizabeth Whitman, Modern Healthcare

A California judge has laid out the next steps for coordinating dozens of lawsuits filed against the pharmaceutical company Bayer by hundreds of women who say they were harmed by its sterilization implant, Essure. Judge Winifred Smith of Alameda County issued the case management order Dec. 21, 2016.

Health IT

C-suiters: Keep an eye on these technologies in 2017
Susan D. Hall, Fierce Healthcare

From Pepper, the emotional interactive robot, to the new da Vinci Xi Integrated Table Motion to pipeline vaccines, ECRI Institute highlights 10 healthcare technologies C-suiters should keep an eye on in 2017. The organization’s annual watch list outlines technologies that hospital leaders should bring into their hospitals—and which ones to keep out. But separating the facts from the hype isn’t easy, they note.

A Message from the College of American Pathologists:

Pathologists are physicians who provide a diagnosis of cancer. Getting that right is absolutely critical. Watch as Dr. Jiang navigates the high stakes of diagnosis.

Opinions, Editorials and Perspectives

Family Doctors: All Americans Need Access to Affordable, Quality Care
John Meigs Jr., Morning Consult

Since Election Day, health care analysts have tried to forecast the fate of our health care system. Much remains uncertain, but what is undisputed is the goal that all Americans must be able to obtain affordable, high-quality and efficient health care.

Some Republicans Try to Head Off a Health Care Calamity
The Editorial Board, The New York Times

President-elect Donald Trump and other Republican leaders may be determined to repeal the Affordable Care Act immediately, but a few more sensible members of the party are now trying to slow down this runaway train. They recognize the danger in destroying a program that directly benefits 22 million Americans — and indirectly millions more by controlling costs — without a plan to replace it.

Seven Questions About Health Reform
Harold Pollack and Timothy S. Jost, The New York Times

On Tuesday, Donald J. Trump said he wanted Congress to repeal the Affordable Care Act right away and replace it with a new plan “very shortly thereafter.” But before they abandon all the work that has gone into the health care law since 2010, President-elect Trump and Republicans in Congress owe Americans a detailed explanation of how they plan to replace it.

A Repeal and Replace Explainer
The Editorial Board, The Wall Street Journal

Every important legislative reform has Perils of Pauline moments, but the early Republican anxiety over ObamaCare repeal and replace is less than promising. Liberals want to label the effort a failure before the hard work even begins, and President-elect Trump and Congress need to swiftly unite around a better health-care alternative and a political strategy to pass it.

Where’s the GOP’s health-care plan?
Katrina vanden Heuvel, The Washington Post

For six years, Republicans have voted more than 60 times to repeal and replace the Affordable Care Act. “Repeal and replace” was a staple of Donald Trump’s stump speech.

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

ACO-Affiliated Hospitals Reduced Rehospitalizations from Skilled Nursing Facilities Faster Than Other Hospitals
Ulrika Winblad et al., The Commonwealth Fund

A study of hospitals in U.S. metropolitan areas found those affiliated with accountable care organizations (ACOs) were able to more quickly reduce the rate at which patients discharged to skilled nursing facilities needed to be readmitted within 30 days. Careful attention should be paid to the discharge planning methods and information exchange practices used by ACO-affiliated hospitals, which could contribute to the difference in reduced readmission rates.