Health Brief: Trump Budget Proposal May Cap NIH Grants

Washington Brief

  • President Donald Trump’s final budget proposal for fiscal year 2018 might propose a 10 percent cap on grants awarded by the National Institutes of Health. Health and Human Services Secretary Tom Price said earlier this year that indirect costs represented “inefficiencies” at NIH, but the proposal is likely to face some bipartisan opposition in Congress. (The Atlantic)
  • As Senate Republicans begin crafting their health care bill, a group of about a dozen GOP governors is pushing a proposal to maintain the Affordable Care Act’s expansion of Medicaid, while limiting federal spending for certain populations through block grants or per capita caps. (Reuters)
  • The Trump administration took action to let consumers buy an Obamacare-approved health plan directly from a broker or an insurer’s website, instead of having to go through It’s the second action by the administration this week aimed at deregulating the federal insurance exchanges created under the 2010 health care law. (Modern Healthcare)

Business Brief

  • The drug industry is fighting efforts at the state level targeting rising high prices. Lawmakers have filed bills in about 30 states that include provisions to further regulate drug prices, require manufacturers to justify price increases or to form purchasing groups with other states to negotiate lower prices. (The Wall Street Journal)
  • Sanofi is facing backlash from lawmakers and advocacy groups for rejecting a request from the U.S. Army to set an affordable price for a Zika virus vaccine that the drugmaker is developing using taxpayer dollars. (Stat News)
  • The Justice Department filed a lawsuit accusing UnitedHealth Group of bilking the federal government of more than $1 billion through its Medicare Advantage plans. It’s the second time this month that the government agency has intervened to support a whistleblower suing UnitedHealth under the federal False Claims Act. (Kaiser Health News)

Chart Review

Events Calendar (All Times Local)

House Ways and Means subcommittee hearing on Medicare 2 p.m.
NIHCM webinar on coverage for high-need patients 2:30 p.m.



U.S. governors work Senate as new power brokers in Obamacare repeal
Yasmeen Abutaleb, Reuters

A group of about a dozen Republican governors is pushing for its own set of national healthcare reforms, flexing its considerable muscle in the national debate over the future of Obamacare as the U.S. Senate begins writing its bill. Led by Governor John Kasich of Ohio, the governors are using a nine-page proposal they crafted in February as the platform to shape what they think a critical portion of an Obamacare replacement law should look like, according to a half dozen people who helped write the plan.

Senate grapples with looming health care deadline
Caitlin Owens, Axios

There’s a big reason Senate Republicans have floated the idea of a short-term health care package: Insurers have to decide whether to participate in Affordable Care Act federal exchanges in 2018 by June 21. That creates a hard deadline for Congress if it wants to help shore up marketplaces in states like Iowa, which might have no carriers next year.

Lobby groups to watch in Senate healthcare fight
Rachel Roubein, The Hill

Lobbying groups opposed to the House’s healthcare reform bill are pinning their hopes on the Senate for big changes. Industry groups felt largely cut out of the House’s drafting and passage of the American Health Care Act and now are clamoring for action to fix what they view as serious defects in the legislation.

Price’s Remarks On Opioid Treatment Were Unscientific And Damaging, Experts Say
Jake Harper, NPR News

Addiction experts are up in arms over remarks by Health and Human Services Secretary Tom Price in which he referred to medication-assisted treatment for addiction as “substituting one opioid for another.” Nearly 700 researchers and practitioners sent a letter Monday communicating their criticisms to Price and urging him to “set the record straight.”

Senator Bill Cassidy has a track record in health care and ideas for reform. Will anyone listen?
Lev Facher, Stat News

Louisiana’s senior senator, a former liver doctor, has practiced medicine for decades. Bill Cassidy has taught medical students; led efforts to vaccinate thousands of Louisiana schoolchildren; founded a community clinic that pairs uninsured patients with doctors willing to treat them; and after Hurricane Katrina helped to transform an abandoned Kmart in Baton Rouge into a makeshift hospital wing.

Blood tests significantly underestimated lead levels, FDA and CDC warn
Laurie McGinley, The Washington Post 

Federal officials are warning that some blood tests may have “significantly” underestimated lead levels, and they are urging the retesting of some children, as well as pregnant and breast-feeding women. The Food and Drug Administration and the Centers for Disease Control and Prevention said the tests in question were made by Magellan Diagnostics, a leading testing company.

Global Stocks Fall After U.S. Rout as Bonds Gain: Markets Wrap
Samuel Potter et al., Bloomberg News

European and Asian equity markets slumped in the wake of the worst day in eight months for U.S. stocks as investors rushed to the safety of bonds. Shares across Europe extended declines after the S&P 500 Index plummeted by the most since September, following reports that U.S. President Donald Trump asked FBI director James Comey in February to halt an investigation and the justice department appointed a special counsel to probe Russia’s role in the 2016 election.


Trump administration lets consumers skip
Virgil Dickson, Modern Healthcare

The Trump administration took another step Wednesday toward deregulating federal insurance exchanges created under the Affordable Care Act. For coverage in 2018, consumers can buy an ACA-approved plan directly from a broker or an insurer’s website instead of having to go through, the CMS announced.

UnitedHealth Doctored Medicare Records, Overbilled U.S. By $1 Billion, Feds Claim
Fred Schulte, Kaiser Health News

The Justice Department on Tuesday accused giant insurer UnitedHealth Group of overcharging the federal government by more than $1 billion through its Medicare Advantage plans. In a 79-page lawsuit filed in Los Angeles, the Justice Department alleged that the insurer made patients appear sicker than they were in order to collect higher Medicare payments than it deserved.

Around round of premium hikes brewing: blame Trump or Obama?
Ricardo Alonso-Zaldivar, The Associated Press

Another year of big premium increases and dwindling choice is looking like a distinct possibility for many consumers who buy their own health insurance — but why, and who’s to blame? President Donald Trump has seized on early market rumbles as validation of his claim that “Obamacare” is a disaster, collapsing of its own weight. Democrats, meanwhile, accuse Trump of “sabotage” on a program he’s dissed and wants to dismantle.

Secret Sauce In Maine’s Successful High-Risk Pool: Enough Money
Patty Wight, Maine Public

As the GOP health care bill moves from the U.S. House of Representatives to the Senate, many consumers and lawmakers are especially worried that people with preexisting conditions won’t be able to find affordable health coverage. There are a number of strategies under consideration, but one option touted by House Republicans borrows an idea that Maine used just before the Affordable Care Act went into effect.

Rauner’s Medicaid overhaul: Who bid, and who backed out
Kristen Schorsch, Modern Healthcare

Family Health Network is notably absent from a group of insurers that have bid on a lucrative contract for a major Illinois Medicaid initiative. Now the fate of the Chicago-based health plan, known as FHN, is unclear.


Nursing homes and hospice providers face looming emergency preparedness deadline
Steven Ross Johnson, Modern Healthcare

After Hurricane Katrina in 2005, Amedisys decided it needed to upgrade its disaster plan. The national home healthcare and hospice provider began conducting risk analysis and factoring in local potential hazards to develop a plan to ensure staff and residents at its U.S. facilities could weather natural disasters.

Pharma, Biotech and Devices

Trump Reportedly Considering New Cuts to Biomedical Research
Ed Yong, The Atlantic

Two months ago, the Trump administration unveiled its so-called “skinny budget,” which envisioned cutting funds for the National Institutes of Health by 18 percent, or $5.8 billion. Scientists were appalled.

Price pushes Congress to follow Trump plan for more FDA user fees
Sarah Karlin-Smith, Politico

HHS Secretary Tom Price pressed Congress to heed President Donald Trump’s call to make the FDA rely more on industry fees — and less on taxpayer dollars — for product evaluations, as lawmakers continue work on extending the agency’s user fee programs. The request, made in a letter to Senate HELP ranking Democrat Patty Murray, could threaten deals the agency already struck with name-brand, generic and biosimilar manufacturers, as well as device makers, by forcing the industries to ante up more than they committed.

As States Wage Battles on High Drug Prices, Drugmakers Fight Back
Peter Loftus, The Wall Street Journal

Amid increasing calls for curbs on U.S. drug pricing, some of the most aggressive legislative action is happening at the state level—and industry lobbyists are fanning out to fight back. Lawmakers have introduced bills in about 30 state legislatures this year, seeking to regulate drug prices; require manufacturers to justify price increases; or to form purchasing groups with other states to negotiate lower prices, according to the National Academy for State Health Policy, a nonprofit policy group that has drafted model drug-pricing bills for state use.

Sanofi rejects US Army request for ‘fair’ pricing for a Zika vaccine
Ed Silverman, Stat News

As the US Army proceeds with plans to issue a license to Sanofi Pasteur to develop a vaccine for the Zika virus, the company last month rejected a request to maintain affordable pricing for Americans, according to an Army timeline of events that we have reviewed. The rejection prompted anger from Senator Bernie Sanders, who has pushed the US Army to negotiate a more favorable agreement with Sanofi, which is one of the world’s largest vaccine makers and has received a $43 million US research grant.

Lawmakers shoot down Trump’s proposed cuts to medical research
Rachel Roubein and Jessie Hellman, The Hill

Lawmakers are making clear that they have no intention of carrying out President Trump’s proposal to decrease funding for the National Institutes of Health (NIH), the nation’s medical research agency. In a hearing Wednesday, Rep. Tom Cole (R-Okla.) — the chairman of the House Appropriations subcommittee overseeing the NIH’s budget — said he was “disappointed” to see the White House’s recommendation to cut NIH funding by about $5.8 billion in its budget proposal for fiscal 2018.

Health IT

Cleveland Clinic’s Donley on telehealth advances, clinician wellness and ongoing efforts to achieve the Triple Aim
Ilene MacDonald, Fierce Healthcare

The Cleveland Clinic is making inroads in the quest to reach the Triple Aim of healthcare—better care, better health and lower costs—and the successes so far have inspired clinicians within the organization to want to do more. The nonprofit multispecialty academic medical center, a leader in efforts to improve the patient experience, has several ongoing initiatives that aim to provide patients with better access to care, more affordable care and improve the quality of care, Chief of Staff Brian Donley, M.D., told FierceHealthcare in an exclusive interview.

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Opinions, Editorials and Perspectives

Turning Up the Volume on Over-the-Counter Hearing Aids
Joe Kennedy and Marsha Blackburn, Morning Consult 

Walking the aisles of your local pharmacy, it can be easy to overlook the amount of innovation tucked into those unassuming shelves. For those with high blood pressure, there is a monitor readily available.

My son has Down syndrome. The GOP’s health-care bill scares me to death.
Allison Wohl, The Washington Post

The American Health Care Act scares me. I’m scared for all Americans with disabilities.

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Research Reports

AHCA Would Affect Medicare, Too
Cindy Mann and Allison Orris, The Commonwealth Fund

“Don’t touch my Medicare” has been a rallying cry in recent years, first as Congress considered health reform and now as it debates the fate of the Affordable Care Act (ACA). While the bill that would repeal and replace the ACA—the American Health Care Act (AHCA)—does not include explicit changes to Medicare, the legislation could have a profound impact on the 11 million Medicare beneficiaries who also rely on Medicaid for key components of their care.