Health Brief: Trump to Sign Executive Order Allowing Lower-Cost, Less Comprehensive Health Plans


Government Brief

  • President Donald Trump is expected to sign an executive order this week that could allow insurers to offer lower-cost, bare-bones coverage that is presently restricted under the Affordable Care Act. The policy, which is designed to give healthy people cheaper coverage options, could split the insurance market in two, leaving higher-risk individuals in a smaller pool that sees higher costs. (The Wall Street Journal)
  • Trump phoned Senate Minority Leader Chuck Schumer (D-N.Y.) in an attempt to work with Democrats on health care reform. In a statement confirming the phone call, Schumer said he urged Trump to support a bipartisan Senate effort to stabilize the ACA exchanges, after Trump said he wanted to take another shot at repealing the 2010 law. (Axios)
  • A key issue of Senate Republicans in the bipartisan Obamacare negotiations is giving states more flexibility over their health care systems. While the ACA allows states to waive certain federal requirements, some state officials say the process is time-consuming and the rules too cumbersome for them to get policies approved that could lower premiums for their residents. (Washington Examiner)

Business Brief

  • New York-based Pfizer and Indian drugmaker Cipla are collaborating with the American Cancer Society on an initiative that will steeply discount the price of lifesaving cancer treatments in Africa. Under the agreement, which is modeled after a campaign against AIDS in Africa, the two companies have pledged to charge rock-bottom prices for 16 chemotherapy drugs, and top American oncologists will also work to simplify complex cancer treatment guidelines for underequipped African hospitals. (The New York Times)
  • While initially skeptical, some providers have embraced mandatory bundled-payment programs for total joint replacement procedures, impressed with how they have encouraged physicians to lower costs. But now many providers who participate in the programs worry about steps taken at the Department of Health and Human Services to roll back some of the programs or make them voluntary instead of mandatory. (Modern Healthcare)
  • Health care campaigners, the generics drug industry and some members of the European Union are pushing for legislative changes to laws that brand-name drugmakers use to protect their novel medicines from competitors. The battle has high stakes, as changes to European laws on patent protection could have an impact on the pharmaceutical industry’s presence in the region. (Politico)

Chart Review

Events Calendar (All Times Local)

Monday
Federal holiday — no events scheduled
Tuesday
No events scheduled
Wednesday
House Energy and Commerce subcommittee hearing on 340B 10 a.m.
Bipartisan Policy Center event on Medicare and Social Security 10 a.m.
House Energy and Commerce subcommittee hearing on the opioid crisis 10:15 a.m.
National MACRA MIPS/APM Summit 1 p.m.
Thursday
National MACRA MIPS/APM summit 7 a.m.
U.S. Chamber of Commerce event on the opioid epidemic 8:30 a.m.
Friday
National MACRA MIPS/APM summit 7:30 a.m.
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General

Trump phones a friend on health care
Jonathan Swan and Mike Allen, Axios

A Trump tweet this morning confirms last night’s Axios scoop: “I called Chuck Schumer yesterday to see if the Dems want to do a great HealthCare Bill. ObamaCare is badly broken, big premiums. Who knows!”

Trump vents to wealthy donors about failure to repeal Obamacare
Alex Isenstadt, Politico

President Donald Trump told a gathering of wealthy donors in North Carolina on Saturday evening that he is determined to push forward on health care reform — but acknowledged that he is facing serious obstacles in doing so. At a time of widespread frustration in the Republican Party about its repeated failure to repeal Obamacare, the president said he wants to restart the talks.

Fearsome Plague Epidemic Strikes Madagascar
Donald G. McNeil Jr., The New York Times

Madagascar has been struck by a fast-spreading outbreak of plague, creating panic and prompting the World Health Organization to send 1.2 million doses of antibiotics to the island nation. Since August, the country has reported over 200 infections and 33 deaths.

European Stocks Rise Led by Spain; Sterling Gains: Markets Wrap
Cormac Mullen, Bloomberg

European stocks edged higher, led by equities in Spain after a weekend of mass demonstrations in Catalonia in favor of Spanish unity. Sterling gained as Prime Minister Theresa May looked poised to reassert her leadership, while Turkey’s lira tumbled amid tensions with the U.S.

Payers

Trump Executive Order Could Divide the Health Insurance Market
Louise Radnofsky et al., The Wall Street Journal

President Donald Trump’s executive order on health insurance, the most significant step so far to put his stamp on health policy, is designed to give more options to healthy consumers. It also could divide the insurance market in two.

States plead for federal flexibility on health spending
Kimberly Leonard, Washington Examiner

In a strongly worded letter to the Trump administration, Oklahoma’s health commissioner recently expressed frustration that a state waiver to lower costs for Obamacare customers had not been approved as quickly as federal officials had promised. The proposal called for a reinsurance program in which government funding pays for costly medical claims while keeping prices down for other customers.

Democrats accuse Trump of ‘sabotage’ on Obamacare sign-ups
Paul Demko and Adam Cancryn, Politico

Obamacare’s first open enrollment season under the Trump administration is expected to be a flop — and even the law’s most ardent supporters are worried there’s little they can do to change that. With less than a month before sign-up begins, the federal government has gutted outreach and marketing, slashed funding to outside enrollment groups and left state officials in the dark on key details.

Overlooked By ACA: Many People Paying Full Price For Insurance ‘Getting Slammed’
Julie Rovner, Kaiser Health News

Paul Melquist of St. Paul, Minn., has a message for the people who wrote the Affordable Care Act: “Quit wrecking my health care.” Teri Goodrich, of Raleigh, N.C., has the same complaint.

Trump Officials Dispute the Benefits of Birth Control to Justify Rules
Anna Edney, Bloomberg

When the Trump administration elected to stop requiring many employers to offer birth-control coverage in their health plans, it devoted nine of its new rule’s 163 pages to questioning the links between contraception and preventing unplanned pregnancies. In the rule released Friday, officials attacked a 2011 report that recommended mandatory birth-control coverage to help women avoid unintended pregnancies.

Providers

Bundled-payment joint replacement programs winning over surgeons
Harris Meyer, Modern Healthcare

When administrator Dr. Geoffrey Cole found out last year that his hospital would be participating in Medicare’s mandatory bundled-payment program for total hip and knee replacement procedures, he started meeting with orthopedic surgeons. Cole initially was skeptical about the Comprehensive Care for Joint Replacement, or CJR, program the CMS Innovation Center launched in April 2016.

In Puerto Rico, lives depend on volunteer doctors and diesel generators
Robin Respaut and Nick Brown, Reuters

At a community center in Orocovis, an isolated agricultural town of 23,000 in the mountains of central Puerto Rico, six oxygen-dependent patients drew breath with the help of the diesel generator powering their equipment. Then the generator sputtered as if it might die.

Pharma, Biotech and Devices

As Cancer Tears Through Africa, Drug Makers Draw Up a Battle Plan
Donald G. McNeil Jr., The New York Times

In a remarkable initiative modeled on the campaign against AIDS in Africa, two major pharmaceutical companies, working with the American Cancer Society, will steeply discount the prices of cancer medicines in Africa. Under the new agreement, the companies — Pfizer, based in New York, and Cipla, based in Mumbai — have promised to charge rock-bottom prices for 16 common chemotherapy drugs.

Drug lobby’s patent law
Helen Collis, Politico

Europe is attempting to play mediator in a politically charged, high-stakes dispute involving one of its most powerful industries — the drugs lobby. The pharmaceutical industry has a host of intellectual property rights to choose from to protect its novel medicines from competitors once they are approved for sale.

China to accept overseas trial data in bid to speed up drug approvals
Adam Jourdan, Reuters

China said it plans to accept data from overseas clinical trials to speed up approvals of drugs, a potential boon for international drugmakers as well as patients who often face lengthy delays for new medicines to reach the market. The move, outlined by the Cabinet late on Sunday, seeks to address high medicine costs and access to healthcare for China’s population of nearly 1.4 billion.

Health IT

HHS gives University of Mississippi Medical Center, Medical University of South Carolina national telehealth designation
Evan Sweeney, FierceHealthcare

An agency within the Department of Health and Human Services has appointed medical centers in South Carolina and Mississippi as the country’s two designated Telehealth Centers of Excellence. This week, the Health Resources and Services Administration (HRSA) named the University of Mississippi Medical Center (UMMC) and the Medical University of South Carolina (MUSC) as national coordinating centers for telehealth.

Opinions, Editorials and Perspectives

A Chance to Do Right By Congestive Heart Failure Patients
Peggy Hardesty, Morning Consult 

Imagine being so sick that you cannot bathe or dress yourself without assistance, never mind shop for groceries or go for a gentle walk around your yard or neighborhood. Now, imagine there’s a medicine that can be administered at home that helps you overcome those problems and improves quality of life, but for legacy historical reasons your health insurance — Medicare — will not pay for it until 2021.

A Health Care Plan That’s Universal and Bipartisan
Ed Dolan, The New York Times

After the collapse of Republican efforts at one-party health care reform, many Democrats have embraced Senator Bernie Sanders’s Medicare for All proposal. Few liberals would object to this “single payer” plan if it could be enacted with a magic wand, but the political realities of getting it through Congress are daunting.

Congress quietly puts a crucial part of Obamacare on the chopping block
Editorial Board, The Washington Post

THE OBAMACARE debate has been out of whack from the start. Republicans have criticized the wrong things, allowing Democrats to ignore the Affordable Care Act’s biggest flaws. Now, this off-kilter debate may lead to the quiet loss of one of the law’s most important provisions, currently on Congress’s chopping block.

Can the U.S. Repair Its Health Care While Keeping Its Innovation Edge?
Aaron E. Carroll and Austin Frakt, The New York Times

The United States health care system has many problems, but it also promotes more innovation than its counterparts in other nations. That’s why discussions of remaking American health care often raise concerns about threats to innovation.

Here’s how a loophole in a transparency law can distort medical practices
Ed Silverman, Stat News

For the past four years, the federal government has required drug makers to report any meals they buy for doctors, as well as any payments for speaking, consulting, and running clinical trials. The system has succeeded in shining a light on financial ties that may unduly influence medical practice and research, a concern heightened by a series of pharma scandals involving illegal marketing, as well as studies showing such payments sway prescribing.

The Beltway Factor Drug Shareholders Must Take Seriously
Charley Grant, The Wall Street Journal

Pharmaceuticals investors have learned by now not to worry about big talk coming from Washington, D.C., politicians. They should be taking the words of Food and Drug Administration commissioner Scott Gottlieb very seriously, however.

Reverse Patent Trolls Are Harming Drug Innovation—and Patients
Brent Saunders, The Wall Street Journal

Allergan ’s agreement with the Saint Regis Mohawk Tribe has inspired a lot of commentary. Under the deal, my company transferred the patents for Restasis, a prescription eyedrop, to the Native American tribe as a way of protecting the intellectual property from unfair challenges.

Research Reports

Long-Term Care Insurance: Knowledge Barriers, Risk Perception and Adverse Selection
Martin Boyer et al., The National Bureau of Economic Research

We conduct a stated-choice experiment where respondents are asked to rate various insurance products aimed to protect against financial risks associated with long-term care needs. Using exogenous variation in prices from the survey design, and objective risks computed from a dynamic microsimulation model, these stated-choice probabilities are used to predict market equilibrium for long-term care insurance using the framework developed by Einav et al. (2010).