Health Brief: White House Pressuring GOP Leaders to Schedule Health Care Vote for Next Week

Washington Brief

  • Despite pressure from the White House, Republicans leaders in the House are unlikely to hold a vote next week to repeal the Affordable Care Act since it remains unclear whether they can muster the 216 votes needed for passage, according to GOP congressional aides. (Politico)
  • The “buy American, hire American” executive order that President Donald Trump signed this week could negatively impact hospitals and states that rely on the H-1B visa program to hire physicians from abroad, according to a new study. (Kaiser Health News)
  • Billionaire philanthropist Bill Gates, a vaccine advocate, spoke for the first time publicly about his private meeting with Trump last month, and he said he brought up the issue of vaccines. (Stat News) As a presidential candidate, Trump lent credence to discredited claims linking vaccines to autism, but his administration has yet to signal the direction of its vaccine policy. (Morning Consult)

Business Brief

  • Anthem submitted preliminary filings indicating it would offer health care plans on the ACA exchanges in Virginia and Kentucky next year, despite the uncertainty surrounding the future of the law. Cigna and Aetna have also made similar filings in Virginia, but UnitedHealth Group plans to leave that exchange. (The Wall Street Journal)
  • With the administration mum on whether it will continue to fund cost-sharing subsidies for low-income Americans, states such as Colorado, Kentucky, New Hampshire and Oregon have extended their deadlines for insurers to submit rates for 2018 Obamacare health plans. (Modern Healthcare)
  • Two companies are competing to develop a new treatment that would make it easier for doctors to deliver medication effectively to the inner ear. (Reuters)

Chart Review

Events Calendar (All Times Local)

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White House pressures GOP leaders on Obamacare showdown next week
Rachael Bade, et al., Politico

A frantic and impatient White House is pressuring House GOP leaders for another showdown vote on repealing Obamacare next week so it can notch a legislative win before President Donald Trump’s first 100 days in office. But while the outlines of a possible deal are starting to come together, it’s far from clear that House Republican leaders have found the sweet spot to pass their embattled alternative health plan.

The education of President Trump by Bill Gates, global health advocate
Helen Branswell, Stat News

In these early days of Donald Trump’s administration, Americans and the rest of the world have been watching the education and evolution of a new president. Foreign policy is tricky.

Despite Campaign Rhetoric, Trump Mostly Silent on Vaccine Policy
Jon Reid, Morning Consult 

On the campaign trail, President Donald Trump met with prominent vaccine skeptics and ranted about the debunked theory that vaccines cause autism. But as the administration approaches its 100-day mark, the White House has given few indications about the direction of its vaccine policy.

How G.O.P. in 2 States Coaxed the Health Law to Success or Crisis
Abby Goodnough and Reed Abelson, The New York Times

When President Trump describes the Affordable Care Act as “imploding,” Lori Roll, an insurance agent here, does not consider it hyperbole. Only one health insurer in Oklahoma is left selling coverage through the federal marketplace, and the hospital in this city of 36,000 is not in the network.

Bonds Rise as Stocks Languish Before French Vote: Markets Wrap
V Ramakrishnan, Bloomberg News

France led gains in the region’s government bonds before the nation goes to the first round of voting that puts the future of the common currency at play. Stock volatility scaled its highest level in nine months while European equities swung between gains and losses.


Amid growing uncertainty, states extend deadlines to file 2018 rates
Shelby Livingston, Modern Healthcare

With time running out to set insurance prices and still no sign of whether the Trump administration will continue funding cost-sharing subsidies for low-income Americans, several states are giving health insurers a little more wiggle room to file 2018 rates. State insurance regulators hope an extra few weeks to price plans will be enough to ease the insurance industry’s jitters created by efforts to repeal and replace the Affordable Care Act and keep insurers from bailing on the exchanges.

A New G.O.P. Health Proposal Evokes the Old Days
Margot Sanger-Katz, The New York Times

In the days before Obamacare, applying for health insurance meant filling out dozens of pages of forms and submitting medical records. It was almost impossible to compare prices.

Under Trump, states may demand work for Medicaid
Ricardo Alonso-Zaldivar, The Associated Press

Work requirements for Medicaid could lead to major changes in the social safety net under President Donald Trump. It sounds like a simple question: Should adults who are able to work be required to do so to get taxpayer provided health insurance?

States may end coverage for kids as federal funds dry up
Virgil Dickson, Modern Healthcare

Several states may soon have to suspend programs that provide healthcare coverage for children unless Congress reauthorizes funding for the Children’s Health Insurance Program, according to a government agency. Arizona, California, Minnesota, North Carolina and the District of Columbia will run out of CHIP funding by December 2017 unless Congress approves additional funds for the program, according to a report by the Medicaid and CHIP Payment and Access Commission (MACPAC) discussed during a Thursday panel meeting.


Clamping Down On Visas Could Leave Some Areas Underserved By Doctors
Michelle Andrews, Kaiser Health News

Limiting the number of foreign doctors who can get visas to practice in the United States could have a significant impact on certain hospitals and states that rely on them, according to a new study. The research, published online in JAMA this week, found that more than 2,100 U.S. employers were certified to fill nearly 10,500 physician jobs nationwide, in 2016.

Stalking the ‘Unknown Enemy’: Doctors Turn Scope On Rare Diseases
Anna Gorman, Kaiser Health News

Lynn Whittaker stood in the hallway of her home looking at the framed photos on the wall. In one, her son, Andrew, is playing high school water polo. In another, he’s holding a trombone.

Pharma, Biotech and Devices

Two-horse race: Auris, Otonomy seek FDA nod for inner-ear therapies
Natalie Grover and Divya Grover, Reuters

Doctors have struggled for years to deliver medication effectively to the inner ear, but two companies are vying to be first to introduce new treatments which, if successful, could together chalk up some $800 million in peak sales. Pivotal drug-trial data from Otonomy Inc and Auris Medical Holding AG is expected to show whether two competing approaches can address ear disorders associated with hearing loss and balance.

Cherokee Nation sues drug firms, retailers for flooding communities with opioids
Scott Higham and Lenny Bernstein, The Washington Post

Lawyers for the Cherokee Nation opened a new line of attack against the pharmaceutical industry Thursday, filing a lawsuit in tribal court that accuses the nation’s six top drug distributors and pharmacies of flooding communities in Oklahoma with hundreds of millions of highly addictive pain pills. The suit alleges that the companies violated sovereign Cherokee laws by failing to prevent the diversion of pain pills to the black market, profiting from the growing opioid epidemic and decimating communities across the nation’s 14 counties in the state.

Codeine cough syrup should not be given to kids, FDA warns
Kate Sheridan, Stat News

The FDA issued its strongest level of drug warnings Thursday concerning opioid pain-reliever use in children. Medicines containing codeine and another narcotic, tramadol, will now require a label indicating that they should not be used by children under 12.

Sanofi Genzyme hit with patent lawsuit over new eczema drug
Max Stendahl, Boston Business Journal

Sanofi Genzyme’s next potential blockbuster treatment is running into legal trouble in California, where a unit of Amgen has accused the Cambridge rare disease drugmaker of infringing one of its patents. Immunex Corp., a subsidiary of Amgen (Nasdaq: AMGN), filed a complaint in Los Angeles federal court on April 5 claiming that an eczema drug developed by Sanofi (NYSE: SNY) and Regeneron Pharmaceuticals (Nasdaq: REGN) infringes a patent related to a failed asthma treatment.

Biotech firm pulls pioneering gene therapy due to no demand
Ben Hirschler, Reuters

The biotech company behind the Western world’s first gene therapy and the most expensive prescription medicine in history is giving up on the product because of lack of demand. Only one patient has been treated commercially since the drug was first approved in Europe nearly five years ago, a spokeswoman for Dutch-based UniQure said on Thursday.

Health IT

How Trump’s visa overhaul could weaken the health IT industry and drive up healthcare costs
Evan Sweeney, Fierce Healthcare

President Trump’s executive order this week aiming to limit the number of foreign workers in U.S. jobs could deal a significant blow to both payers and providers that use overseas workers to fill a growing health IT workforce—and further impede efforts to lower healthcare costs. The executive order, signed on Tuesday, calls for the Secretary of State, the Attorney General, the Secretary of Labor and the Secretary of Homeland Security to suggest reforms to the H-1B visa program to “help ensure that H-1B visas are awarded to the most-skilled or highest-paid petition beneficiaries.”

A Message from the College of American Pathologists:

Pathologists are physicians whose diagnoses drive care decisions made by patients, primary care physicians, and surgeons. Watch as Dr. Jiang navigates the high stakes of diagnosis.

Opinions, Editorials and Perspectives

Trump’s NIH Cuts Will Slow March Toward Human-Focused Science
Kristie Sullivan, Morning Consult 

President Donald Trump’s 2018 budget proposal calls for drastic funding cuts to scientific research and a major reorganization of the National Institutes of Health, our government’s largest source of medical research funding. While we need scientific research to continue to improve public health and well-being, it is time to better prioritize our research spending to focus on humans instead of animals.

The GOP’s latest health-care plan is comically bad
Eugene Robinson, The Washington Post 

House Republicans are apparently ready for yet another attempt to snatch health insurance away from constituents who need it. Someone should remind Speaker Paul Ryan of a saying often attributed to his legendary predecessor Sam Rayburn: “There’s no education in the second kick of the mule.”

Republicans must protect vulnerable patients: Michael Steele
Michael Steele, USA Today

Following the withdrawal of the Affordable Health Care Act by Speaker Paul Ryan last month, much has been written about the poor strategic decision by President Trump and the GOP to tackle health care as their first major legislative effort. But, the reality of healthcare remains for many Americans: As a country, we spend an average of $10,000 per person per year on health care, and that growth will continue at a faster rate than our overall economy over the next decade.

The Balloon, the Box and Health Care
Paul Krugman, The New York Times

Imagine a man who for some reason is determined to stuff a balloon into a box — a box that, aside from being the wrong shape, just isn’t big enough. He starts working at one corner, pushing the balloon into position.

The Trump Administration Might Squander Its First Year
James C. Capretta, The National Review

Treasury Secretary Steve Mnuchin says the initial goal of completing tax reform before the August congressional recess is no longer feasible because of the delay in getting health-care reform completed. But that’s an excuse, not an explanation.

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

Frequency of Evidence-Based Screening for Retinopathy in Type 1 Diabetes
The DCCT/EDIC Research Group, The New England Journal of Medicine 

In patients who have had type 1 diabetes for 5 years, current recommendations regarding screening for diabetic retinopathy include annual dilated retinal examinations to detect proliferative retinopathy or clinically significant macular edema, both of which require timely intervention to preserve vision. During 30 years of the Diabetes Control and Complications Trial (DCCT) and its longitudinal follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study, retinal photography was performed at intervals of 6 months to 4 years.