Health Brief: White House Supports Cruz Proposal

Washington Brief

  • The White House is supporting a conservative proposal by Sen. Ted Cruz (R-Texas) that would let insurers sell plans that do not adhere to consumer protections, even though GOP leaders remain leery of the idea. Cruz’s proposal is one of many being analyzed by the Congressional Budget Office. (The New York Times)
  • The CBO’s cost estimate could be critical for conservatives in making the case that Cruz’s proposal complies with the Senate’s arcane Byrd rule. The bigger the budgetary difference, the easier it would be to justify that it has a direct budgetary impact that’s not merely incidental. (Vox)
  • Congressional Republicans have promised to lower premiums in their effort to overhaul the Affordable Care Act, but in doing so they ignore the $3.2 trillion-plus the U.S. spends on health care overall. (Politico)

Business Brief

  • Two clinical trials testing Merck & Co.’s Keytruda as a treatment for blood cancer were suspended by the Food and Drug Administration after more patients receiving the drug died than those receiving other treatments. (The Wall Street Journal)
  • At least 25 states, cities and counties have filed lawsuits against companies that manufacture and distribute highly addictive painkillers within the past year, as the worst drug epidemic in U.S. history continues to escalate. (The Washington Post)
  • Low-cost health plans on the individual market are more likely exclude the nation’s top cancer doctors, according to a new study. (Bloomberg News)

Chart Review

Events Calendar (All Times Local)

National Academy of Medicine on care for high-need patients 1 p.m.
American Enterprise Institute event on health savings accounts 2 p.m.
No events scheduled



White House Backs Conservative Health Plan, but G.O.P. Leaders Are Leery
Robert Pear, The New York Times

The White House is backing a health care proposal that would make it easier for insurance companies to avoid complying with consumer protection standards, siding with some of the most conservative senators, though Senate Republican leaders remain leery of the idea. The proposal, advanced by Senator Ted Cruz, Republican of Texas, is one of many being analyzed by the Congressional Budget Office as Senate Republicans try to muster votes for their bill to repeal major provisions of the Affordable Care Act.

Ted Cruz faces tough Obamacare questions at otherwise friendly town hall
David M. Drucker, Washington Examiner

Even a controlled town hall that was supposed to stay focused on issues affecting military veterans couldn’t suppress the debate over repealing Obamacare that is roiling Washington and the rest of the country. Near the tail end of a forum here with Sen. Ted Cruz, R-Texas, that was sponsored and run by Concerned Veterans for American, a conservative group, an argument broke out over the merits of repealing the Affordable Care Act.

If Republicans reach a health care deal, it must survive this obscure Senate rule
Dylan Scott, Vox

The fate of the Republican drive to repeal and replace Obamacare — and of the millions of Americans who could be left uninsured if it succeeds — could come down to a complex and obscure Senate rule. That rule will determine what provisions Republicans can include in the bill, how much of Obamacare they can repeal, and perhaps whether the most conservative GOP senators will vote for it.

European Bonds and Stocks Slump; Oil Rises on Data: Markets Wrap
Samuel Potter, Bloomberg News

Markets took a nervous turn in the European session, with government bonds slumping in the wake of a disappointing French debt sale and the selloff spilling over into stocks. Oil clawed back some of its biggest loss in four weeks, while gold and silver retreated.


GOP promises lower health premiums but ignores all that’s driving them
Joanne Kenen, Politico

Republicans promise to bring down the cost of health insurance for millions of Americans by repealing Obamacare. But in the race to make insurance premiums cheaper, they ignore a more ominous number — the $3.2 trillion-plus the U.S. spends annually on health care overall.

Medicaid changes could save Kentucky money; others to lose benefits
Adam Beam, The Associated Press

Proposed changes to Kentucky’s Medicaid program could save state taxpayers an extra $27 million while costing an additional 9,000 people their health coverage. Those are both projections for Republican Gov. Matt Bevin’s updated plan to overhaul the state’s Medicaid program, the joint federal and state health coverage program for the poor and disabled.

Low-Cost Health Insurance Limits Access to Top Cancer Doctors
Michelle Cortez and Zachary Tracer, Bloomberg News

The nation’s top cancer doctors are more likely to be excluded from low-cost health insurance plans offered on the nation’s individual market, potentially crimping access to the highest-quality care for Americans when they need it most, a new study found. The individual exchanges, opened in 2014 as part of the Affordable Care Act, often include lower-cost policies that limit the number of physicians available to members as a way to cut costs.

How Senate’s health bill could disrupt small biz coverage
Caitlin Owens, Axios

A little-noticed provision of the Senate health care bill — one that provides new insurance options for small businesses and the self-employed — could have big consequences, potentially making it harder for sick people to get affordable coverage. The provision, as written, could cause “fragmentation of the market resulting from an unlevel playing field.

As Seniors Get Sicker, They’re More Likely To Drop Medicare Advantage Plans
Fred Schulte, Kaiser Health News

When Sol Shipotow enrolled in a new Medicare Advantage health plan earlier this year, he expected to keep the doctor who treats his serious eye condition. “That turned out not to be so,” said Shipotow, 83, who lives in Bensalem, Pa.


BCRA spells trouble for providers
Alex Kacik, Modern Healthcare

California has been approaching universal healthcare coverage in large part thanks to the expansion of the Medicare and Medi-Cal programs under the Affordable Care Act. Only 3.5% of California’s population is uninsured and one out of every two children are covered by Medicaid, according to Marin General Hospital CEO Lee Domanico.

Soon-Shiong buys into California hospital system
Bob Herman, Axios

NantWorks, the genomics and health technology company founded by billionaire doctor Patrick Soon-Shiong, has acquired a majority stake in the management company that operates Verity Health System — a network of six hospitals that predominantly treats the poor and teetered on the brink of bankruptcy a couple years ago. BlueMountain Capital Management, the hedge fund that bought Verity, will maintain a minority interest and put up extra funding.

Pharma, Biotech and Devices

FDA Suspends Certain Clinical Trials of Merck’s Keytruda
Peter Loftus, The Wall Street Journal

The U.S. Food and Drug Administration suspended two clinical trials and a portion of a third testing Merck MRK -0.17% & Co.’s Keytruda as a treatment for blood cancer, after more patients receiving the drug died than those receiving other treatments, the company said. Merck said Wednesday the FDA determined the risks of Keytruda, when added to the other drugs the patients in the trial were taking, outweighed any potential benefit for patients with the blood cancer multiple myeloma, based on available data.

Drugmakers and distributors face barrage of lawsuits over opioid epidemic
Scott Higham and Lenny Bernstein, The Washington Post

The companies that manufacture and distribute highly addictive painkillers are facing a barrage of lawsuits for the toll their product has taken on communities across the country as the worst drug epidemic in U.S. history continues to escalate. Within the past year, at least 25 states, cities and counties have filed civil cases against manufacturers, distributors and large drugstore chains that make up the $13 billion-a-year opioid industry.

Louisiana considers radical step to counter high drug prices: Federal intervention
Carolyn Y. Johnson, The Washington Post

In this city on the east bank of the Mississippi River, Rebekah Gee, Louisiana’s health secretary, presides over what she calls the “public-health-crisis cradle” of America. Poverty and poor health collide here to produce some of the nation’s worst rates of obesity, premature birth and other maladies.

New On The Streets: Drug For Nerve Pain Boosts High For Opioid Abusers
Carmen Heredia Rodriguez, Kaiser Health News

On April 5, Ciera Smith sat in a car parked on the gravel driveway of the Rural Women’s Recovery Program here with a choice to make: go to jail or enter treatment for her addiction. Smith, 22, started abusing drugs when she was 18, enticed by the “good time” she and her friends found in smoking marijuana.

Drug and device makers pay providers $8 billion in 2016
Virgil Dickson, Modern Healthcare

Payments from drug and device companies to physicians and teaching hospitals hit more than $8 billion in 2016. The CMS released the third full year of Open Payments data on Friday.

Health IT

Maryland pediatric practices feel the ripple effect of school telemedicine programs
Annette Boyle, Fierce Healthcare

When Howard County, Maryland, launched a telemedicine initiative in five elementary schools, it aimed to improve access to healthcare for students, reduce illness-related absences and improve student educational outcomes. Inadvertently, it also encouraged local pediatric practices not included in the initial rollout to test and adopt telemedicine for themselves.

Opinions, Editorials and Perspectives

How Clinically Integrated Networks Can Help the Health Care System
Kate Harveston, Morning Consult 

As American politicians continue to debate what was obvious to the United Nations in 1948 — that timely and effective health care is a basic human right — regulators and operators in the free market are turning to modern technologies to update our treatment models and health care infrastructure. One of the major stumbling blocks on the way toward real progressive change was realizing that, under our current profit-driven health care system, individual insurers and providers can reward themselves for referrals or otherwise conspire to put money first and health results second.

‘Repeal now, replace later’ will kill the GOP’s health-care reform
Marc A. Thiessen, The Washington Post

When King Solomon proposed splitting the baby, he knew that actually splitting the baby would have killed it. It was a ruse to save the child.

We thought our daughter had escaped her preexisting condition. We were wrong.
Elizabeth L. Silver, The Washington Post

My daughter had a stroke when she was 6 weeks old. More specifically, she suffered a brain bleed.

How Many Jobs Does ObamaCare Kill?
Casey B. Mulligan, The Wall Street Journal

Democrats loudly complain that people will lose health insurance if the Affordable Care Act is repealed. They never mention those who lose jobs because the ACA remains.

Research Reports

The Financial Impact of the American Health Care Act’s Medicaid Provisions on Safety-Net Hospitals
Allen Dobson, The Commonwealth Fund

Safety-net hospitals play a vital role in our health care system, delivering significant care to Medicaid, uninsured, and other vulnerable patients. The American Health Care Act (AHCA) would make changes to Medicaid that would substantially reduce federal funding, resulting in potential adverse effects on safety-net hospitals and the populations they serve.