OVERNIGHT HEALTHCARE: Cantor makes no mention of O-Care alternative

Outgoing House Majority Leader Eric CantorEric CantorTrump allies warn: No compromise on immigration Chamber of Commerce overhauls lobbying operation Laura Ingraham under consideration for White House press secretary MORE (R-Va.) made no mention of an ObamaCare replacement bill on Wednesday in another sign that the House may not pass an alternative before the August recess.

At a Capitol Hill press conference, Cantor failed to bring up future plans for healthcare as he discussed his legislative priorities for the next seven weeks, before he steps down as majority leader on July 31.

Passage of an ObamaCare alternative plan was already seen as unlikely despite numerous GOP promises to "repeal and replace" the healthcare law. A busy floor schedule and an imminent leadership transition further complicate the possibility.

Other Republicans are wary of the political risks of passing a replacement bill and giving Democrats a target for criticism.

DRUGMAKERS VS. INSURERS: The most powerful drug and insurance lobby groups continued their heated fight over rising healthcare costs with each side blaming the other.

The Pharmaceutical Research and Manufacturers of America joined patient advocacy groups Wednesday to release a new report that says patients with chronic diseases are being discriminated against.

The report from Avalere Health found many insurance plans available through the federal and state marketplaces were requiring higher co-payments for drugs to treat diseases such as HIV/AIDS and cancer, putting a higher burden on patients.

The groups say this violates the nondiscrimination provisions of the Affordable Care Act and urged the Department of Health and Human Services to release guidance specifically banning the practice.

But insurers didn’t take the accusation lying down.

Responding to PhRMA, America’s Health Insurance Plans said the blame lies with rising prices of specialty drugs.

Brendan Buck, AHIP spokesperson and former aide to Speaker John BoehnerJohn BoehnerBoehner compares Trump to Teddy Roosevelt Boehner: 'Thank God' I wasn't in the middle of election Ryan delays committee assignments until 2017 MORE (R-Ohio), said drugmakers are trying to deflect the issue of increasing healthcare costs by blaming everything but drug prices.

“Drugmakers have no straight-face explanation to justify the increasingly astronomical prices they have been charging for their medications,” he said. “That’s why they want to talk about anything – ANYTHING – other than the prices they are charging.”

BARE-BONES COVERAGE: AHIP also urged lawmakers Wednesday to widen the availability of cheap, bare-bones coverage under ObamaCare that they say could entice more consumers to enter the marketplaces.

AHIP said that creating a cheaper tier of coverage, also known as “catastrophic plans,” on the exchanges that is available to everyone would "further the public policy goal of affordability."

Under the group's proposal, the Affordable Care Act would allow consumers to purchase a health plan with an actuarial value slightly lower than the current lowest "bronze" tier of coverage.

The policies would comply with other rules under ObamaCare, such as the minimum benefit standards and the requirement for free preventive care, but would likely be cheaper than the exchanges' current options.

PAYING FOR RISK CORRIDOR: Republican lawmakers are questioning new Health and Human Services (HHS) Secretary Sylvia BurwellSylvia Mathews BurwellObamaCare demonstrates dangers of government interference FDA’s hostility blocks Zika-prevention technology HHS projects 13.8M ObamaCare signups for 2017 MORE’s authority to help some insurers cover the costs of risky consumers.

Rep. Fred Upton (R-Mich) and Sen. Jeff SessionsJeff Sessions House passes water bill with Flint aid, drought relief Liberal Dems: Trump filling Cabinet with 'stooges' Poll: Most say Trump will change DC MORE (R-Ala.) wrote to Burwell on her second day in office, stating that while she has the authority to operate the risk corridor program under the Affordable Care Act, there is no provision stating where she can pull the funding from.

The administration’s fiscal year 2015 budget states funding for the program would come from the Centers for Medicare and Medicaid Services (CMS), but Upton and Sessions say that is illegal, citing opinions from the Congressional Research Service (CRS) and the Government Accountability Office (GAO).

Instead, they said, Congress would have to authorize any transfer of funds from CMS budget before insurers could be paid.

BILL TO EXTEND CHIP: Sen. Jay RockefellerJay RockefellerLobbying world Overnight Tech: Senators place holds on FCC commissioner Overnight Tech: Senate panel to vote on Dem FCC commissioner MORE (D-W.Va.) introduced legislation Wednesday that would fund the Children's Health Insurance Program through 2019. While the program is currently authorized through that year, its budget is set to expire next September.

Rockefeller, who helped craft the program in 1997, praised CHIP for helping reduce the number of uninsured children. Advocates for children praised the legislation and vowed to help move it through the process.

In addition to extending funds, Rockefeller's bill provides incentives for states to expand CHIP coverage and offer improved dental care for kids.

QUALITY OVER QUANTITY: A new report by McKesson Research, finds the healthcare system is rapidly moving from a volume-based model to a value-based model.

This means payers and hospitals are putting more emphasis on reimbursements based on quality over quantity of care. More than two-thirds of reimbursements are expected to be based on value measurements in five years, up from just one third today according to the report.


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