Overnight Health Care -- Sponsored by PCMA -- Conservatives work on new ObamaCare replacement plan

Overnight Health Care -- Sponsored by PCMA -- Conservatives work on new ObamaCare replacement plan
© Greg Nash

Welcome to Overnight Health Care, sponsored by the Pharmaceutical Care Management Association


Happy recess Thursday. Conservative groups haven't given up on repealing ObamaCare, even if the chances for action are slim. Keeping reading for more on their new effort.

Also today, health officials keep dropping hints about President TrumpDonald John TrumpDemocrats slide in battle for Senate Trump believes Kushner relationship with Saudi crown prince a liability: report Christine Blasey Ford to be honored by Palo Alto City Council MORE's big drug pricing rollout next week, and the House Veterans Affairs Committee introduced a bill to reauthorize a key veterans health care program.


But first... Conservative groups aim to unveil ObamaCare replacement plan this month.

Conservative groups are working on a new ObamaCare replacement plan even though their effort has virtually no chance of moving in Congress this year.

Why? It's part of a push to keep the repeal dream alive despite the obstacles, including from GOP leadership. "This is outside-in and bottom-up," said Marie Fishpaw of the Heritage Foundation.

Who is on board? It's being led by the Heritage Foundation, the Galen Institute and former Sen. Rick Santorum (R-Pa.).

The White House too. "The White House fully supports the efforts of a broad coalition working to address the Obamacare disaster and increase affordable healthcare options for middle-class Americans," deputy press secretary Hogan Gidley said in a statement.

White House officials have been attending some of the meetings, Fishpaw confirmed.

Sen. Bill CassidyWilliam (Bill) Morgan CassidyTrump signs bills banning drug pricing 'gag clauses' Dem ad accuses Heller of 'lying' about record on pre-existing conditions GOP senator suggests criminal referral for third Kavanaugh accuser's 'apparently false affidavit' MORE (R-La.) has moved on. Cassidy helped draft the namesake Graham-Cassidy replacement bill that failed to advance.

"Graham-Cassidy is dead, but skyrocketing health care costs still need to be addressed," a Cassidy spokesman said. "Our focus is on new solutions and new ideas that lower costs for families and reflect the latest developments in the health care marketplace."

The details: Like Graham-Cassidy, there are block grants to states in the conservative proposal, but unlike Graham-Cassidy there is no cap on Medicaid payments. Pre-existing condition protections still up in the air.

Read more here.



Sponsored Content — Pharmaceutical Care Management Association

Pharmacy benefit managers (PBMs) are hired by employers, unions, and government programs to negotiate aggressive discounts from drug companies and drugstores.  PBMs continue to keep overall spending and out-of-pocket costs down despite massive price hikes by drugmakers. Learn how PBMs are part of the solution to reducing Rx costs at DrugBenefitSolutions.com.



FDA chief hints at changes to drug rebates.

Just days ahead of the rollout of President Trump's anticipated drug pricing initiative, the head of the FDA suggested officials might take another look at the legal status of rebates paid by drug companies to insurers and pharmacy benefit managers.

In a speech on Thursday, FDA commissioner Scott Gottlieb said if the federal anti-kickback law that protects such rebates were changed, it could help increase competition and make drugs more affordable.

"One of the dynamics I've talked about before that's driving higher and higher list prices is the system of rebates between payers and manufacturers," Gottlieb said. "And so what if we took on this system directly, by having the federal government reexamine the current safe harbor for drug rebates?"

Policy hints: Gottlieb discussed some of what the new drug pricing initiative will look like, but didn't go into much detail. Some hints:

  • One piece involves HHS Secretary Alex Azar making a series of changes to "the pricing mechanisms" of Medicare Part D.
  • Stopping brand-name drug companies from gaming the system in order to keep generic competition off the market.

A warning to drug companies: "I can tell you that the framework ... will dismantle many of the provisions that shield parts of the drug industry from more vigorous competition," Gottlieb said.

Read more here.



Changes for VA health program?

President Trump urged Congress to "fix" a veterans' health-care program hours after the chairman of the House Veterans' Affairs Committee reintroduced a plan to do so.

"This spring marks [four years] since the Phoenix VA crisis. We won't forget what happened to our GREAT VETS," Trump tweeted.

What's at issue: Trump is referring to the Veterans Choice Program, which was created in the wake of the 2014 wait-time scandal that started with the Phoenix Veterans Affairs health-care system. It allows some veterans to see private doctors, but only in cases where they have to wait more than 30 days for an appointment or drive more than 40 miles to a facility.

New bill: House Veterans' Affairs Committee Chairman Phil RoeDavid (Phil) Phillip RoeBezos honored for public service at DC gala Lawmakers demand action, hearing in response to VA improperly denying sexual trauma claims Veterans Affairs’ inability to manage its workforce suggests benefits of managed care MORE (R-Tenn.) reintroduced legislation that would overhaul private-care options for veterans enrolled in the VA health system. The bill would:

  • Expand caregiver benefits for older veterans and create a process for closing excess facilities.
  • Expand the ranks of veterans eligible to see private-sector health specialists, as well as entitle veterans enrolled in the system to see a private doctor without a co-pay twice a year.
  • Allocate $5.2 billion to keep the Choice program funded until the new program is implemented.

The controversy: Privatization. The bill was originally negotiated as part of the massive government spending bill Congress passed in March, but was stripped out after last-minute objections by House Democrats, who feel it moves too far toward privatizing the VA.

Read more here.


We get it... you vape.

The FDA is giving wide leeway to electronic cigarettes as it attempts to push people away from traditional tobacco products.

In the last year, the agency has taken initial steps to place further curbs on traditional cigarettes even as it has eased new rules on the vaping industry that were issued by the Obama administration.

FDA Commissioner Scott Gottlieb is walking a fine line as he attempts to balance the regulation of two types of tobacco products. FDA officials say the goal is to spur innovation of products that may be less harmful for adults, but health advocates are skeptical.

They think the agency is pushing smokers away from one harmful product right into another one, and argue the research on the health effects of e-cigarettes is still too new for products to remain on the market unregulated.

Read more here.



Sponsored content - Pharmaceutical Care Management Association

Pharmacy benefit managers (PBMs) have outlined several policy solutions to ensure patients receive opioid prescriptions when safe and medically appropriate. One important solution would be requiring e-prescribing of controlled substances in Medicare (S. 2460 / H.R. 3528, the Every Prescription Conveyed Securely Act). A new study by the Opioid Safety Alliance finds this could save taxpayers $13 billion over 10 years.



What we're reading

'A Persistent Puzzle': Californians Embrace Medicaid -- But Food Stamps? Not So Much. (Kaiser Health News)

New Front on Opioid Litigation: Suits Over Rising Premiums​ (The Wall Street Journal)

Here's why it's a nightmare to lower U.S. drug prices  (The Washington Post's Health 202 newsletter)


State by state   

Alcohol abuse, drug overdoses and suicides. "Deaths of despair" drag down Kentucky's health rank (Lexington Herald Leader)

Inadequate oversight allows poor care at California nursing homes to go unchecked, state audit finds (Kaiser Health News)

Ban on abortion after 15 weeks nearing passage in Louisiana (The Associated Press)


From The Hill's opinion pages

Tom Price: My remarks on individual mandate repeal were taken completely out of context  

Say it with me: Democrats are the party of health care

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