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KHN First Edition: November 23, 2015


First Edition

Monday, November 23, 2015
Check Kaiser Health News online for the latest headlines

Today’s early morning highlights from the major news organizations.

Kaiser Health News: Fewer Medicare-Subsidized Drug Plans Means Less Choice For Low-Income Seniors
Reporting for Kaiser Health News, Susan Jaffe writes: "Even though health problems forced Denise Scott to retire several years ago, she feels 'very blessed' because her medicine is still relatively inexpensive and a subsidy for low-income Medicare beneficiaries covers the full cost of her monthly drug plan premiums. But the subsidy is not going to stretch as far next year. That’s because the premium for Scott’s current plan will cost more than her federal subsidy. The 64-year-old from Cleveland is among the 2 million older or disabled Americans who will have to find new coverage that accepts the subsidy as full premium payment or else pay for the shortfall." (Jaffe, 11/23)

The New York Times: Pfizer And Allergan Reach $150 Billion Merger Deal
Pfizer has clinched a blockbuster merger with a fellow drug maker, one worth more than $150 billion, that can best be described in superlatives. When it is announced — most likely on Monday, people briefed on the matter said — the deal to buy Allergan, the maker of Botox, would be one of the biggest ever takeovers in the health care industry. And it would be the largest acquisition yet in a banner year for mergers. (de la Merced, 11/22)

The Wall Street Journal: Pfizer, Allergan Agree On Historic Merger Deal
Pfizer Inc. and Allergan PLC agreed on a historic merger deal worth more than $150 billion that would create the world’s biggest drug maker and move one of the top names in corporate America to a foreign country. The boards of each company ratified the deal Sunday and it could be announced Monday, according to people familiar with the matter. The final terms include 11.3 Pfizer shares for every Allergan share and the deal also contains a small cash component, they said. (Rockoff and Mattioli, 11/22)

The Washington Post: HHS Proposes More Consumer-Friendly Rules For ACA Health Plans
Federal health officials Friday proposed changes to the rules for health coverage sold through insurance exchanges, including a possible floor for how many doctors and other providers each plan must include. The rules are intended to make it easier for consumers to compare their options in the marketplaces created under the Affordable Care Act. They would define standard deductibles and co-payments, and allow insurers to sell plans with that specific benefit design. (Goldstein, 11/20)

The Wall Street Journal: Health Law’s 2017 Enrollment Period, End Of Election Campaigns To Coincide
The next sign-up season for 2017 health coverage under the Affordable Care Act will begin just as the 2016 election campaigns draw to a close, under draft rules released by the Obama administration on Friday afternoon. The open enrollment period for people buying insurance on their own for 2017 will start Nov. 1, 2016, and end Jan. 31, 2017, federal officials outlined in the draft rules. In earlier iterations of regulations, they had suggested starting as early as Oct. 1, before appearing to settle on the same dates they are using for this year’s open enrollment period, which is now three weeks under way. (Radnofsky and Wilde Mathews, 11/20)

USA Today: Insurers: Obamacare Changes Needed Soon To Protect Us From Losses
Federal regulators on Friday proposed potential solutions to some of the Obamacare problems that led UnitedHealth Group to warn it may exit the health exchanges in 2017, but the government also may make it tougher for insurers to limit the number of doctors and hospitals in their plan networks. The proposed rule from the Centers for Medicare and Medicaid Services would reduce insurers' administrative costs, maintain fee levels and improve the accuracy of a payment formula designed to minimize insurers' risks when taking on new customers. (O'Donnell, 11/21)

The Wall Street Journal: Aetna, Anthem Say Individual Commercial Business Is On Track
Health insurers Aetna Inc. and Anthem Inc. on Friday said their individual commercial businesses have performed within expectations lately, a day after UnitedHealth Group Inc. said it was considering exiting the Affordable Care Act’s exchanges. The statements could be a sign that big problems with business on government exchanges aren’t widespread across insurers. (Becker, 11/20)

Reuters: Aetna, Anthem Reassure Investors On Obamacare Business
U.S. health insurers Aetna Inc and Anthem Inc on Friday sought to reassure investors that their Obamacare businesses had not worsened after UnitedHealth Group Inc warned of mounting losses in that sector. Aetna and Anthem said their individual insurance businesses, which include the plans created by President Barack Obama's national healthcare reform law, had performed in line with projections through October. Both backed their earnings forecasts for 2015. (Humer, 11/20)

The Associated Press: Insurers Reassure Investors About ACA Exchange Business
Health insurers rallied Friday to ease investor and customer concerns about the Affordable Care Act's public insurance exchanges a day after the nation's biggest insurer questioned its future in that still-developing market. Blue Cross-Blue Shield insurer Anthem and Medicaid coverage provider Molina Healthcare both said they are making money off their exchange business, and Anthem joined Aetna, the nation's third-largest health insurer, in reaffirming its 2015 earnings forecast. (Murphy, 11/20)

The New York Times: States Urged To Review Health Insurer Mergers
Consumer advocates and antitrust experts are urging state regulators to closely examine the proposed mergers of major health insurance companies, saying they threaten to leave consumers with fewer choices and higher prices. On Friday, David A. Balto, an antitrust lawyer and former federal regulator, asked the National Association of Insurance Commissioners, composed of state officials, to create a working group to help regulators conduct their reviews. (Abelson, 11/20)

The Wall Street Journal: Concerns Over Valeant Spread To Other Drug Makers
As questions mount about the viability of Valeant Pharmaceuticals International Inc.’s business model, concerns are also spreading to other drug makers seen as following a similar playbook. Shares of Horizon Pharma PLC and Mallinckrodt PLC, two of the largest companies most often compared with Valeant, have fallen roughly 25% in the past three months. ... Like Valeant, the firms are part of a new breed of pharmaceutical company that has limited costly investment in research and development and instead sought sales growth through debt-fueled acquisitions. (Walker, 11/22)

The Wall Street Journal: Turing To Cut Price Of Drug Daraprim As Much As 50%
Turing Pharmaceuticals AG, the small drug maker that gained notoriety for raising the price of an anti-parasite tablet more than 50-fold, is drawing up plans to discount the drug as much as 50% to hospitals, according to a person familiar with the matter. Even with the discounts, the drug—Daraprim—would still cost hospitals far more than it did before Turing bought the U.S. rights in August and raised the price to $750 a tablet, from $13.50. The amount of the discount will depend on how much of the drug hospitals use, the person said. (Rockoff, 11/20)

The Associated Press: Obama Administration Sets Stage For A Debate On Drug Costs
The Obama administration set the stage Friday for a national debate on the rising cost of prescription drugs, a pressing issue for voters but one that's unlikely to see quick solutions under a lame-duck president facing an opposition Congress. Saying that too many people are struggling to pay for their medications, Health and Human Services Secretary Sylvia Burwell opened a daylong forum that presented a range of perspectives, from the pharmaceutical industry to a cancer patient with $270,000 in bills for just one drug. (Alonso-Zaldivar, 11/20)

The New York Times: Administration Is Seeking Ways To Keep Prescription Drugs Affordable
The Obama administration began building a political case Friday for government actions to protect people against high pharmaceutical costs, saying millions of Americans were unable to afford lifesaving prescription drugs. "As costs go up, so does everyone’s anxiety about their continued access to their prescription medicine,” said Andrew M. Slavitt, the acting administrator of the federal Centers for Medicare and Medicaid Services. He spoke at a daylong forum the administration held to solicit ideas from consumer advocates, doctors, drugmakers, insurers and employers. (Pear, 11/20)

The Washington Post: Sharp Increases In Drug Costs Draw Hundreds To Government Forum
The Obama administration’s top health officials said Friday that the nation needs greater clarity about the cost and effectiveness of prescription drugs as part of a strategy to make medicines more affordable without stunting the emergence of new pharmaceuticals. The current scattered system, in which drugs are priced differently depending on who is paying for them, "end[s] up obscuring" their true cost and, in turn, the impact on which patients have access to them, said Andy Slavitt, who oversees Medicare, Medicaid and insurance exchanges in the Health and Human Services department. (Goldstein, 11/20)

The New York Times: Hillary Clinton Proposes Middle-Class Tax Cut Tied To Health Care
Hillary Rodham Clinton on Friday proposed a tax credit for families and individuals who face excessive and unexpected health care costs, the first part of multipronged approach to giving middle-class Americans tax relief that she will unveil in the coming days, according to her campaign. The proposal, which would provide a tax credit on health costs of up to $2,500 for an individual and $5,000 for a family, comes as Mrs. Clinton has sought to use the issue of taxes on the middle-class to draw a distinction between her proposals and those of her main rival for the Democratic presidential nomination, Senator Bernie Sanders of Vermont. (Chozick, 11/20)

The Washington Post: Clinton Ramps Up Efforts To Undercut Sanders With Middle-Class Voters
All week, Clinton’s and San­ders’s camps traded barbs over middle-class taxes, an issue that Clinton’s campaign believes is a proxy for broader differences between the two candidates. Clinton’s stance highlights her focus on preserving President Obama’s health-care legacy, while Sanders has offered a proposal that seeks to make good on his promise of bringing a “political revolution.” ... in campaign stops in Tennessee and South Carolina, she focused on health care and a plan to give middle-class families as much as $5,000 in tax credits for unexpected out-of-pocket health-care costs. (Phillip and Wagner, 11/21)

The Wall Street Journal: Clinton’s Proposed Tax Credits Expand
If you’re caring for an aging parent, deciding whether to invest in rural America or struggling to pay medical bills, Hillary Clinton has a tax credit for you. As the Democratic presidential front-runner rolls out her policy agenda, she has repeatedly turned to the tax code as one of her favorite policy tools. It offers a way to reward behavior she wants to see more of, punish actions that she sees as harmful and directly aid families with particular challenges. ... The Clinton campaign pitched its latest idea on Sunday, a tax credit worth up to $1,200 for people caring for aging parents and grandparents. The credit would be available to those whose out-of-pocket expenses reach $6,000, with the value of the credit phasing out for upper-income families. (Rubin and Meckler, 11/23)

The Associated Press: Clinton Proposes Tax Break For Caregivers
[Hillary Clinton] is seeking a tax credit to offset up to $6,000 in caregiving expenses for elderly family members. In her proposal, Clinton states that the number of Americans needing long-term care and support is expected to grow from about 12 million today to 27 million by 2050. She says that family members often have to take time away from work, using vacation time or personal time to provide care. (Lucey, 11/22)

The Washington Post: Sanders Camp Calls Clinton Tax Proposals ‘Republican Lite’
A senior aide to Sen. Bernie Sanders on Sunday characterized Hillary Clinton’s latest tax plans as “tentative half-steps that sound Republican-lite,” escalating the sparring between the Democratic presidential campaigns over their respective commitments to helping the middle class. ... The statement came in response to a pair of initiatives put forward by Clinton on Sunday that would benefit people who care for an elderly parent or other family member. (Wagner, 11/22)

The Washington Post's Fact Checker: Bernie Sanders’s Claim That He Would Expand, Not Dismantle, The Affordable Care Act
Sanders has said repeatedly that he wants to build on the health-care system created under the Affordable Care Act and to expand it to provide health insurance regardless of income or age. It’s clear that the provisions in his bill to “repeal” ACA state exchanges was not just for the sake of repealing the law, in the way critics who oppose passage of ACA use the term “repeal.” But the language of his legislation — all three times he introduced it — clearly stated that existing federal programs would be replaced with a new program that he sought to create. It wouldn’t simply increase current levels of coverage but would create a whole new health insurance system with new quality-control methods, a new standards board, and more. (Lee, 11/23)

The New York Times: With Ben Carson, The Doctor And The Politician Can Vary Sharply
As a surgeon, [Ben Carson] was praised for his dedication, unassuming demeanor and attention to detail. As a candidate, he has sometimes seemed imprecise or ill-informed, as when he said China had intervened in Syria, and prone to odd assertions like his belief that Joseph built the pyramids to store grain. Some articles have questioned the accuracy of parts of “Gifted Hands.” His comments doubting evolution and the medically recommended schedule of vaccines have baffled people in science and medicine. (Belluck and Eder, 11/22)

The Wall Street Journal: Louisiana Governor-Elect Vows Budget Changes
Democrat John Bel Edwards’s improbable win in the Louisiana’s governor’s race on Saturday could set off a domino chain of changes in the state, including the likely expansion of Medicaid eligibility and a call for a special legislative session to deal with a looming billion-dollar budget gap. Mr. Edwards received 56% of the votes in Saturday’s gubernatorial runoff election, defeating Republican U.S. Sen. David Vitter. (Bauerlein, 11/22)

The Washington Post: For One Rare Disease Community, A Rare Moment Of Hope
On Tuesday, and again in January, a Food and Drug Administration advisory committee will consider whether to recommend approval of two drugs to slow the muscle deterioration at the root of Duchenne [muscular dystrophy]. If approved, the medications would become the first treatments for a condition that affects an estimated 1 in 3,500 boys. “It’s really a momentous time,” said Louis Kunkel, a Harvard geneticist, credited with discovering the gene behind Duchenne, who has long helped search for treatments. “For years, we’ve been able to do nothing for these families and their children. . . . I thought we would have cracked this nut a long time ago.” (Dennis, 11/21)

The Wall Street Journal: GAO Study Illustrates Cost Of Doctor-Administered Drugs In Medicare
A federal analysis released Friday illustrates how the Medicare program came to spend $20.9 billion a year on doctor-administered drugs. One-quarter of those drugs cost from $51,000 to $536,000 per person annually, according to a study by the Government Accountability Office, released by Rep. Chris Van Hollen (D., Md.). The study also said that by 2013 about 332,000 Medicare participants were obligated to pay out-of-pocket costs ranging from $1,900 to $107,000 a year for new drugs in the Medicare Part B program. (Burton, 11/20)

The New York Times: States Lead Effort To Let Pharmacists Prescribe Birth Control
Most Western countries require a doctor’s prescription for hormonal contraceptives like pills, patches and rings, but starting sometime in the next few months, women in California and Oregon will be able to obtain these types of birth control by getting a prescription directly from the pharmacist who dispenses them, a more convenient and potentially less expensive option than going to the doctor. Pharmacists will be authorized to prescribe contraceptives after a quick screening process in which women fill out a questionnaire about their health and medical histories. The contraceptives will be covered by insurance, as they are now. (Belluck and Tavernise, 11/22)

The New York Times: Heroin, Survivor Of War On Drugs, Returns With New Face
United States military operations in Afghanistan, now in their 15th year, are routinely described as America’s longest war. For overseas combat, that is true. But nothing tops the domestic “war on drugs” that an American president declared more than four decades ago. The casualty rate has been exceedingly high. Nearly 44,000 Americans a year — 120 a day — now die of drug overdoses. Neither traffic accidents nor gun violence, each claiming 30,000-plus lives a year, causes so much ruination. The annual drug toll is six times the total of American deaths in all wars since Vietnam. (Haberman, 11/22)

The Washington Post: Thousands Of Drug Users Are Rescuing Each Other With Antidote Naloxone
As the opioid epidemic has exploded in small towns and suburbs in recent years, officials have scrambled to put naloxone in the hands of drug users’ families and friends, and to make it more widely available by equipping police officers with the drug. At the same time, thousands of lives are being saved by giving the antidote to drug users. More than 80 percent of overdose victims revived by “laypeople” were rescued by other users, most of them in the past few years, according to one national survey published in June. (Bernstein, 11/22)

USA Today: Report: Youth Drug Overdose Deaths Up In 35 States Over A Decade
Thirty-five states saw youth drug overdose deaths increase dramatically in the past decade, according to a new report. And in five states – Kansas, Montana, Ohio, Wisconsin and Wyoming – the overdose death rates more than quadrupled. Drug overdoses were the leading cause of injury death in 2013, exceeding that of motor vehicle crashes, says the report released Thursday from Trust for America's Health, a national non-profit group that watchdogs public health issues. (Thadani, 11/20)

The Associated Press: Amid Move To End Montana Cleanup, Some Asbestos Left Behind
Federal officials say their final analysis of a Montana community wracked by a deadly asbestos contamination shows a costly and much-criticized cleanup is working, even though some 700 properties have yet to be investigated and concerns linger over asbestos left behind. The U.S. Environmental Protection Agency has spent more than $540 million removing asbestos in and around the town of Libby in northwest Montana. The material came from a W.R. Grace and Co. vermiculite mine that is now closed. Health workers have estimated that as many as 400 people have died and almost 3,000 have been sickened from exposure. Yet after a lengthy review of the health risks, the EPA said in a report issued Friday that people could continue to live in Libby and neighboring Troy without excessive exposure. (Brown, 11/21)

The Associated Press: Experts Foresee Big Premium Increases For Medicare Drug Plan
With time running out on open enrollment season, many seniors are facing sharply higher premiums for Medicare's popular prescription drug program. The reason: rising drug costs have overtaken a long stretch of stable premiums. Beneficiaries have until Dec. 7 to see if there's a lower-cost plan that will cover their medications in 2016. Consumer advocates and experts say it will pay to shop around this sign-up season. (Alonso-Zaldivar, 11/22)

The Associated Press: New $710-A-Day Drug Saves Lives But Strains State Budgets
A newly approved drug is being hailed as a major advance in treatment of cystic fibrosis, a life-threatening genetic disease that clogs the lungs with mucus and forces patients to struggle to breathe. But it comes with a punishing price tag — abo

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