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In This Edition:

From Kaiser Health News:

Kaiser Health News Original Stories

2. In West Baltimore, Scarce Pharmacies Leave Health Care Gaps

CVS rebuilt a store destroyed by protesters after Freddie Gray’s death last year, but a shortage of quality pharmacies means low-income residents still have unmet needs. (Shefali Luthra and Jeremy Snow, 4/25)

These stories are part of KHN’s special series examining the life-shortening health inequities for residents in and around Baltimore’s Sandtown-Winchester neighborhood, where violence flared last April after Freddie Gray was fatally injured in police custody.

3. Political Cartoon: 'The Learning Curve'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'The Learning Curve'" by Hilary Price.

Here's today's health policy haiku:

APPEALS COURT UPHOLDS TEXAS' MEDICAID CUTS

Rein in Medicaid
But how should we best do it?
Disabled children!

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Summaries Of The News:

Health Law Issues And Implementation

4. Insurers' Exit From Marketplaces Could Play Into Ariz. Senate Race

The expected loss of United plans and some Blue Cross Blue Shield plans could leave parts of Arizona with very little choice, and that could reignite the debate on the health law in the Senate campaign, some political analysts predict. Also in news on the health law, Minnesota weighs contracting out the technical work for the marketplace and a Republican group renews its suggestions on how to replace the health law.

The Arizona Republic: Why Affordable Care Act Could Become Key Issue In Arizona's Senate Race
A potential shakeup in Arizona's Affordable Care Act marketplaces is resurrecting President Barack Obama's 2010 health-care law as a political issue in this year's U.S. Senate race. The developments mean customers will have fewer subsidized plans to pick from next year, and in some rural counties, they could have no options at all. UnitedHealthcare, the national insurance giant, on Tuesday signaled that it intends to abandon Arizona's Affordable Care Act marketplace in 2017. Blue Cross Blue Shield of Arizona, the only other insurer to offer plans in all of Arizona’s 15 counties, also is considering pulling out of some areas. (Nowicki, 4/24)

The Hill: GOP Group Submits ObamaCare Replacement Plan
The conservative Republican Study Committee (RSC) on Friday submitted its recommendations for a Republican replacement for ObamaCare as it seeks to shape a plan being formed by a group of House chairmen. ... The proposal would replace ObamaCare’s refundable tax credits with a tax deduction, which tends to provide less help to low-income people by reducing the taxes people owe rather than allowing for the possibility of getting money back in a refund. ... The law would undo ObamaCare’s provision that bars insurance companies from refusing to cover people with pre-existing conditions and instead set up a system of high-risk pools for them. By repealing ObamaCare, the measure would also undo the law’s expansion of Medicaid, which has provided much of the coverage gains that have led to an estimated 20 million people gaining insurance from ObamaCare. (Sullivan, 4/22)

5. Despite Success In Extending Medicaid Expansion, Ark. Gov. Faces Obstacles Ahead

Opposition to the program is still strong in some areas, and funding in the future could be difficult. News outlets also report on Medicaid developments in Oklahoma and New Mexico.

The Associated Press: Fights Still Ahead On Arkansas Medicaid Plan
With a byzantine end-it-to-save-it maneuver, Arkansas Gov. Asa Hutchinson put his imprint on the hybrid Medicaid expansion he inherited and effectively saved the subsidized insurance program. But there's little guarantee that the Republican governor and legislative leaders won't face the type of budget shutdown fight that's accompanied the program since its inception. ... a bigger question looms: What will it take to save the program when lawmakers take up the issue again in several months? (DeMillo, 4/24)

Tulsa (Okla.) World: Medicaid 'Rebalancing' Proposal Is Popular — In Theory
It seems as though just about everyone in state government likes the Oklahoma Health Care Authority’s Medicaid Rebalancing proposal. Except for the part about $100 million in up-front costs. ... The Health Care Authority administers both the state Medicaid system and Insure Oklahoma, a program that subsidizes private health insurance premiums for low-income Oklahomans. To prevent the state’s Medicaid system, known as SoonerCare, from collapsing, the OHCA proposes growing Insure Oklahoma. To do that, it is asking for a $1.50 increase in the cigarette tax to stabilize Medicaid reimbursement rates, and about $100 million in seed money by 2020 so it can add about 176,000 people in Insure Oklahoma. (Krehbiel and Hoberock, 4/24)

The [Carlsbad, N.M.] Current-Argus: Mental Health Administrators Cleared Of Charges
Charges of Medicaid fraud against three administrators of the now defunct Carlsbad Mental Health Center were dismissed in magistrate court Thursday. Noel Clark, Darril Woodfield and Michael Stoll were indicted in June 2015 by the office of Attorney General Hector Balderas following an investigation they said revealed over-billing and falsification of documents at Carlsbad Mental Health Center. (Onsurez, 4/22)

Pharmaceuticals

6. Drug Companies To Pour $100M Into Battle Against California's Price Control Ballot Initiative

The initiative, likened by one lobbyist to a "grenade being rolled into the conversation," would require the state to pay no more for prescription drugs than the U.S. Department of Veterans Affairs, and the industry is gearing up to fight back. In other news, Novartis' heart-failure drug is getting a warmer welcome in Europe than America, and the company is considering its options in selling its stake in Roche.

Politico: Drug Makers Spend Big To Fight California Price Control Referendum
Donald Trump and Hillary Clinton give drug makers the jitters when they talk about Medicare negotiating the prices of prescription drugs. But the biggest near-term threat to the industry comes from a California ballot initiative that would test a version of that idea in the most populous state. That ballot initiative “is a grenade being rolled into the conversation, and it is being taken very seriously,” says a Republican drug lobbyist in Washington, D.C. (Cook and Karlin-Smith, 4/25)

The Wall Street Journal: Big Pharma Gets Solace From Europe
Are the transatlantic tables turning in pharma Switzerland’s Novartis said this past week that it was seeing faster uptake of heart-failure drug Entresto in Europe than in the U.S. The potential blockbuster has struggled: It sold just $17 million in the first quarter, with Novartis guiding to $200 million for the year, well below forecasts. With heightened focus on the burden of high U.S. drug prices, Novartis said it got a better reception in Europe’s single-payer system than in the U.S. for its value-for-money pitch for Entresto, which helps to reduce hospitalizations. (Thomas, 4/24)

7. 'All Humankind Is Waiting And Watching': Mania Erupts Over Potential Fountain Of Youth Pill

Scientists announce a clinical trial to see if a common Type 2 diabetes treatment could stave off some of the most devastating diseases of advanced age — and seniors are coming out of the woodwork in droves to be involved.

The Wall Street Journal: Fountain Of Youth? Drug Trial Has Seniors Scrambling To Prove They’re Worthy
What if there were a way to stave off the creaks and calamities of old age? Nir Barzilai, director of the Institute for Aging Research at the Albert Einstein College of Medicine, is working on it. With word leaking out, seniors from all over the globe have been hounding Dr. Barzilai and his colleagues to get in on the action—with many writing to prove their worthiness. Never mind that formal patient recruitment is still perhaps a year away. (Levitz, 4/24)

Meanwhile, doctors worry about the amount of medications seniors are prescribed —

The New York Times: The Dangers Of ‘Polypharmacy,’ The Ever-Mounting Pile Of Pills
Dr. Caleb Alexander knows how easily older people can fall into so-called polypharmacy. Perhaps a patient, like most seniors, sees several specialists who write or renew prescriptions. “A cardiologist puts someone on good, evidence-based medications for his heart,” said Dr. Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness. “An endocrinologist does the same for his bones.” And let’s say the patient, like many older adults, also uses an over-the-counter reflux drug and takes a daily aspirin or a zinc supplement and fish oil capsules. “Pretty soon, you have an 82-year-old man who’s on 14 medications,” Dr. Alexander said, barely exaggerating. (Span, 4/22)

Administration News

8. Patients, Advocates To Flood FDA Panel Hearing On Experimental Muscular Dystrophy Treatment

The panel will hear from scientists and patients alike on Monday as it decides whether to recommend that the FDA approve the drug, called eteplirsen. More than 800 patient advocates have registered to appear, making it among the best attended FDA advisory committee meetings in history.

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