In This Edition:
From Kaiser Health News:
The president says Obamacare has been “a complete and total disaster,” and other Republicans see nothing but trouble. But a careful look at the arguments suggest the situation is more complicated. (Julie Rovner, 2/14)
After hearing complaints about its high price, Marathon Pharmaceuticals is pausing the launch of an $89,000 drug for a rare disease. (Sarah Jane Tribble and Sydney Lupkin, 2/13)
Former FDA Commissioner Dr. Robert Califf shares his views about drug approvals, regulations and safety concerns after stepping down from the giant agency. (Sydney Lupkin and Sarah Jane Tribble, 2/14)
A federal judge in Texas last month issued a preliminary injunction barring the government from enforcing a rule allowing insurers to refuse to insure dialysis patients who get premium assistance from charity groups. (Michelle Andrews, 2/14)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Tough Love?'" by Clay Bennett, Chattanooga Times Free Press.
Here's today's health policy haiku:
THE TOLL OF REPEAL
Who would need it anyway?
Just 20 million.
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:
David Shulkin promised he would address the problems that have been plaguing the agency, but that it wouldn't be privatized on his watch.
USA Today: Senate Confirms David Shulkin As Veterans Affairs Secretary
The Senate unaminously confirmed Trump nominee David Shulkin to be secretary of Veterans Affairs Monday night. Shulkin, the lone holdover from the Obama administration among President Trump’s Cabinet picks, has been the VA undersecretary for health since July 2015 and has not drawn the harsh opposition from Democrats that other Trump nominees have faced. (Slack, 2/13)
The Associated Press: Senate Easily Confirms Trump Pick Of Shulkin As VA Secretary
Senators voted 100-0 to approve the former Obama administration official, who was the VA's top health official since 2015, in a rare show of bipartisanship amid partisan rancor over Trump's other nominees. Shulkin secured the backing of Senate Democrats after pledging at his confirmation hearing to always protect veterans' interests, even if it meant disagreeing at times with Trump. (Yen, 2/13)
NPR: Senate Confirms First Nonveteran To Lead VA
Over the past two years, Shulkin oversaw the implementation of the Veterans Access Choice and Accountability Act, a $16 billion congressional fix for the long wait times for veterans seeking care. But an NPR investigation found that the fix itself is broken: A $10 billion program to help veterans get care in the private sector resulted in mountains of red tape, and a $2.5 billion hiring program didn't significantly increase the hiring of new doctors and nurses inside the VA. (Lawrence, 2/13)
The Washington Post: Shulkin Unanimously Confirmed To Head Veterans Affairs
The 57-year-old Pennsylvania native will run the second-largest federal agency after serving 18 months as undersecretary for health in charge of VA’s sprawling medical system, which takes care of nearly 9 million veterans a year. After a long search for a leader who could turn around a system Trump denounced on the campaign trail as a tragic failure, the president surprised critics by turning inside rather than outside for a VA leader. (Rein, 2/13)
Politico: Veterans Affairs Secretary Confirmed 100-0
"Veterans are very fortunate to have Dr. Shulkin voluntarily stay in what has evolved into the most scrutinized and criticized position in the country," Veterans of Foreign Wars National Commander Brian Duffy said in a statement. "And it should be," he added. The conservative Concerned Veterans for America, which has pushed for veterans to obtain greater health care from the private sector and has criticized the VA for not holding problem employees accountable, said Monday it was "encouraged" Shulkin had "acknowledged systemic failures within the VA and the need for transformational reforms to fix them." (O'Brien, 2/13)
High-risk pools that operated in the states before the Affordable Care Act had limited enrollment, very high premiums, steep deductibles, pre-existing condition exclusions lasting six to 12 months, annual and lifetime benefit limits and waiting lists.
Modern Healthcare: Why High-Risk Pools Won't Crack The Pre-Existing Condition Dilemma
Some Republican leaders are promoting state high-risk pools as an alternative to the Affordable Care Act's popular provision requiring health plans to accept consumers regardless of pre-existing medical conditions. They cite Wisconsin's pre-ACA pool, the Health Insurance Risk-Sharing Plan, as a model. But a Wisconsin insurance official recently cautioned a House panel that high-risk pools need a stable funding source and are not a solution for every state. Other experts say state high-risk pools generally were a policy failure across the country, and making them work properly would require a large amount of taxpayer funding. (Meyer, 2/13)
Minnesota Public Radio : To Replace Obamacare, GOP Pushes 'High-Risk' Pool
For many Republicans looking to scrap the Affordable Care Act, the fix will come from separating people into two pools. The lower-cost one would be for healthy people. Those with expensive medical conditions that drive up health spending would be sorted into the more expensive "high-risk" pool. (Zdechlik, 2/13)
Previous KHN coverage: Sounds Like A Good Idea? High-Risk Pools
Health law repeal efforts today look a lot like they did in 2014 during Republicans' most dedicated effort to devise an alternative, but the process took place under the threat of a presidential veto. Meanwhile, this week conservative Republicans will urge leadership to move on repeal, without waiting for a replacement plan. “Instead of continuing to spin our wheels, we need a starting place,” said Republican Study Committee Chairman Mark Walker, R-N.C.
Bloomberg: Republicans' Struggles To Replace Obamacare Feel Like Deja Vu All Over Again
Republicans in Congress are hitting roadblocks as they try to devise a plan to replace Obamacare, stuck over issues like how to structure tax breaks they want to give people to buy insurance. The party stalemated on many of the same obstacles in 2014 during its most extensive effort to devise an alternative, according to lawmakers and aides involved with that effort. "It wasn’t easy for us," said Eric Cantor, then the House majority leader, who led the effort. "There were a lot of thorny issues. The easy way was to gloss over the thorny details and the intra-party divisions." (Kapur, 2/13)
Politico: Conservatives Balking At GOP Leadership's Obamacare Plans
House conservatives — anxious that the GOP’s effort to end Obamacare is getting bogged down in the fight over what a replacement should look like — are plotting a major push to repeal the law immediately without simultaneously approving an alternative. The House Freedom Caucus and a number of Republican Study Committee members this week will urge Speaker Paul Ryan (R-Wis.) and his lieutenants to forego their plan to add replacement provisions to a repeal bill, dubbed “repeal-plus.” Instead, they want to approve the same standalone repeal bill that Congress sent to President Barack Obama in 2016. (Bade, 2/13)
The Hill: Freedom Caucus Vows To Oppose Weakening ObamaCare Repeal
The conservative House Freedom Caucus voted Monday night to oppose an ObamaCare repeal bill if it does not go as far as the repeal measure that passed in 2015, drawing a line in the sand that could complicate Republican repeal efforts. Conservatives have been pushing for the 2015 repeal bill, which kills the core elements of the law including its subsidies, taxes, mandates and Medicaid expansion, to be brought up again. But the move Monday night to oppose an effort if it falls short of that bill is a significant new development. (Sullivan, 2/13)
And in other news on the efforts to dismantle the health law —