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KHN First Edition: March 10, 2017

KHN

First Edition

Friday, March 10, 2017
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: To Save On Drug Costs, Insurer Wants To Steer You To ‘Preferred’ Pharmacies
California Healthline and KHN reporter Pauline Bartolone writes: "One of California’s largest insurers has proposed a change in the benefits of commercial plans next year that would require consumers to pay more for drugs at pharmacies outside an established network. Blue Shield of California wants to create “a tiered pharmacy network” in its 2018 small- and large-group plans, according to preliminary proposals the company submitted to the California Department of Managed Health Care (DMHC), a state health insurance regulator." (3/10)

Kaiser Health News: Truth And Consequence: KHN Joins Team To Parse Lawmakers’ Lingo On Health Law
ProPublica's Charles Ornstein writes: "That led ProPublica to wonder about the accuracy of responses sent to constituents by other members of the House and Senate on the Affordable Care Act and its future. Today, ProPublica is teaming with journalists at Kaiser Health News, Stat and Vox to gather those missives from our readers. On Monday, House Republican leaders unveiled their official proposal to repeal and replace the law. As the legislative debate begins in earnest, we plan to look at the representations made by elected officials from both parties and share what we find." (3/10)

California Healthline: GOP Health Plan Could Be Bitter Pill For California’s Obamacare Exchange
California Healthline and KHN reporter Chad Terhune writes: "Republicans are touting their health plan as the right medicine for ailing insurance markets across the country, from Arizona to Tennessee. But California never landed in sick bay. Its insurance exchange, Covered California, features the healthiest mix of customers nationwide, federal data show. That’s been instrumental in holding down rates and boosting enrollment to 1.5 million. Now state and insurance industry officials fear the replacement plan for the Affordable Care Act, introduced by GOP leaders this week, would threaten those gains." (3/10)

California Healthline: HMO Doctors Take Pains To Slash Opioid Prescriptions
Sam Quinones reports for California Healthline: "On a summer afternoon in 2009, eight Kaiser Permanente doctors met in Pasadena to review the HMO’s most prescribed drugs in Southern California. Sun blasted through the windows and the room had no air conditioning, but what unsettled the doctors most were the slides a pharmacist was presenting. “We were doing so much work treating people with hypertension and diabetes, we thought those drugs would be on the list,” said Dr. Joel Hyatt, then Kaiser’s quality management director in Southern California. Instead, hydrocodone, a generic opioid painkiller, led the list. OxyContin was near the top, even though the HMO didn’t subsidize it and patients had to pay for it themselves." (3/10)

The Washington Post: Obamacare Revision Clears Two House Committees As Trump, Others Tried To Tamp Down Backlash
A Republican proposal to ­revise the Affordable Care Act claimed its first major victories Thursday amid a backlash that both Republican leaders and President Trump spent the day trying to tamp down. Trump met with conservative critics of the plan, signaling both a willingness to negotiate its details and that it does not yet have enough votes to emerge from the House. More acknowledgment of the proposal’s problems came from Senate Republicans, who suggested Thursday that the measure is moving too quickly through the House and in a form unlikely to succeed if it gets to the upper chamber. (DeBonis, Sullivan and Snell, 3/9)

The Associated Press: GOP Leaders Claim Momentum As Health Bill Clears Hurdles
Leaders are aiming for passage by the full House in the next couple of weeks, and from there the legislation would go to the Senate and, they hope, on to Trump's desk. The president has promised to sign it, declaring over Twitter on Thursday, "We are talking to many groups and it will end in a beautiful picture!" Yet at the same time the president is leaving himself a political out, privately telling conservative leaders that if the whole effort fails, Democrats will ultimately shoulder the blame for the problems that remain. That's according to a participant in the meeting Wednesday who spoke only on condition of anonymity to relay the private discussion. (Werner and Fram, 3/9)

The Wall Street Journal: GOP Health Plan Advances After Clearing Two House Committees
Republicans advanced legislation through two House committees on Thursday as part of their goal to dismantle the Affordable Care Act, but signs of discord spread around the capital as conservative lawmakers warned this version of the health-law overhaul won’t pass. ... Conservatives fired warning shots at Republican leaders in an open challenge to House Speaker Paul Ryan (R., Wis.), who said Republicans could either line up behind the House bill or renege on their promise to repeal the law. (Hughes, Armour and son, 3/9)

USA Today: Republican Leaders Warn That Changing Health Care Bill Would Doom It In Senate
House Republican leaders warned their members Thursday that any major changes to the proposed GOP health care bill will prevent its passage in the Senate and kill their best shot at ending Obamacare. Those warnings came as both the House Ways and Means Committee and the Energy and Commerce Committee approved the GOP's American Health Care Act on Thursday without significant amendments after marathon debates. (Kelly, 3/9)

The New York Times: After Halting Start, Trump Plunges Into Effort To Repeal Health Law
President Trump, after a halting start, is now marshaling the full power of his office to win over holdout conservatives and waffling senators to support the House Republicans’ replacement for the Affordable Care Act. There are East Room meetings, evening dinners and sumptuous lunches — even a White House bowling soiree. Mr. Trump is deploying the salesman tactics he sharpened over several decades in New York real estate. His pitch: He is fully behind the bill to scotch President Barack Obama’s signature domestic achievement, but he is open to negotiations on the details. (Haberman and Pear, 3/9)

The Wall Street Journal: House GOP Leaders Surprised By Conservative Opposition To Health Plan
Rep. Mark Meadows, who leads a group of conservative House lawmakers, was home in North Carolina about two weeks ago when he learned details of the emerging Republican health-care plan. Mr. Meadows jumped in the car and drove back to Washington, where he said he warned White House officials he couldn’t support the bill being pushed by House Speaker Paul Ryan. (Armour, Hughes and son, 3/9)

NPR: House Speaker Paul Ryan Sells Health Care Bill As 'Once-In-A-Lifetime' Chance
"This is the chance. This is a once-in-a-lifetime opportunity," said the speaker, roving the stage with a wireless mic, gesturing at both the audience in front of him and the PowerPoint presentation behind him. TED Talk? Late-night infomercial? Nope — it was House Speaker Paul Ryan, making a hard pitch for his health care plan after a week of loud conservative criticism. (Detrow, 3/9)

Politico: Three Misleading Claims From Paul Ryan's Obamacare Lecture
With his jacket off and sleeves rolled up, House Speaker Paul Ryan made the case for the Republican health care law Thursday, walking through a 35-minute PowerPoint presentation to a packed crowd of reporters and millions of viewers watching on the three cable TV networks. It was quintessential Ryan, calmly explaining the details of the American Health Care Act looking more like a college professor than a professional politician. But in making his case, Ryan made a series of misleading statements, both about the current state of Obamacare and the details of the replacement bill. (Vinik, 3/9)

Politico: Ryan Planning More Health Care Votes Alongside Repeal Effort
House Republicans will vote on a second health care bill the week they vote to repeal Obamacare, Speaker Paul Ryan told Sean Hannity on Thursday afternoon. The Wisconsin Republican did not divulge many details about the legislation, though he said it would likely allow people to purchase insurance through association health plans. Such a proposal has always been part of the GOP alternative, Ryan told Hannity, but Senate rules bar leadership from including it in their fast-tracked repeal bill. (Bade, 3/9)

Politico: Budget Referee May Call Foul On Obamacare Repeal
The fate of Obamacare may lie in the hands of a number-crunching Republican appointee whose bottom line might single-handedly blow up the GOP quest to repeal and replace it. Congressional Budget Office Director Keith Hall was handpicked two years ago by top Republicans in Congress -- including now Health and Human Service Secretary Tom Price -- to lead a nonpartisan office that will soon release its estimate of how many Americans the Republican health care bill will cover and whether it shrinks or balloons the federal deficit. (Pradhan, 3/10)

The New York Times: White House Casts Pre-Emptive Doubt On Congressional Budget Office
President Trump showed an affinity for “working the referees” in his race to the White House, criticizing a federal judge as biased, panning polls as rigged and even questioning the aptitude of the nation’s intelligence agencies. Now, with Mr. Trump’s administration aggressively pitching the House Republican plan to repeal and replace the Affordable Care Act, Capitol Hill’s official scorekeeper — the Congressional Budget Office — is coming under intense fire. (Rappeport, 3/9)

Politico: Conservative Demands Threaten To Derail Obamacare Repeal
Hill conservatives were just handed the opening they’ve been waiting for: An invitation from President Donald Trump to “negotiate” on an Obamacare replacement. There’s just one big problem: They’re all over the place on what they want. The discord on the far-right is becoming a real problem for Republicans. (Bade and Cheney, 3/10)

Politico: Trump's Obamacare Moves Cause Chaos In Congress
President Donald Trump's early efforts to court conservatives opposed to the GOP's Obamacare replacement is backfiring in Congress — emboldening the far right to demand changes that could repel centrists critical to its passage. While the president has given a full-throated endorsement of the bill, he's also suggested he's open to "negotiations." The mixed signals have allowed hard-line conservatives and leadership to hear what they want to hear. Each side is taking Trump's words and arguing he's in their corner. (Bade and Everett, 3/9)

The Wall Street Journal: Will ‘Trumpcare’ Catch On? The Democrats Are Trying - Washington Wire
One of the most effective branding campaigns in U.S. political history was the Republicans’ nicknaming of the Affordable Care Act “Obamacare.” ... Now that House Republicans have begun debate on their “repeal and replace” alternative, the American Health Care Act, the Democrats have been quick to take a lesson from the Republicans’ battle plan. “Trumpcare is finally available to the public and Democrats, a growing number of conservatives, and millions of Americans don’t like what they see,” Senate Minority Leader Chuck Schumer said in a Tuesday afternoon news conference. He and Democratic Sen. Patty Murray of Washington used the term a combined nine times. (Nasaw, 3/9)

Los Angeles Times: He Might Not Call It 'Trumpcare,' But The President Will Likely Own Any Obamacare Replacement
Trump and his advisors have yet to utter the term “Trumpcare,” and some still doubt his commitment to the latest congressional plan to alter President Obama’s signature healthcare law. But there’s little question that the outcome of the healthcare debate will play a major role in defining Trump’s first term in office, affecting his ability to deliver on other priorities such as a $1-trillion plan to rebuild public works, a multibillion-dollar border wall and a daunting challenge to rewrite the tax code. (Bierman and Mascaro, 3/9)

Politico: White House Pushes Party Officials Nationwide To Mobilize On Health Overhaul
Facing mounting roadblocks on Capitol Hill, the White House is pleading with political supporters across the nation to pressure congressional Republicans to support President Donald Trump’s health care overhaul. During a national conference call Thursday evening, White House political director Bill Stepien told Trump backers and national Republican Party officials to pressure members of Congress to support key planks of the president’s agenda — notably his plan to replace Obamacare. (Isenstadt, 3/9)

The Associated Press: Women's Health Services Face Cuts In Republican Bill
Women seeking abortions and some basic health services, including prenatal care, contraception and cancer screenings, would face restrictions and struggle to pay for some of that medical care under the House Republicans' proposed bill. The legislation, which would replace much of former President Barack Obama's health law, was approved by two House committees on Thursday. Republicans are hoping to move quickly to pass it, despite unified opposition from Democrats, criticism from some conservatives who don't think it goes far enough and several health groups who fear millions of Americans would lose coverage and benefits. (Jalonick, 3/9)

The Washington Post: ‘Is That Not Correct?’: Male GOP Lawmaker Asks Why Men Should Pay For Prenatal Coverage
In the 27 hours the House Energy and Commerce Committee spent debating Republicans’ Obamacare revision plan, a handful of moments stand out. This is one of them. At the start, Democratic Rep. Mike Doyle (Pa.) was talking with Republican Rep. John Shimkus (Ill.) about Shimkus’s objections to the Affordable Care Act’s requirements for health-insurance plans. ... “What about men having to purchase prenatal care?” Shimkus said. At that point, one could hear the room start to stir. “I’m just ... is that not correct?” Shimkus said. “And should they?” (Viebeck, 3/9)

FiveThirtyEight: How Defunding Planned Parenthood Could Affect Health Care
The House Republicans’ plan to replace the Affordable Care Act, announced Monday, would bar reproductive health care providers who offer abortion from receiving federal Medicaid reimbursements for one year.1 Although no federal money is spent on abortions except in cases of rape, incest or where the mother’s life is at risk, about 40 percent of Planned Parenthood’s revenue for other services — including contraception, sexually transmitted infection testing and cancer screenings — comes from the government, mostly through Medicaid. (Thomson-DeVeaux, 3/9)

The Washington Post: GOP Health-Care Bill Would Drop Addiction Treatment Mandate Covering 1.3 Million Americans
The Republican proposal to replace the Affordable Care Act would strip away what advocates say is essential coverage for drug addiction treatment as the number of people dying from opiate overdoses is skyrocketing nationwide. Beginning in 2020, the plan would eliminate an Affordable Care Act requirement that Medicaid cover basic mental-health and addiction services in states that expanded it, allowing them to decide whether to include those benefits in Medicaid plans. (Zezima and Ingraham, 3/9)

The Washington Post: The Poor ‘Just Don’t Want Health Care’: Republican Congressman Faces Backlash Over Comments
A first-term congressman who spent three decades as a physician — and is now part of a group of Republican doctors who have a major role in replacing Obamacare — is facing backlash after saying that poor people “just don’t want health care and aren’t going to take care of themselves.” Rep. Roger Marshall, (R-Kan.), a member of the GOP Doctors Caucus, said comments he made to STAT were not meant to suggest that poor people take health care for granted. The comments were published in a story last week about his burgeoning role in the fight to replace the Affordable Care Act. (Phillips, 3/9)

The Associated Press: GOP Health Bill Would Cut CDC's $1B Disease Fighting Fund
A proposal to replace the Obama health care law would cut out a pillar of funding for the nation's lead public health agency, and experts say that would likely curtail programs across the country to prevent problems like lead poisoning and hospital infections. The Republican bill calls for the elimination of a $1 billion-a-year fund created for the Centers for Disease Control and Prevention by the Affordable Care Act in 2010. The fund's goal: Pay for public health programs designed to prevent illness and, therefore, reduce health care costs. (Stobbe, 3/9)

The Wall Street Journal: Ads Push Conservatives To Get On Board With GOP Health Plan
A GOP outside group closely aligned with Speaker Paul Ryan (R., Wis.) is set to begin airing ads targeted at 30 members of the Freedom Caucus, urging their constituents to call them to vote in favor of Republican leadership’s bill to replace the Affordable Care Act. The ads, paid for by the American Action Network, a nonprofit not required to disclose its donors, mark the first time this year that a major outside group is spending money to keep members of the Republican Party in line. The group is spending $500,000 to air the ads for two weeks, bringing its total spending on the GOP health-care plan to over $8 million since January. (Hackman, 3/9)

The Hill: Senate Advances Trump's Medicaid, Medicare Pick
The Senate is advancing Seema Verma, President Trump's nominee to lead the Centers for Medicare and Medicaid Services. Senators voted 54-44 Thursday on her nomination, which needed only a simple majority to overcome the initial procedural hurdle. (Carney, 3/9)

Los Angeles Times: Many Of California's Republican Members Of Congress Are Saying Very Little About Their Party'S Healthcare Bill
Many of California’s congressional Republicans represent districts with a large number of people who have insurance under Obamacare, and they’re taking a cautious approach to the House Republican plan to replace the healthcare law. A proposed replacement for Obamacare released earlier this week has drawn a firestorm of criticism on the left and the right. By Thursday, most of the 14 Republicans in the California delegation, including some of the seven who represent districts that backed Democrat Hillary Clinton for president, had said only that they were still assessing the proposed law. (Wire, 3/9)

The Wall Street Journal: The Wild Card Of Health-Care Reform
While the Republican plan to overhaul health care took a beating on Capitol Hill, nearby President Donald Trump was discussing something untouched by Congress: prescription-drug costs. Any effort to rein in drug costs, a favorite topic of the president, could seriously harm the pharmaceutical industry. (Grant, 3/9)


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