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KHN First Edition: May 4, 2017

KHN

First Edition

Thursday, May 04, 2017
Check Kaiser Health News online for the latest headlines

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

California Healthline: Blue Shield CEO Says GOP’s ‘Flawed’ Health Bill Would Harm Sicker Consumers
Chad Terhune reports: "The chief executive of Blue Shield of California, the largest insurer on the state’s insurance marketplace, issued a blunt critique of the Republican health care bill, saying it would once more lock Americans with preexisting conditions out of affordable coverage. In an interview with California Healthline on Wednesday, Paul Markovich said the GOP’s American Health Care Act is “flawed” and “could return us to a time when people who were born with a birth defect or who became sick could not purchase or afford insurance.” The bill is set to come up for a vote in the House of Representatives on Thursday." (Terhune, 5/3)

Kaiser Health News: Drug Coverage Denied By Medicare? How Seniors Can Fight Back
Judith Graham reports: "Kenneth Buss had taken Xarelto, a blood thinner, for more than a year when his mail-order pharmacy refused a request to refill his prescription several weeks ago. Buss, 79 and prone to dangerous blood clots, immediately contacted his physician, who urged Buss’ Medicare drug plan to approve the medication. The request was denied. But Buss didn’t let the matter drop. Without coverage, a 90-day supply of Xarelto costs about $1,300 at a local pharmacy — more than 10 times what Buss had been paying." (Graham, 5/4)

Kaiser Health News: Pseudoscience Fuels Fear Behind Minnesota Measles Outbreak
Minnesota Public Radio's Mark Zdechlik reports: "Health officials in Minnesota are scrambling to contain a measles outbreak that has sickened primarily Somali-American children. Officials have identified 34 cases as of Wednesday, and they’re worried there will be more. In Minnesota, the vast majority of children under age 2 get vaccinated against measles. But state health officials said most Somali-American 2-year-olds have not had the vaccine, about 6 out of 10. As the outbreak spreads, that statistic worries health officials, including Michael Osterholm, the director of the University of Minnesota’s Center for Infectious Disease Research and Policy." (Zdechlik, 5/4)

The New York Times: With $8 Billion Deal On Health Bill, House G.O.P. Leader Says ‘We Have Enough Votes’
House Republican leaders planned to hold a showdown vote Thursday on their bill to repeal and replace large portions of the Affordable Care Act after adding $8 billion to the measure to help cover insurance costs for people with pre-existing conditions. “We have enough votes,” Representative Kevin McCarthy of California, the House majority leader, said Wednesday night. “It’ll pass.” (Kaplan and Pear, 5/3)

USA Today: Obamacare Repeal Bill: House To Vote Thursday
House GOP leaders announced the vote Wednesday night after weeks of negotiations, hours of wooing wavering Republicans, and a last-minute sweetener added to the bill: an $8 billion amendment to help patients with pre-existing conditions pay for higher premiums and out-of-pocket costs. (Shesgreen, 5/3)

The Washington Post: Republicans Plan Health-Care Vote On Thursday, Capping Weeks Of Fits And Starts
Rep. Fred Upton, an influential Republican from Michigan, introduced the amendment that was key to resolving a major sticking point this week. It provides more financial assistance — $8 billion over five years — to help people with preexisting conditions pay for medical costs. Those people are at risk of losing protections under the GOP plan, which seeks to repeal and replace major parts of the ACA. Just a day earlier, Upton said he could not support the Republican plan because of its stance on preexisting conditions. But he sounded an optimistic note after sketching out his fix Wednesday and meeting with President Trump at the White House. (Sullivan, Weigel and Snell, 5/3)

Politico: House To Vote Thursday On Obamacare Repeal
Trump helped engineer the late-Tuesday jolt that brought the AHCA back from its latest brush with failure. After top Republican Rep. Fred Upton of Michigan broke against the bill, Trump called him and asked him why. Upton said he told Trump that the GOP bill’s latest iteration broke earlier pledges to protect people with pre-existing conditions. “You wanted this to be as strong on preexisting as Obamacare. Quite frankly, it’s not,” Upton said he told the president, even reading Trump his own quote from over the weekend making that promise. “I’ve been working on language that would fix it.” (Cheney, Bresnahan and Dawsey, 5/3)

The Wall Street Journal: U.S. House To Vote Thursday On Health-Care Bill
Thursday’s vote could redeem House Speaker Paul Ryan (R., Wis.) and deliver President Donald Trump his first major legislative win, coming just after the 100-day mark of his tenure passed with little accomplished on Capitol Hill. But it also will cast a long political shadow for House Republicans in the months leading up to next year’s midterm elections. Already, many GOP lawmakers face constituents back home incensed over the prospect of changes to health-care benefits that affect millions. (son, Hackman and Radnofsky, 5/3)

The Associated Press: GOP Revives Struggling Health Care Bill And Plans House Vote
Passage would also send it to an uncertain fate in the Senate, where some Republicans consider the House measure too harsh. Polls have shown Obama's much-maligned law has actually gained in popularity as the debate over a replacement health care program has accelerated. "House Republicans are going to tattoo this moral monstrosity to their foreheads, and the American people will hold them accountable," said House Minority Leader Nancy Pelosi, D-Calif. (5/4)

The New York Times: What To Watch For: Nail-Biter On Repealing Health Law
After weeks of fits and starts, House Republican leaders plan on Thursday to try yet again to advance legislation to repeal and replace major parts of the Affordable Care Act. A sizable number of House Republicans have been either opposed to the bill or undecided in recent days. But Republican leaders now say they have the votes to pass the legislation, called the American Health Care Act. (Kaplan, 5/4)

The Washington Post: House GOP Strategy To Save Health-Care Bill Hinges On More Money For Preexisting Conditions
Even before the precise language was released Wednesday night, leading health policy experts said the amendment raises big questions about how — and how well — it would work in practice. Among the most significant: How many states would back away from the federal protections for people with medical conditions? And how many of those people would lose their coverage because of other changes in the House plan? “Does it really guarantee that all individuals who have preexisting conditions will be able to find insurance at affordable rates?” said Dan Mendelson, president of Avalere Health, a Washington-based consulting firm. (Goldstein, 5/3)

The Wall Street Journal: Jumping Into High-Risk Insurance Pools
The sickest 10% of Americans account for about two-thirds of health-care spending, according to the Kaiser Family Foundation. The ACA requires almost everyone to have insurance or pay a fine so healthy customers would subsidize sick ones. High-risk pools take a different approach, separating the sickest people into their own pool so premiums for healthy customers would fall. (Hackman, 5/3)

The New York Times: Pre-Existing Conditions: Evaluating Competing Claims
In the debate over how the effort to replace the Affordable Care Act would affect those with pre-existing health conditions, opponents and supporters alike have offered misleading talking points. Faced with polling indicating public support for protections, and after an emotional appeal by the television host Jimmy Kimmel that has gone viral, Republicans are making a dubious case that their updated bill provides similar coverage for those who are less healthy, while Democrats are overstating claims about how many are affected. Here’s an assessment. (Qiu, 5/3)

The Washington Post: Here’s What You Need To Know About Preexisting Conditions In The GOP Health Plan
Before the Affordable Care Act, insurance companies could consider a person’s health status when determining premiums, sometimes making coverage unaffordable or even unavailable if a person was already sick with a problem that required expensive treatment. The ACA prohibited that, in part by requiring everyone to purchase insurance. But that “individual mandate” was unpopular and Republicans would eliminate that requirement in their proposed American Health Care Act. (Kessler, 5/4)

Politico: Extra Cash In Health Bill Gets Votes — But Not Coverage
“Short answer, this does not make any meaningful difference,” said Chris Sloan, a senior manager at consultant Avalere Health, who did an analysis of the legislation’s stability fund. “High-risk pools are incredibly expensive and an additional $8 billion over five years doesn’t lead to that [many] more people being able to be covered. ”Even Rep. Fred Upton (R-Mich.), the lawmaker who got the extra money in the bill, said he didn’t know if $8 billion extra money — added to the $130 billion already included in the bill — was the right number. (Cancryn, 5/3)

NPR: House To Vote On GOP Health Care Bill Thursday, Majority Leader Kevin McCarthy Says It Will Pass
Several states have tried high-risk pools in the past, but they were typically underfunded, leaving millions of people with no access to adequate health care. Lawmakers hope that by putting the heft and money of the federal government behind them, they may work better. The federal government is already in the business. It pays for the health care of more than 40 percent of the population, through Medicare, Medicaid, the military and the Department of Veterans Affairs, according to the Census Bureau. (Kodjak, 5/3)

The Wall Street Journal: Top 10 States For Pre-Existing Conditions All Went For Trump
[The] “yes’’ votes on the bill are coming largely from lawmakers whose states have the largest shares of people likely to be affected by changes to coverage for pre-existing conditions, the Kaiser figures suggest. These lawmakers as a group are arguing that the bill will cut insurance costs while offering “layers of protections,’’ as House Speaker Paul Ryan put it, for those with medical conditions. Data from the Kaiser Family Foundation gives a broad sense of which states have the most at stake in the debate over whether the House GOP bill leaves people with medical conditions protected or disadvantaged. (Chinni, 5/3)

The New York Times: Jimmy Kimmel Sheds Light On Health Coverage For Infants With Birth Defects
Jimmy Kimmel’s tearful description of his newborn son’s heart defect has galvanized parents across the country. A few shared his experience as a frantic new father; many more gave silent thanks that they had been spared this ordeal. But the talk-show host’s monologue has also focused new attention on how infants with such birth defects were cared for before passage of the Affordable Care Act, and what may lie ahead for them should the legislation be repealed. (Kolata and Goodnough, 5/3)

The Wall Street Journal: How Health-Care Bill Would Affect You
The Republican proposal to overhaul the Affordable Care Act, which is expected to receive a vote in the House on Thursday, would bring big changes to health-care coverage for many Americans. Here are some of the most important ones. (Armour and Hackman, 5/3)

The Wall Street Journal: Little-Noted Provision Of GOP Health Bill Could Alter Employer Plans
Many people who obtain health insurance through their employers—about half of the country—could be at risk of losing protections that limit out-of-pocket costs for catastrophic illnesses, due to a little-noticed provision of the House Republican health-care bill to be considered Thursday, health-policy experts say. The provision, part of a last-minute amendment, lets states obtain waivers from certain Affordable Care Act insurance regulations. Insurers in states that obtain the waivers could be freed from a regulation mandating that they cover 10 particular types of health services, among them maternity care, prescription drugs, mental health treatment and hospitalization. (Armour and Hackman, 5/4)

The New York Times: A Little-Noticed Target In The House Health Bill: Special Education
While House Republicans lined up votes Wednesday for a Thursday showdown over their bill to repeal the Affordable Care Act, Vickie Glenn sat in her Murphysboro, Ill., office and prayed for it to fail. Ms. Glenn, a Medicaid coordinator for Tri-County Special Education, an Illinois cooperative that helps more than 20 school districts deliver special education services to students, was worried about an issue that few in Congress were discussing: how the new American Health Care Act, with its deep cuts to Medicaid, would affect her 2,500 students. (Green, 5/3)

Politico: Tuesday Group Leader Under Fire Over Health Care Deal
Republican Rep. Tom MacArthur might have singlehandedly saved the Obamacare repeal effort. But rather than being hailed as a hero, the New Jersey lawmaker has come under fire from GOP centrists, who are incensed he negotiated with Freedom Caucus ringleader Mark Meadows. (Bade and Cheney, 5/3)

Politico: No One Wants A Health Care Win More Than Priebus
President Donald Trump promised voters that, as president, he’d make repealing and replacing Obamacare his top priority in office. But perhaps no one in Washington has as much riding on the outcome of this week’s negotiations to keep the American Health Care Act as Trump’s chief of staff, Reince Priebus, whose standing with the president depends on getting a bill passed. (Palmeri, Dawsey and Nussbaum, 5/3)

Politico: Deep-Pocketed Health Care Lobbies Line Up Against Trump
Just about every major health care group opposes President Donald Trump’s health care overhaul — and the self-styled negotiator-in-chief hasn’t tried cutting a deal with them. The opposition from the deep-pocketed health care industry — and patient advocacy groups from the American Heart Association to the March of Dimes — has made it hard for Republicans to push Obamacare repeal through the House. And they could be a persistent obstacle if the legislation makes it to the Senate. (Cancryn, Karlin-Smith and Demko, 5/3)

Politico: Trump Still Enforcing Obamacare Mandate
The Trump administration is still dutifully enforcing Obamacare's individual mandate, despite early signals it might undermine the unpopular linchpin of the health care law. Weeks after the close of tax season, the IRS continues to process penalties from potentially millions of taxpayers who refused to purchase health insurance last year. (Ehley and Lorenzo, 5/3)

The Washington Post: Iowa Obamacare Program On Verge Of Collapse As Congressional Uncertainty Takes Its Toll
Iowa’s last major Affordable Care Act insurer threatened on Wednesday to pull out from the state’s marketplace next year, the latest step in a sudden collapse of the state’s insurance marketplace that holds ominous signs for health care customers in states across the county. If Minnesota-based Medica follows through on its threat not to sell plans in 2018, Iowa could be the first state to lack any insurers on its exchanges in all but a handful of counties. (Johnson, 5/3)

The Associated Press: Arkansas Lawmakers Vote To Scale Back Hybrid Medicaid Plan
Arkansas lawmakers voted Wednesday to scale back the state's first-in-the-nation hybrid Medicaid expansion under a plan that would move 60,000 people off the program and require some remaining participants to work. The changes are part of an effort in Republican-leaning Arkansas to take advantage of President Donald Trump's willingness to give states more flexibility in restricting coverage. Arkansas is pursuing the changes despite GOP efforts in Washington to repeal the Affordable Care Act, which enabled the state's program. (5/3)


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