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KHN First Edition: October 18, 2017


First Edition

Wednesday, October 18, 2017
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: 2 Senators Reach Deal On A Health Law Fix, But Bringing Congress Along Is Tricky
After nearly two months of negotiations, key senators said Tuesday they have reached a bipartisan deal on a proposal intended to stabilize the Affordable Care Act’s insurance market, which has been rocked by recent actions by President Donald Trump. Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), respectively the chairman and the top Democrat of the Senate Health, Education, Labor and Pensions Committee, negotiated the emerging deal. The milestone agreement, they said, would guarantee payment of “cost-sharing reduction” subsidies that help some policyholders with low incomes afford their deductibles and other out-of-pocket costs for two years, 2018 and 2019. (Rovner, 10/17)

Kaiser Health News: Chasing Millions In Medicaid Dollars, Hospitals Buy Up Nursing Homes
Westminster Village North, a nursing home and retirement community in Indianapolis, recently added 25 beds and two kitchens to speed food delivery to residents. It also redesigned patient rooms to ease wheelchair use and added Wi-Fi and flat-screen televisions. This fall, it’s opening a new assisted living unit. “We have seen amazing changes and created a more home-like environment for our residents,” said Shelley Rauch, executive director of the home. (Galewitz, 10/18)

California Healthline: Questions Loom About Obamacare As Covered California’s Open Enrollment Nears
With open enrollment a little more than two weeks away, President Donald Trump took a one-two punch at the Affordable Care Act.Last week, Trump said he would stop paying key subsidies, known as cost-sharing reductions, which compensate insurers for providing discounts on deductibles and copays. He also signed an executive order aimed at loosening the rules for association health plans — organized by certain types of professional, trade or interest groups — and short-term medical insurance. (10/17)

The New York Times: 2 Senators Strike Deal On Health Subsidies That Trump Cut Off
Two leading senators, hoping to stabilize teetering health insurance markets under the Affordable Care Act, reached a bipartisan deal on Tuesday to fund critical subsidies to insurers that President Trump moved just days ago to cut off. ... The plan by the senators, Lamar Alexander, Republican of Tennessee, and Patty Murray, Democrat of Washington, would fund the subsidies for two years, a step that would provide at least short-term certainty to insurers. The subsidies, known as cost-sharing reduction payments, reimburse insurance companies for lowering deductibles, co-payments and other out-of-pocket costs for low-income customers. (Kaplan and Pear, 10/17)

The Wall Street Journal: What Democrats And GOP Get In Bipartisan Health-Care Deal
The Alexander-Murray deal addresses the Democrats’ most immediate concern: subsidies known as cost-sharing reduction payments, billions of dollars paid to insurers to limit out-of-pocket costs for low-income consumers. These payments had never been approved by Congress, and President Donald Trump announced last week he would discontinue making them. Democrats and health analysts feared cutting off the payments would send costs soaring in the ACA market and might prompt some insurers to exit. A two-year guarantee will lend the law some measure of stability at a time when Democrats are attempting to ward off repeated GOP efforts to roll it back. ... What do Republicans get? Mr. Alexander, the lead GOP negotiator, said that the deal expands the usefulness of ACA waivers that allow states to sidestep certain ACA rules to remold some aspects of the law, such as how premium subsidies are distributed or how much insurers can be permitted to charge their oldest customers. (Hackman and Wilde Mathews, 10/17)

The Associated Press: Senate Health Care Deal In Doubt As Trump Says He's Opposed
A bipartisan Senate deal to curb the growth of health insurance premiums is reeling after President Donald Trump reversed course and opposed the agreement and top congressional Republicans and conservatives gave it a frosty reception. ... In remarks Tuesday in the Rose Garden, Trump called the deal "a very good solution" that would calm insurance markets, giving him time to pursue his goal of scrapping Obama's 2010 Affordable Care Act, the target of Republican derision since it was signed into law. Although top Democrats and some Republicans praised the Alexander-Murray compromise agreement, Trump backed off after a day of criticism from many in the GOP. (10/18)

The Washington Post: Another Last-Ditch Effort To Tackle Obamacare Stalls Within Hours Of Its Release
The measure presented congressional Republicans with an uncomfortable choice between helping sustain coverage for many Americans and making good on a long-standing campaign promise — and paying the consequences — by allowing the ACA to falter. Senate Republican leaders did not immediately endorse the proposal. Influential House Republicans panned the blueprint, and Trump offered conflicting reviews. The discord swiftly cast the plan’s viability into serious doubt. (Sullivan, Eilperin and Goldstein, 10/17)

Politico: Trump Would Have To Broker Obamacare Truce
[G]etting the deal though would require a sustained, focused lobbying effort on Capitol Hill, where Republicans are facing a biting political calculus. They’re still stinging from spending all of this year in a draining but fruitless effort to repeal and replace Obamacare — the law that congressional Republicans have been trying to uproot for seven years. Now, they would have to decide whether the state flexibility concessions Alexander got are enough. (Haberkorn and Cancryn, 10/17)

NPR: Senators Reach Deal To Stabilize ACA Insurance Markets For 2 Years
Murray said she and Alexander had had discussions with more than half the Senate about the bill and she believed the plan would get broad support. Alexander said they'll work to get co-sponsors for the legislation throughout the week so they can bring a bill to McConnell for consideration. McConnell has not said whether he supports the effort. (Kodjak, 10/17)

The Hill: New Health Deal Falls Flat With GOP 
A bipartisan Senate deal that would extend critical ObamaCare payments to insurers for two years got the cold shoulder from Republicans on Tuesday, suggesting it faces a rocky path to become law. The chairman of the conservative Republican Study Committee in the House dismissed the offering from Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) as an affront to GOP promises to repeal President Obama’s signature legislation. (Sullivan, 10/17)

The Hill: McCain, Murkowski Signal Support For Deal On ObamaCare Payments
Two holdouts on the GOP effort to repeal ObamaCare are throwing their support behind a bipartisan deal to extend payments to insurers after President Trump moved to nix them. Republican Sens. John McCain (Ariz.) and Lisa Murkowski (Alaska) on Tuesday both praised the agreement to provide two years of the cost-sharing reduction payments. (Carney, 10/17)

The Wall Street Journal: Senators Reach Deal To Shore Up Health-Insurance Markets
The bill needs 60 votes to pass in the Senate, where Republicans hold 52 seats. The deal is most likely to get a vote in both chambers if it is tethered to another issue. In the Senate, one possibility is that it could be combined with a disaster-relief bill passed by the House last week, lawmakers and aides said. (Armour and son, 10/17)

The Hill: House Freedom Chairman Calls ObamaCare Deal 'Good Start'
The chairman of the powerful House Freedom Caucus said more work needs to be done to get conservatives to support a bipartisan Senate deal to extend critical ObamaCare payments to insurers, but he called it a starting point. “There are elements in the Alexander-Murray plan that we can build on, but much more work needs to be done,” Rep. Mark Meadows (R-N.C) in a statement, but he called it a "good start." (Weixel, 10/17)

The Hill: Heritage Foundation Rips Bipartisan Health Care Deal Ahead Of Trump Speech
A senior fellow for the Heritage Foundation, an influential conservative think tank, ripped a bipartisan deal on Tuesday that would provide funding for key health-care subsidies that President Trump recently announced he would cut off. In a statement issued hours after Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), leaders of the Senate Health Committee, announced that they had agreed on a plan to stabilize insurance markets under the Affordable Care Act, Ed Haislmaier, a senior research fellow in health-care policy for the Heritage Foundation, said the proposal would offer little stability for the unsubsidized insurance market. (Greenwood, 10/17)

The Wall Street Journal: Health Insurers Step Up Open Enrollment Push As Window To Sign Up Shrinks
With enrollment for 2018 Affordable Care Act health-insurance plans starting in just two weeks, insurers are bracing for a drop-off among consumers put off by higher rates, confusion about the law’s standing and a shorter window to choose coverage. Companies like Blue Cross Blue Shield of Michigan, Florida Blue and Medica are rushing to shore up their customer base as the future of the 2010 health law continues to be debated on Capitol Hill, where two senators Tuesday announced a tentative deal aimed at bolstering the ACA marketplaces. The insurers are using advertising, letters, emails and other outreach techniques to reassure enrollees about their insurance options under the ACA in 2018. (Wilde Mathews, 10/18)

The Wall Street Journal: UnitedHealth Revenue Grows Despite ACA Exit
UnitedHealth Group Inc.’s core insurance and health-services businesses grew in its latest quarter, despite a dent in revenue caused by the company’s decision to pull out of most Affordable Care Act markets. The latest quarterly results from the nation’s largest health insurer come as the market is facing policy changes related to the ACA. President Donald Trump last week signed an executive order seeking to provide lower-cost plans in the individual insurance market, and he has said his administration will end payments to insurers that offset subsidies to low-income consumers. (Prang and Wilde Mathews, 10/17)

The Hill: Dems Introduce Public Option For ObamaCare
Sens. Michael Bennet (D-Colo.) and Tim Kaine (D-Va.) on Tuesday introduced a bill to add a government-run “public option” plan to ObamaCare, modeled on Medicare. The plan, part of a long-running debate in the Democratic Party about how far to go in expanding government-run health insurance, would move ObamaCare to the left but does not go as far as Sen. Bernie Sanders's (I-Vt.) "Medicare for all" plan. (Sullivan, 10/17)

The Washington Post: Single Payer System: A Healthcare Alternative To Affordable Care Act?
As Republican efforts to repeal and replace the Affordable Care Act continue in the background, some Democrats are starting to eye a new health policy goal: implementing a single-payer system. Sen. Bernie Sanders (I-Vt.) introduced a single-payer bill in mid-September with 16 Democratic co-sponsors — 16 more than he got when he introduced the bill two years earlier. But how is the health-care system funded now, and how would “single-payer” change that? (Soffen, 10/17)

The Washington Post: Trump Eyeing Former Drug Firm Executive Alex Azar For Health And Human Services Secretary
Alex Azar, a former pharmaceutical executive and a top health official during the George W. Bush administration, is now the leading candidate to head the Department of Health and Human Services, two Republicans briefed on the matter said Tuesday. Azar served a decade at Lilly USA, the biggest affiliate of Eli Lilly and Co., including five years as president. He directly led a biomedicines division that covered, among other areas, neuroscience, immunology and cardiology, and was also responsible for the company’s sales and marketing operations. (Eilperin and Goldstein, 10/17)

The Hill: Newly Controversial Opioid Enforcement Law Under Fire 
Several lawmakers are pushing to repeal or revisit a law critics say enables the flow of deadly and addictive opioids, hours after President Trump’s drug czar nominee withdrew his name amid the controversy. The little-noticed legislation is reportedly undermining the Drug Enforcement Administration’s (DEA) ability to police drug distributors and was heavily influenced by industry lobbying, according to a joint Washington Post and “60 Minutes” investigation published Sunday.  The report was based in part on a high-ranking whistleblower within the DEA. (Roubein, 10/17)

The Washington Post: Congresswoman Requests Hearings On Whether DEA Chief Misled Her About Bill
A Los Angeles congresswoman who co-sponsored a controversial law that has hobbled the Drug Enforcement Administration said Tuesday that the head of the agency personally assured her that the measure would not hamstring law enforcement efforts. Rep. Judy Chu (D-Calif.), an original co-sponsor of the bill, called Tuesday for an investigation into whether the law is harming enforcement against “bad actors” and requested hearings to examine whether she was misled. (Higham and Bernstein, 10/17)

The Washington Post: McCaskill’s False Claim That She ‘Wasn’t Here’ When The DEA Bill Was Passed
In the wake of The Washington Post/“60 minutes” investigation detailing how 2016 legislation passed by Congress weakened the Drug Enforcement Administration’s ability to go after drug distributors, even as opioid-related deaths continue to rise, Sen. McCaskill has led the charge for repealing the law. Already, President Trump’s choice for drug czar, Rep. Tom Marino (R-Pa.), withdrew his nomination after the report exposed his role in spearheading the bill’s passage through Congress. (Kessler, 10/17)

The Washington Post: Another Outbreak Related To The Nation’s Opioid Crisis: Hepatitis C
The nation’s opioid epidemic has unleashed a secondary outbreak: the rampant spread of hepatitis C. New cases of the liver disease have nearly tripled nationwide in just a few years, driven largely by the use of needles among drug users in their 20s and 30s, spawning a new generation of hepatitis C patients. Because a treatment that cures the disease costs tens of thousands of dollars, is limited by insurance and Medicaid, and is mostly unavailable to people who are still using illicit drugs, there probably will be financial and public health ramifications for decades to come. (Zezima, 10/17)

NPR/Propublica: Oversized Eyedrops Waste Medicine And Money
If you've ever put in eyedrops, some of them have almost certainly spilled onto your eyelid or cheek. The good news is the mess doesn't necessarily mean you missed. The bad news is that medicine you wiped off your face is wasted by design — and it's well-known to the drug companies that make the drops. (Allen, 10/18)

The New York Times: Google Maps Pulls Calorie-Counting Feature After Criticism
Stephanie Zerwas, the clinical director of the Center of Excellence for Eating Disorders at the University of North Carolina, was trying to find a restaurant in Orlando, Fla., last weekend, so she put the address into Google Maps for directions. She was baffled to see a new feature: The iPhone app told her that walking instead of driving would burn 70 calories. While it was perhaps meant as an incentive to walk, those with eating disorders might instead fixate on the number, a dangerous mind-set that counselors try to minimize, she said. (Victor, 10/17)

NPR: 4 Genes Linked To Obsessive Compulsive Disorder
People who have obsessive-compulsive disorder can get trapped inside a thought. It repeats itself, like a stuck song. Did I lock the door? Is that doorknob clean enough to touch? I better wash my hands again — and again. The biology underpinning this loop remains murky to scientists, but scientists are beginning to sniff out potential genetic factors behind OCD and shed light on how the disorder affects the brain. (Chen, 10/17)

The New York Times: A Diabetes Monitor That Spares The Fingers
For the past year and a half I’ve been buying a medical device from Italy that has improved my life immeasurably. It wasn’t easy: I roped in a good friend who had moved to Milan to buy the device and ship it to me because it wasn’t yet available in the States. And it was expensive: over $1,600 a year. (Zimberoff, 10/17)

The Associated Press: Appeals Court Tosses $72 Million Award In Talcum Powder Case
A Missouri appeals court on Tuesday that vacated a $72 million award to an Alabama woman who claimed her use of Johnson & Johnson products that contained talcum contributed to her ovarian cancer has thrown the fate of awards in similar cases into doubt. The Missouri Eastern District Court’s ruled that Missouri was not the proper jurisdiction to hear a lawsuit filed by Jacqueline Fox, 62, of Birmingham, Alabama, who claimed the baby powder she used for feminine hygiene for about 25 years contributed to her cancer. (Stafford, 10/17)

San Diego Union-Times: Death Toll From San Diego Hepatitis A Outbreak Rises To 19; More Than 500 Cases Confirmed
San Diego’s hepatitis A outbreak added another death Tuesday, pushing the total to 19 as the number of confirmed cases passed 500. Updated numbers released by the county Health and Human Services Agency come as a massive effort around vaccination, sanitation and public education continues to try and stop the largest surge of the viral disease since the vaccine for hepatitis A was approved in the late 1990s. (Sisson, 10/17)

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2017 Kaiser Health News. All rights reserved.

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