By Dan Diamond | 05/18/2017 10:24 AM EDT
While Republicans continue their partisan push to repeal the ACA, a pair of bipartisan health care initiatives are getting floated in the Senate. But first: New findings on Obamacare's effect on health care.
HOW DEMOCRATS' HEALTH CARE LAW IMPROVED HEALTH CARE - A pair of studies offer new evidence that the Affordable Care Act's coverage expansions led to measurable improvements in access and outcomes, even as Republicans move to roll those expansions back.
More preventive care and improved self-reported health. That's the conclusion of a new Health Affairs study led by Harvard's Ben Sommers, which looked at how coverage expansion played out across three states.
The researchers compared Arkansas and Kentucky - both of which expanded Medicaid through the ACA - and Texas, which didn't accept the optional expansion. What they found across all three states was that people who gained health coverage saw:
- A 41-percentage-point increase in having a usual source of care
- A 23-percentage-point increase in "excellent" self-reported health
Newly insured Americans also reported a $337 cut in annual out-of-pocket spending. See the study.
These new findings on Obamacare's effects on low-income adults line up with previous surveys - some of which were co-authored by Sommers, a highly regarded economist who served as an HHS adviser during the Obama administration.
More cancers were detected, too. That's the takeaway from a study led by Xuesong Han of the American Cancer Society, which will be presented at the American Society of Clinical Oncology meeting next month in Chicago.
The researchers tracked five types of cancer that can be detected via screening - breast, lung, colorectal, cervical and prostate tumors - and found the rate of early detection increased by roughly one percentage point, Bloomberg's Michelle Cortez reports.
"Obviously the changes aren't enormous," cautioned cancer researcher Bruce Johnson, the incoming ASCO president. But the uptake in screening can build steadily over years, he added, and the payoff can be significant - "the earlier the stage [detected], the more likely the person is to be cured." More.
BIPARTISAN SENATE PUSH FOR SUBSTANCE ABUSE CARE - Six senators on Wednesday introduced legislation that they say will ease longstanding federal restrictions on Medicaid reimbursement for substance abuse treatment centers, Pro's Brianna Ehley reports.
- Who's pushing the bill: Sens. Dick Durbin (D-Ill.), Rob Portman (R-Ohio), Sherrod Brown (D-Ohio), Shelley Moore Capito (R-W.V.), Angus King (I-Maine), and Susan Collins (R-Maine). All are from states that have been among the hardest hit by opioid addiction.
- Why they're introducing it: The senators say it would expand access to care amid a nationwide opioid epidemic.
- How it'd work: The bill would allow substance abuse treatment centers with as many as 40 beds to be reimbursed by Medicaid for up to 60 consecutive days. The proposal would dial back a decades-old law prohibiting Medicaid from paying for patient care at facilities with more than 16 beds. That law, known as the Institutes for Mental Diseases exclusion, was originally meant to discourage institutionalization, but health experts say it has created a major barrier to care and a severe nationwide shortage of psychiatric beds.
THIS IS THURSDAY PULSE - Where it's been two weeks, and a zillion news cycles, since the American Health Care Act passed the House.
Don't be forlorn: America may have forgotten, but we celebrate health care news in POLITICO's Rose Garden every day. Send tips to firstname.lastname@example.org or @ddiamond on Twitter.
With help from Renuka Rayasam (@RenuRayasam) and Rachana Pradhan (@RachanaDixit).
ON TAP TODAY - The House Energy & Commerce Committee's health subcommittee will mark up FDA user fee reauthorization legislation and two other public health bills at 10 a.m.
The Senate Finance Committee will mark up The Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act at 10:30 a.m.
Reps. Jan Schakowsky (D-Ill.) and Terri Sewell (D-Ala.) are among those meeting at the Ronald Reagan Building this morning to discuss the SMART Student Health and Wellness model, which focuses on treating the "whole child" at public schools. The model was created out of a partnership with CVS Health, Ginn Group Consulting, Chicago Public Schools, and the Hispanic Heritage Foundation.
INSURANCE COMMISSIONERS URGE WHITE HOUSE: FUND ACA SUBSIDIES - That's the upshot of a letter from the National Association of Insurance Commissioners to the administration.
"Your action is critical to the viability and stability of the individual health insurance markets" in many states, they write. "The time to act is now." (h/t Andy Slavitt).
ANOTHER TAKE ON HHS's WAIVER CHECKLIST - Wednesday's PULSE reported on a new HHS checklist that's intended to help states apply for innovation waivers through Obamacare. While some pro-ACA advocates warned that the checklist would allow Republican-led states to undermine elements of the health law, Jason Levitis - who co-chaired the Obama administration's waiver implementation team while at the Treasury Department - believes it will be a boon.
"This is a constructive step to help states apply for waivers," Levitis told PULSE, saying that HHS encouraging states to develop reinsurance programs like Alaska's program would be a step forward. "This kind of waiver is a really useful way to provide state flexibility and help stabilize insurance markets."
** A message from PhRMA: Patients share the cost of medicines. They should share the savings. Medicine costs increased just 3.8% in 2016 thanks to significant rebates and discounts negotiated between biopharmaceutical companies and insurers. So why are patients' out-of-pocket costs continuing to go way up? Find out at http://onphr.ma/2qekIyT. **
EYE ON PHARMA
Draft bill floats biggest overhaul of over-the-counter drugs in 40 years. Sens. Johnny Isakson (R-Ga.) and Bob Casey (D-Pa.) are circulating a draft bipartisan plan that proposes the most sweeping changes in more than four decades to the FDA's oft-criticized process for regulating over-the-counter drugs.
The agency, industry groups and health experts say the regulatory regime is woefully out of date. Under the proposal obtained by POLITICO, product approvals would be streamlined so FDA would no longer be required to do rulemaking for each therapeutic class. Instead, the HHS secretary could administratively establish standards for each OTC drug type. Keep reading: More for Pros.
FIRST IN PULSE: CSRxP debuts new ad hitting pharma. The ad - entitled "Priorities" - is the second in a multi-million dollar nationwide campaign from the drug pricing coalition, and focuses on pharma's claim that price increases are necessary to fund R&D.
"They say the prescription drug costs are so high because they spend so much on research," a narrator intones. "But the simple truth is nine out of the 10 biggest pharma companies spend 50 percent more on advertising." Watch the ad.
Key Republican on appropriations: Yearlong stopgap most likely for fiscal year 2018. The GOP's fractious divide on spending levels will likely force Congress into a yearlong stopgap spending bill, Rep. Mike Simpson (R-Idaho) warned on Wednesday.
"The rest of the appropriators and chairmen will probably kill me, but, I think we're into a [continuing resolution] for 2018," the chairman of the House Appropriations Subcommittee on Energy and Water told reporters.
... Simpson added that infighting over President Donald Trump's proposed spending cuts could make it politically impossible for the GOP to find a path forward on fiscal 2018 appropriations bills, which are due in September, Pro's Sarah Ferris reports.
"This is [OMB Director Mick] Mulvaney's budget," Simpson said. "Like I want to go home after voting against Meals on Wheels and say 'Oh it's a bad program, keeping seniors alive.'" More for Pros.
AROUND THE NATION
Texas: Senate committee considers stem cell research bills. Two bills that would give patients greater access to unproven stem cell therapies got a hearing Wednesday evening in the state Senate's health committee, a key hurdle to their passage, POLITICO's Renuka Rayasam reports from Austin.
- One bill would expand the use of experimental biologic therapies in Texas beyond terminally ill patients to chronically ill patients.
- Another bill would allow patients with a severe chronic disease or terminal illness to access adult stem cell therapies that haven't completed Phase 1 FDA trials. That bill passed the state House last week after one state representative made a tearful plea for passage, citing his wife who ended up in a wheelchair after a car accident.
... David Bales, the chairman of Texans for Cures - a stem cell research advocacy group that opposes the bills - told POLITICO that they would open the door to the proliferation of stem cell clinics that take advantage of patients, cause harmful side effects and hold back legal clinical trials for the treatments.
About thirty states have such "right-to-try" laws on their books, but even without a state blessing, dozens of clinics have set up shop in Texas.
Texas: Abortion still on the agenda. The Texas state Senate committee also considered a bill that would require health facilities that perform abortions to submit regular reports about complications from the procedure. It would create an online database that would track detailed data such as the patient's year of birth, race, marital status, and county of residence, as well as the date of the first day of her last menstrual period.
WHAT WE'RE READING by Adam Cancryn
Health care companies are going public at the lowest rate since 2012 as Congress looks to repeal and replace Obamacare, Marketwatch's Caitlin Huston reports. More.
A cancer drug is showing signs that it could be used to treat severe asthma, according to STAT's Meghana Keshavan. More.
The Irish Times' Peter Murtagh reports that a major hospital in the country successfully turned away 5,000 cyber attacks amid a broader assault on providers nationwide. More.
WIRED's Megan Molteni takes on OMB Director Mick Mulvaney's assertion that the government shouldn't take care of people with diabetes. More.
If NFL superstar Tom Brady is hiding concussions - as his wife Gisele Bundchen seemingly revealed - how many others are doing the same? Gary Myers at the New York Daily News wrestles with the question. More.
** A message from PhRMA: You don't always pay full price for doctor or hospital visits. So why is paying for medicines any different? Unlike for care received from a network hospital or physician's office, insurers charge the full list price of a medicine when patients have a deductible, even if the insurer receives a steep discount. Insurance companies should #sharethesavings with patients. Learn more at http://onphr.ma/2qekIyT. **
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