Daily on Healthcare, sponsored by SBEC: No time for ‘Obamacare 2.0’ in universal healthcare hearing?

By | December 4, 2019

Subscribe today to the Washington Examiner magazine and get Washington Briefing: politics and policy stories that will keep you up to date with what’s going on in Washington. SUBSCRIBE NOW: Just $ 1.00 an issue!

NO TIME FOR OBAMACARE 2.0 IN UNIVERSAL HEALTHCARE HEARING? The date is finally on the books for the Energy and Commerce’s Health Subcommittee to hear the Medicare for All Act.

It’s set for Tuesday, Dec.10, but, just like the three other House hearings on “Medicare for all,” the idea won’t be the only one considered. The subcommittee will be discussing six other bills dealing with coverage expansion, largely through expanding who can buy into a government plan.

There’s one bill that’s notably absent from the list. We’ve been calling it “Obamacare 2.0,” (h/t Charles Gaba, author of ACASignups.net), because its actual name, the Protecting Pre-Existing Conditions and Making Healthcare More Affordable Act, doesn’t have the friendliest acronym. It’s also a bill that really does expand on Obamacare.

The legislation, a favorite of Democratic leaders and centrists, with 159 co-sponsors, funnels more money into Obamacare to boost coverage and lower the cost of premiums for customers, and it undoes actions by the Trump administration to sell plans outside of the law’s rules. It would let people in other income brackets get subsidies, likely bringing in customers who were previously priced out. According to the Commonwealth Fund, such actions could reduce the number of uninsured by roughly 5 million people. And that’s only if more states don’t expand Medicaid.

It’s the kind of bill Democratic leaders can encourage liberals to agree to as a short-term change to patch up Obamacare before moving on to more drastic changes to the healthcare system.

Plus, the legislation stands apart from the other bills getting a hearing in a very important way: Industry groups won’t fight it. In many ways, it fits the bill of what they are looking for when they talk about the need to “expand what’s working” and “fix what’s broken.”

Portions of the bill, including its reinsurance fund and provisions for advertising open enrollment, did get marked up and passed in Energy and Commerce alongside measures to lower drug prices. That could mean that Speaker Nancy Pelosi would bring “Obamacare 2.0” straight to the floor. House leadership aides didn’t get back to us about a timeline ahead of sending out the newsletter.

Pelosi might have just the right opportunity. We’re expecting to hear any day now about whether the 5th Circuit will rule to strike down Obamacare.

The bill wouldn’t help neutralize a court decision (it doesn’t address the individual mandate at all), but it would send a powerful political message at a time when the Trump administration asked the court to throw the whole law out.

Good morning and welcome to the Washington Examiner’s Daily on Healthcare! This newsletter is written by senior healthcare reporter Kimberly Leonard (@LeonardKL) and healthcare reporter Cassidy Morrison (@CassMorrison94). You can reach us with tips, calendar items, or suggestions at dailyonhealthcare@washingtonexaminer.com. If someone forwarded you this email and you’d like to receive it regularly, you can subscribe here.

HOSPITAL GROUPS SUE TO BLOCK TRUMP ADMINISTRATION TRANSPARENCY RULE: The American Hospital Association and other hospital groups filed a lawsuit Wednesday to block the recently announced Trump administration rule mandating that hospitals publish standard charges for care as well as costs for care after negotiations with insurers — rates that insurers and providers have long kept secret from patients. The lawsuit, filed in the U.S. District Court of Washington, maintains that the rule requiring such price transparency violates hospitals’ and insurers’ First Amendment rights and surpasses the statutory intent of the Affordable Care Act. “The burden of compliance with the rule is enormous, and way out of line with any projected benefits associated with the rule,” Wednesday’s suit said.

BIG DAY FOR PAID LEAVE: Bipartisan legislation to let new parents draw on future child tax credits early to fund leave from work is being rolled out Wednesday afternoon. First daughter and senior White House adviser Ivanka Trump has been shepherding along discussions on paid parental leave, though hasn’t explicitly backed a specific approach. Leaders of the bill introduced Wednesday in the Senate are Republican Bill Cassidy of Louisiana and Democrat Kyrsten Sinema of Arizona. Over in the House, the bill is being introduced by Democrat Colin Allred of Texas and Republican Elise Stefanik of New York.

‘SILVER LOADING’ HELPED RURAL AREAS: After President Trump ended direct funding for cost-sharing reduction subsidies, or CSRs, health insurance sold on the Obamacare exchanges became more affordable for subsidized people living in rural areas, even more so than in cities, according to a new study in Health Affairs. That’s because of what is known as “silver loading,” a practice in which insurers stack up premiums differently so that they can still fund the CSRs, which lower out-of-pocket costs for low-income people. The effect? Average minimum net monthly premiums for subsidized enrollees rural parts of the U.S. decreased from $ 288 in 2017 to $ 162 in 2019, while those of their urban counterparts decreased from $ 275 to $ 180. The worst off in terms of costs, however, were unsubsidized people living in rural areas.

IS THERE A WAY TO GET MORE PEOPLE TO GET THE FLU SHOT? The House Energy and Commerce’s Oversight panel is holding a hearing Wednesday morning about how to improve vaccination rates. According to a new survey from NORC at the University of Chicago, 37% of adults do not intend to get a flu shot this season, largely because they don’t think it works well and because they’re concerned about side effects. Lawmakers will get the chance to question top health officials about their prevention work, and to check in on how the development of a universal flu vaccine is going. Tune in to the hearing.

E+C CONSIDERS COSMETICS BILLS: The Energy and Commerce Health Subcommittee will review two bills Wednesday pertaining to the safety of cosmetics. The first, introduced by Democrat Jan Schakowsky, would require cosmetics manufacturers to disclose to the Food and Drug Administration for the first time all ingredients in their products, including chemicals and fragrances, to protect users and the environment from exposure to harmful chemicals. The bill would also give the FDA authority to recall products it deems unsafe and would ban animal testing where a viable animal testing alternative is available. The other bill under consideration, the Cosmetic Safety Enhancement Act of 2019, also sponsored by Schakowsky, would require all cosmetics manufacturers to register with Health and Human Services, which will take on more of an oversight role. The FDA would have the authority to suspend the manufacturers’ registration if the ingredients of the cosmetics are deemed more dangerous to the public than beneficial. Tune in here.

WHITE HOUSE ECONOMISTS: IF LEFT UNTREATED, PELOSI’S DRUG PRICING BILL COULD KILL YOU: The White House Council of Economic Advisers estimated in an analysis published Tuesday that Pelosi’s Lower Drug Costs Now Act would lead to 100 fewer new prescription drugs hitting the market in the next decade, much more than the Congressional Budget Office’s estimated eight to 15 fewer drugs. This lack of innovative treatments, the CEA report said, “would reduce Americans’ average life expectancy by about four months.”

Part of Pelosi’s bill mandates that pharmaceutical companies negotiate prices for up to 250 drugs with the government or face financial penalties, which the agency said would lead to companies choosing not to sell their newest drugs in the U.S. at the risk of losing money in a deal with the government. While the CBO reported in October that Pelosi’s bill would save the federal government about $ 345 billion over 10 years, the CEA said the loss of innovation and “resulting worse health outcomes” would cost the federal government about $ 1 trillion in that same time period.

YANG SAYS HE WOULD INVEST IN SUPERVISED INJECTION SITES: Presidential candidate Andrew Yang told The Hill Tuesday that as president he would invest in supervised drug injection sites, which allow users to access addiction counseling and treatment while healthcare professionals stand by with overdose reversal drugs. “You go home [after an overdose] and you’re still addicted and you wind up in many cases overdosing again,” Yang said. “So we need to refer these people to counseling, treatment and safe consumption sites as needed.” A Pennsylvania federal judge ruled in October that the Trump administration could not block the nonprofit Safehouse from opening a supervised injection site in Philadelphia. In California, state lawmakers reintroduced a bill in February to allow San Francisco to open a supervised injection site for three years.

Yang also said the U.S. should take a page out of Portugal’s book: In the midst of its own drug crisis starting in the 80s, the Portuguese government decriminalized possession and personal use of small amounts of all drugs, opioids included, in 2001. When people in Portugal are found with a small supply of drugs — only 10 day supplies — including heroin, rather than being imprisoned, they’re sent to the local Commission for Dissuasion of Drug Addiction which comprises medical doctors, psychologists, social workers, and a lawyer. What might seem crazy about Portugal’s policy is that the drug-induced mortality rate among adults 15-64 was four deaths per million in 2017, much lower than the most recent European average of 22 deaths per million.

TOO FEW AMERICANS KNOW THEY HAVE HIV OR HAVE ACCESS TO TREATMENT: The Centers for Disease Control and Prevention found that only 37% of Americans with HIV have access to treatment to delay progression of the virus. Four in five people, 82%, could benefit from HIV prevention treatments, like Truvada for PrEP, but aren’t taking it. The CDC Vital Signs report said it was not prescribed enough in 2018, and young people of color were disproportionately affected.

The Rundown

Iowa Public Radio As the kidney transplant list grows, Iowans seek out living donors

The Associated Press Biden steps up hits on Buttigieg, Warren over healthcare

Kaiser Health News An Atlanta nonprofit brings medical care and connection to the homeless

The Times-Picayune New Orleans inmate’s fentanyl overdose sparks lawsuit against Sheriff Gusman: ‘This is a pattern’

Georgia Health News Georgia and the South feeling brunt of the flu

Stat A clinical trial for Huntington’s opens the door to hope for some patients. Only so many can get in



Congress in session.

9 a.m.-1 p.m. National Press Club. 529 14th St. NW. Health Affairs briefing on rural health. Details.

10 a.m. 2322 Rayburn. House Energy and Commerce Committee’s Health Subcommittee hearing on “Building Consumer Confidence by Empowering FDA to Improve Cosmetic Safety.” Details.

10:30 a.m. 2123 Rayburn. House Energy and Commerce Committee’s Oversight and Investigations Subcommittee hearing on “Flu Season: U.S. Health Preparedness and Response.” Details.

Noon. Dirksen G-50. Alliance for Health Policy congressional briefing on “The Science, Policy, and Potential of Cell and Gene Therapies.” Details.

3 p.m. Cannon 122. Congressional Baby Caucus briefing on “Rise in Vaccine-Preventable Diseases.”


7:30 a.m.-5 p.m. National Press Club. 529 14th St. NW. American Medical Informatics Association Health Informatics Policy Forum. Program.

Noon. Cato Institute webcast on “Is It the Drug? Rethinking Conventional Views of Substance Use, Abuse, and Addiction.” Details.

MONDAY | Dec. 10

10 a.m. 1225 I St. NW. Bipartisan Policy Center event on “Advancing Comprehensive Primary Care in Medicaid.” Details.

TUESDAY | Dec. 10

10 a.m. 2123 Rayburn. Health Energy and Commerce’s Oversight and Investigations Subcommittee hearing on “Securing the U.S. Drug Supply Chain: Oversight of FDA’s Foreign Inspection Program.” Details.

10:30 a.m. 2322 Rayburn. Health Energy and Commerce’s Health Subcommittee to hold hearing on “Proposals to Achieve Universal Health Care Coverage.” Details.


10 a.m. 1225 I St. NW. Bipartisan Policy Center event on “Modernizing the Stark Law and Anti-Kickback Statute to Promote Value-Based Care.” Details.