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Burwell: What To Watch - Health Care Edge: Brought to you by the American Hospital Association (AHA)

Burwell: What To Watch 

By Sam Baker, Sophie Novack and Clara Ritger

 

BURWELL'S FIRST HEARING: Sylvia Mathews Burwell will be before the Senate health committee today for the first hearing on her nomination for HHS secretary. Several Senate Republicans have already said they'll support her, but all the same, expect Republicans to use today's hearing to air their grievances about Obamacare -- and about HHS' responsiveness to congressional inquiries. There are still big implementation issues left for Burwell to shape, including exchanges for small businesses. Democrats, meanwhile, will likely hone in on smaller parts of the HHS portfolio, such as rural health, racial and ethnic disparities, and public health -- a big priority for committee Chair Tom Harkin.

Top Health Care News

BURWELL: HHS is extremely difficult to manage, even without something as huge as Obamacare implementation, according to Michael Leavitt, a former HHS secretary under President George W. Bush. "My advice would be to remember it's not the only thing that happens in that department," Leavitt said. "Make sure you begin to understand the other parts of the department that are going to require attention."

"We had food safety for a time, we had pandemic influenza, we had the rollout of Part D. We had a conga line of problems that are coming at HHS all the time," he said. "It was the breadth of responsibility.…The challenge was in being able to manage across that many platforms." (Sam Baker, National Journal)

 
  • Five questions Burwell is likely to face in the hearing. (Jennifer Haberkorn, Politico)

EMPLOYERS CONSIDER MOVING SICKEST WORKERS ONTO ACA EXCHANGES: Moving just one high-cost employee onto the health insurance exchanges could save a company hundreds of thousands of dollars a year, while increasing premium costs for customers and subsidy expenses for taxpayers. (Jay Hancock, Kaiser Health News/Daily Beast)

ARE HOSPITAL PATIENTS HEALTHIER UNDER OBAMACARE? Hospitals prevented nearly 15,000 deaths and 560,000 injuries by reducing additional illnesses and infections acquired in the hospital. That would mean upward of $4 billion in overall health spending savings between 2010 and 2012, according to HHS. (Clara Ritger, National Journal)

  • But even with the improvements, one in eight patients is still harmed during their time in the hospital. (Jordan Rau, Kaiser Health News)

Congress

REPUBLICANS WERE NOT HAPPY SEBELIUS MISSED THE HHS BUDGET HEARING: Republicans used all their time at the Senate Appropriations hearing yesterday to express frustration that outgoing Health and Human Services Secretary Kathleen Sebelius was not present to defend the FY2015 HHS budget, saying it is indicative of a larger issue of lack of transparency within the administration.

"This is more than just the Secretary playing hooky. It's getting to be a persistent problem with this administration, regarding [these hearings] as an inconvenience," Sen. Lamar Alexander said. "The president ought go to Mt. Vernon and remind himself that though the executive office is important, the founders didn't want a king."

 

Present at the hearing were leaders from the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, and the Administration for Children and Families.

Committee Chairman Tom Harkin defended the Secretary, saying it's a tricky situation because Sebelius is leaving and Burwell hasn't yet been confirmed. "While we might have disagreements on some things, [Mike Johanns and I] both agree on one thing," Harkin said, following statements from the Nebraska senator regarding Sebelius's absence. "It's time to retire."

GOP SENATORS DEMAND VOTE ON 20-WEEK ABORTION BAN: Thirty-three senators have asked Majority Leader Harry Reid to bring Sen. Lindsey Graham's Pain-Capable Unborn Child Protection Act to a vote. Thirteen states have already instituted bans on abortions later than 20 weeks. (Ferdous Al-Faruque, The Hill)

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Insurance

TENSION AS INSURERS TELL CONGRESS 80 TO 90 PERCENT OF CUSTOMERS HAVE PAID PREMIUMS: The insurance representatives said the report released by the Energy and Commerce last week claiming only 67 percent had paid as of April 15 was incomplete, leading to partisan bickering at Wednesday's hearing.

"By any rational, reasonable measure we can call this law a success," said Democratic Rep. Diana DeGette.

"While the administration toasts the law's success with its Hollywood allies, declaring this conversation over, we will continue our pursuit for facts," countered Chairman Fred Upton.

  • Republicans also grew frustrated over insurers' responses on the subject of 2015 premium rates. "Has anybody done any kind of analysis?" said Rep. Marsha Blackburn. "You all have conducted no internal analysis on what the trend line is for these premiums?"

"At this point in the filing season, we can't offer any guidance or speculate on where [premiums] are going to fall," said Paul Wingle, executive director of public exchange operations at Aetna. (Elise Viebeck, The Hill)

PHRMA: ACA COST-SHARING COULD LIMIT ACCESS TO PRESCRIPTION DRUGS: "For a typical employer-sponsored health plan, on average people pay about 22 percent of the cost of prescription drugs and their insurance covers the rest, said John Castellani, who heads PhRMA. According to the [Breakaway Health] analysis done for association, the health law's bronze and silver plans require more than twice that amount." (Mary Agnes Carey, Kaiser Health News)

SURVEY: 25 PERCENT OF EXCHANGE CUSTOMERS WERE UNINSURED; 87 PERCENT PAID PREMIUMS: According to the most recent survey from the McKinsey Center for U.S. Health System Reform, the rate of previously uninsured who enrolled in private coverage has remained relatively unchanged from February, while the rate of those who have paid first premiums has increased. (Paul Demko, Modern Healthcare)

FORMER OBAMACARE IMPLEMENTOR RUNNING ON SINGLE-PAYER PLATFORM IN MASSACHUSETTS: "I began to list the policies I wanted to pursue, and then I came to the payment side...and I started to talk to the people who helped shape Vermont, looked at Vermont, and I just said, 'oh my, there is just one straight shot here, it's going to single-payer,'" former CMS Administrator and current gubernatorial candidate Don Berwick said in an interview Wednesday. "At that point it was more about thinking about putting it on the table. Now it is the entire table." (Sarah Kliff, Vox Media)

'FACE OF THE CAMPAIGN' FOR OBAMACARE CAUGHT IN MEDICAID ENROLLMENT TRAP: "Every story is unique, but the theme that keeps coming up is how complicated this is," said Jane Delgado, president of the National Alliance for Hispanic Health, a nonpartisan advocacy network. (Carla K. Johnson, Associated Press)

Providers

HOW THE HEALTH LAW IS BOOSTING PUBLIC HOSPITAL COMPANIES: Hospital Corporation of America said in its states that have expanded Medicaid under the ACA, the company has seen Medicaid admission growth and a 29 percent decline in uninsured admissions, compared to a 5.9 percent increase in uninsured admissions in non-expansion states. (Eleanor Kennedy, Nashville Business Journal)

WEB START-UPS WILL HELP YOU FIND DOCTORS IN A HURRY: "Grand Rounds is one of many healthcare startups bringing on-demand, concierge-like services once reserved for the ultra-rich to the middle class – similar to what tech outfits like Google, Amazon, Uber, and Lyft have done for personal shopping and transportation. These budding companies offer basic access to medical advice, appointments and other assistance." (Daniela Hernandez, Kaiser Health News/Wired)

Research and Studies

SCIENTISTS CREATE ORGANISMS WITH EXPANDED ARTIFICIAL GENETIC CODE: Researchers hope the advancement could lead to the development of organisms that can make medicines that cells with the natural genetic code cannot, but others are concerned the "alien" life form could have negative ethical and legal implications. (Andrew Pollack, New York Times)

STUDY: MEDICATION CUTS VIOLENCE IN MENTALLY ILL: "Previous evidence suggests that people with severe mental illnesses do have an elevated risk of violent behavior, compared with the general population, particularly when they are untreated or are engaged in substance abuse. But there has been limited research on the question of whether taking psychiatric medication helps to reduce violence. At the same time, some mental-health experts express concerns about the side effects of heavy-duty psychiatric medications, relative to their benefit." (Shirley S. Wang, Wall Street Journal)

E-Cigarettes

HOW CANDY E-CIGARETTE MAKERS MAKE THEIR PRODUCTS SMELL LIKE CANDY: New research finds that the same flavor chemicals are present in candy and candy-flavored tobacco products. (Clara Ritger, National Journal)

Happening Today

SYLVIA MATHEWS BURWELL NOMINATION FOR HHS SECRETARY: The Senate Health, Education, Labor and Pensions Committee will meet at 10 a.m. in 430 Dirksen to evaluate the president's nomination of Sylvia Mathews Burwell for the position of Health and Human Services Secretary.

CONVERSATIONS WITH CONSERVATIVES: The Heritage Foundation will be talking about Benghazi and the Affordable Care Act at 11 a.m. in 2226 Rayburn with members of the House Republican caucus.

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