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Health Care Edge

Sebelius's No Show - Health Care Edge: Brought to you by the American Hospital Association (AHA)

Sebelius's No Show

By Sam BakerSophie Novack, Clara Ritger, and Stacy Kaper

 

OBAMA'S TEAM TAKES ITS BUDGET TO CONGRESS: The Health and Human Services 2015 budget request is getting another look-through this morning in the Senate Appropriations Committee' health panel. HHS is asking for more than $1 trillion--the first time the agency has ever asked for such an amount and a reflection of the strain the nation's aging population is putting on government benefits programs.

What's on the Agenda: Some Democrats are planning to use their question time to focus on the federal government's role in providing health services to the population. Others will be looking out for home state concerns, such as Alaskan Senator Mark Begich, who is up for re-election this year and wants to make sure the Indian Health Service is fully funded.

But that doesn't mean Obamacare's off the hook--South Carolina Senator Lindsey Graham wants to make sure the costs of the health law's implementation are "meeting expectations." That said, most of the funding for the Affordable Care Act is not subject to Congressional approval -- and though HHS is requesting a small sum for the federal health insurance exchange, HHS Secretary Kathleen Sebelius has said she could gather up the funds from other parts of the agency's budget if Congress nixes the line item.

 

Notably Absent: HHS Secretary Kathleen Sebelius. Some Republicans are miffed that she's not testifying before the committee, including Senator Jerry Moran from Sebelius's home state of Kansas. Moran said her absence "reduces the chances that the American people and their elected representatives in Washington D.C. will have a voice in expressing our views toward how money should be spent."

When and Where: 10 a.m., Dirksen Senate Office Building (SD-138)

The Witness List: The CDC's Thomas Frieden, the Health Resources and Services Administration's Mary Wakefield, Mark Greenberg at the Administration for Children and Families and Tim Love of the Centers for Medicare and Medicaid Services.

ALSO SET TO COME UP: Iowa Democratic Senator Tom Harkin plans to ask for implementation details about the early childhood education and community health programs--a presidential priority outlined in Obama's 2013 State of the Union address--that was agreed to in the omnibus bill in January.

 

BURWELL IS MAKING THE ROUNDS WITH THE SENATE GOP: Republican Senator Lisa Murkowski of Alaska shared details of her meeting with Sylvia Mathews Burwell, director of the Office of Management and Budget and the president's nominee to replace Kathleen Sebelius as HHS Secretary.

"I had a chance to visit with Sylvia Burwell yesterday and I had a lot of questions for her – very Alaska specific – I've got some issues as they relate to HHS and I wanted her to be aware of them," Murkowski said. "We talked a lot about the situations in Alaska with high health care costs, high insurance costs and how the demographics and the geography just require lots of different looks at things. So it was a good opportunity for me to get a little bit more specific about the concerns that I have."

Murkowski's not the only one getting face time with Burwell. Republican Senator Orrin Hatch met with her for 35 minutes in his office, a spokeswoman for the Utah senator said. In emailed remarks, Hatch called their conversation "constructive and frank" and focused on the health law. "From skyrocketing premiums to higher taxes and fewer choices – the adverse impacts on American families, seniors and job creators continue to mount on a daily basis," Hatch said. "We had an honest discussion on how Ms. Burwell can work with Congress to address these challenges."

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Burwell is set to appear before the Senate Health, Education, Labor and Pensions Committee on Thursday.

Insurers

INSURERS SAY MOST OBAMACARE ENROLLEES PAID PREMIUMS: According to company testimonies prepared for the House hearing today, WellPoint has received first premium payments from as many as 90 percent of customers, Aetna is in the "low to mid-80 percent range," and Health Care Service Corp. -- which operates Blue Cross Blue Shield plans in five states -- has received at least 83 percent. (Robert Pear, New York Times)

  • Others testifying that did not include payment percentages are Cigna, Blue Cross Blue Shield, and America's Health Insurance Plans.
  • The insurance companies said that the release of a report last week by Republicans on the committee claiming only 67 percent of ACA customers had paid their first premiums as of April 15 was premature, because it counted a few million of enrollees who signed up for coverage beginning May 1 but whose payments were not due until at least April 30 as "unpaid." (Sam Baker, National Journal)
  • Insurance company representatives will appear before the House Energy and Commerce Committee today at 10:15 a.m.

D.C. APPROVES TAX ON ALL INSURERS IN THE DISTRICT TO FUND HEALTH EXCHANGE: "The plan will fund the exchange starting next year, when it has a budget of $28.8 million. Beginning in 2015, the exchanges that 14 states and the District of Columbia set up under the law won't have federal funding and have to become self-sustaining. Exchanges got hundreds of millions of dollars in federal startup funds." (Louise Radnofsky, Wall Street Journal)

HUMANA REPORTS LOWER PROFIT IN FIRST QUARTER: The company said it spent more on marketing and investments tied to new products, such as Medicare Advantage and ACA exchange plans, and health care reform taxes and fees. (Caroline Humer, Reuters)

Medicaid

IS NOT EXPANDING MEDICAID A LEADING CAUSE OF PREVENTABLE DEATH? A study released Monday on the impact of health reform in Massachusetts found that every 830 additional people that got insurance prevented about one death. A 2012 Urban Institute report estimated that 15.1 million uninsured adults could get covered if every state expanded Medicaid. Taking the two figures together would equal about 18,193 deaths prevented per year through Medicaid expansion. (Tom Liu, Advisory Board Company)

  • This would put Medicaid expansion fifth in the top potentially preventable deaths from a Centers for Disease Control and Prevention report released last week.

PROTESTORS SHUT DOWN MISSOURI SENATE TO DEMAND MEDICAID EXPANSION: Watch video of the protest here. (Niraj Chokshi, Washington Post)

Congress

HOUSE DEMS UNVEIL ALTERNATIVE MENTAL HEALTH BILL: "The wide-ranging bill from Rep. Ron Barber (D-Ariz.) abandons a series of aggressive and controversial steps proposed by Rep. Tim Murphy (R-Pa.) that are intended to empower family members coping with extreme cases of mental illness. In its place, the Democratic measure proposes new federal initiatives to help prevent and treat mental illness. The Democratic bill also contains specific measures to boost care for schoolchildren, veterans and seniors, and urges increased research on serious mental illness." (Ferdous Al-Faruque and Elise Viebeck, The Hill)

BIPARTISAN EFFORT ASKS WHAT CONGRESS CAN DO TO SUPPORT BIOMEDICAL INNOVATION: Leadership on both sides of the Energy and Commerce Committee, joined by Majority leader Eric Cantor and other Representatives, led a discussion Tuesday with agency and organization heads on investing in 21st century cures. The roundtable focused on what Congress can do to to help science research, and the factors that are holding innovation back: inconsistent and insufficient funding, regulatory burdens, concerns of losing scientists to other countries, and more.

"Why is medical research discretionary? Why is health discretionary?" NIH Director Francis Collins said. "This is the most important investment a country can make. Every other country thinks like this; we seem to have lost our way." Collins focused on the need for a stable and predictable funding flow in order to be able to conduct research and take risks, and said one of his main concerns is losing the next generation of scientists to other countries or other fields, because they don't have confidence there is a path for them here.

Drugs

EXPENSIVE CANCER DRUGS ON THE RISE: "Merck says its $14.2 billion sale of its consumer health unit to Bayer will allow the company to focus investments elsewhere, specifically naming an experimental cancer-fighting drug as an example for future growth for the company. The Merck deal follows on the sale of other cancer drugs, including Novartis's deal with GlaxoSmithKline, and Pfizer's ongoing pursuit of AstraZeneca, which has a notable stable of cancer drugs. The timing of Merck's sale, announced Tuesday, also comes as new research shows just how lucrative the area is." (Jason Millman, Washington Post)

FDA TO TEST BLOOD PRESSURE DRUGS FOLLOWING COMPLAINTS: Regulators will carry out an extensive study of blood pressure drugs that account for nearly 40 million prescriptions a year, after receiving thousands of complaints from doctors and patients citing ineffectiveness and worrisome side effects. (Anna Edney, Bloomberg News)

PRESCRIPTION DRUG RECORDS GO BEHIND PRIVACY WALL: Citing privacy concerns, some courts and legislators are restricting warrantless police access to prescription drug databases for those they suspect of committing a crime. (Joe Palazzolo, Wall Street Journal)

Politics

HILLARY CLINTON VOICES STRONG SUPPORT FOR ACA: "[The polling] tells the same story: A small majority of Americans don't think they like the Affordable Care Act, but a large majority of Americans don't want to do away with the protections that are in the Affordable Care Act. A small majority wants to repeal it, but that is slowly receding as a rising majority says, 'No, fix it,'" Clinton said at a health conference Tuesday. "This is the tradition of good, old-fashioned American pragmatism." (Katie Glueck, Politico)

STEEP FALL FOR SEBELIUS: The outgoing HHS Secretary was named the number one most influential person in health care last year, yet didn't make the cut for nominees this year, Dan Diamond points out.

Spending

GOOD NEWS ON FEDERAL HEALTH SPENDING: The government now expects to spend $900 billion less on major health care programs -- Medicare, Medicaid, and the health exchange subsidies -- over the next decade than it projected three years ago, according to a new analysis by the Committee for a Responsible Federal Budget. The analysis of Congressional Budget Office data suggests the slowdown is due 80 percent in part to the slow growth in health care costs over the last four years, and 20 percent to specific policy change. (Sarah Kliff, Vox Media)

Demographics

AMERICA IS GETTING OLDER, FASTER: The number of Americans 65 and older is expected to double to 83.7 million -- or a fifth of the nation's population -- by 2050, compared with 43.1 million in 2012, according to a Census Bureau report released Tuesday. The shift to the long-projected older country is accelerating due to declines in fertility and mortality rates, likely leading to big changes for issues like Social Security, health care, and education, (Timothy Williams, New York Times)

Longread

A CANCER DOCTOR ON LOSING HIS WIFE TO CANCER: "When Ruth was first diagnosed with breast cancer, friends would routinely comment to us along the lines of 'It's so good Peter knows so much about this disease.' But others disagreed, imagining I suffered more from my knowledge. Whether I was better or worse off I kept filing away as a pointless academic debate, like wondering if Edna Pontellier's death in The Awakening was a resignation or a liberation, or whether Batman would ever just get over it. But in the lobby of my hospital, I knew the answer: My knowledge was too clear-eyed. I couldn't pretend for another day or hour or minute that there were good days ahead." (Peter B. Bach, New York Magazine)

Happening Today

REVIEW OF THE FY2015 HHS BUDGET: The Senate Appropriations Committee convenes at 10 a.m. in 138 Dirksen to hear from the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services and the Health Resources and Services Administration about the president's proposed health budget.

INSURANCE INDUSTRY HEARING: House Energy and Commerce will hold a hearing titled "PPACA Enrollment and the Insurance Industry," at 10:15 a.m.

HEALTH IT AND PAYMENT MODEL BRIEFING: The Workgroup for Electronic Data Interchange holds a briefing on the progress the health IT industry is making in the creation of payment models under the ACA. Representatives from WellPoint, Christiana Care Health System and QSI - Nextgen HealthCare are scheduled to be in attendance at 1:30 p.m. in 188 Russell.

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Health Care Edge is one of my top resources."

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