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Morning Briefing

Summaries of health policy coverage from major news organizations

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Thursday, Feb 2 2017

Full Issue

Viewpoints: Obamacare's Popularity Goes Up Even As It Might Go Away; Why The GOP Says Undoing The ACA Puts Patients First

A selection of opinions on health care from around the country.

When the Affordable Care Act passed Congress in 2010, more Americans disliked it than liked it. And that was the pattern in public opinion for the next six years. But since Donald J. Trump, who promised to repeal the law, was elected president, that long-held pattern has begun to shift. In a variety of recent polls, with questions asked in different ways, more Americans are now saying they favor Obamacare than oppose it. (Margot Sanger-Katz and Haeyoun Park, 2/1)

Everywhere you turn, health markets are nearing collapse. It鈥檚 an unfortunate and catastrophic reality of too much federal intervention in our health care. From soaring deductibles and skyrocketing premiums to fleeing insurers, it鈥檚 no wonder patients are paying more out of pocket each year under the so-called 鈥淎ffordable Care Act.鈥 Today, the Energy and Commerce Committee鈥檚 Health Subcommittee will examine four legislative solutions to help deliver relief. Together, the bills will play an important role in being among the first bricks placed in the rebuilding of our health care system. Collectively, they will give patients relief from the law鈥檚 soaring costs, tighten enrollment gaps, and protect taxpayers. (Reps. Larry Bucshon, R-Ind., Marsha Blackburn. R-Tenn., Bill Flores, R-Texas, and Greg Walden, R-Ore., 2/2)

President Trump and Republican members of Congress charge full speed ahead with repealing and replacing Obamacare, [a reader] asks: 鈥淲hat is the current state of congressional reps鈥 coverage?鈥 Another way of phrasing that might be: Aren鈥檛 these guys shooting themselves in the foot? (David Lazarus, 2/1)

this era in which the聽Orwellian manipulation of language by politicians to聽say聽the opposite of what they mean has reached a fever pitch, we should be especially wary when conservatives hide their plans to cut Social Security and Medicare benefits behind a smokescreen of euphemism.聽Jared Bernstein, a fellow at the Center on Budget and Policy Priorities and a former chief economist to Vice President Joe Biden, has put in a plea to journalists to call out policy makers when they pull this stunt鈥攁nd not to empower politicians by doing the same thing. (Michael Hiltzik, 2/1)

Today, the Senate Finance Committee advanced President Donald Trump鈥檚 nominee for Secretary of Health and Human Services, Tom Price (R-Ga), to a full Senate vote. Not a single Democrat was present. We as medical students at Price鈥檚 alma mater, University of Michigan Medical School, share many of the concerns that prompted the boycott, which Democrats implemented following a report from the Wall Street Journal that Price had falsely denied purchasing 鈥減rivileged鈥 stock options during his testimony before the Senate Finance Committee. As Senator Elizabeth Warren pointed out during the hearing, Price鈥檚 broader decision to 鈥渁ctively trade in health stocks while writing policy that could affect them raises serious questions about potential conflicts of interest and about [his] judgment.鈥 (Ilana Fischer, Kathryn Brown and Nithya Vijayakumar, 2/1)

Healthcare experts have been warning that Republican dithering on a replacement for the Affordable Care Act would be a further discouragement for participating insurance companies. Now, the first shoe has dropped: Aetna, which sharply聽reduced its ACA footprint this year, is signaling that it will be entirely out of the market in 2018. (Michael Hiltzik, 2/1)

The entire health-insurance industry is in limbo. But Anthem Inc. seems happy there.聽As its peers run聽screaming from the Affordable Care Act -- over which Republicans聽are looming with a knife and a tax-cutting gleam in their eyes --聽Anthem is sticking around in the ACA's individual exchange market. Anthem, which reported earnings on Wednesday that topped Wall Street forecasts, still聽thinks it can break even or profit聽on ACA plans in 2017. And it's holding out hope for fixes that will let it stay into 2018. Neither of those things is likely to be true. (Max Nisen, 2/1)

President Donald Trump and the Republican-controlled Congress are considering proposals to convert funding for Medicaid into a block-grant program. While this could produce expenditure predictability and lower costs for the federal government, such an approach raises questions for states and the program's core mission, as well as concerns over efficiency, accountability and equity. (Dr. Patricia Gabow, 2/1)

Is Medicaid鈥檚 long-term care benefit a zero-sum game where limited resources are shifted from one beneficiary to another? For instance, could the government significantly increase long-term care benefits for some by barring people from using spousal annuities to qualify for Medicaid? Or should resources be expanded to provide all eligible seniors and younger people with disabilities the care they need? Those contrasting views, divided along partisan political lines, were on full display today at the House Energy and Commerce Committee. (Howard Gleckman, 2/1)

Early in his presidency, Barack Obama invested his political capital in a push to reform the health insurance system. Universal coverage was a long-held liberal priority. It was not, however, the priority of most Americans during the Great Recession. Although Obama succeeded in passing the Affordable Care Act, he paid an immense political price. His choice to focus on healthcare 鈥 and therefore sideline economic initiatives 鈥 led to his party鈥檚 historic losses in Congress and undercut Democrats鈥 appeal to many working-class voters who went on to support Donald Trump. (David Paul Kuhn, 2/2)

These are difficult days for those of us who have advocated for pay-for-performance (P4P) as a policy tool to improve health care quality. The idea behind P4P has always been simple: physicians and hospitals should be financially rewarded for providing high-quality care and financially penalized for providing low-quality care. Although this idea has been around for some time, it gained national traction over the past decade, as policy makers pushed toward paying for 鈥渧alue鈥 and not just volume. ... Six years after the ACA鈥檚 passage, the evidence on P4P in general is largely mixed, and the evidence on Hospital Value-Based Purchasing (VBP), the national hospital P4P program, is discouraging. (Ashish K. Jha, 2/1)

Surprise medical bills occur when patients cannot avoid being treated by providers outside their health plan鈥檚 contracted network 鈥 either because the provider is not chosen by the patient, for example the emergency department physician or the anesthesiologist assisting a surgery, or because patients are not even aware that the provider is involved in their care, such as a pathologist examining a biopsy. (Loren Adler, Mark Hall, Caitlin Brandt, Paul B. Ginsburg and Steven Lieberman, 2/1)

The new year is already underway and we expect both a new Republican-dominated Congress and President Donald Trump to bring ambitious policy changes to health care. With significant pent up energy among the Republicans and a limited 18-month window for legislation, lawmakers will be in an immediate all-out policy-making mode. This is particularly true for health care, which many in Congress consider a top issue on the docket. With an eagerness for change, health care is in flux, and difficult decisions will need to be made that will directly affect Americans both socially and economically. In this world, many are left wondering what to expect in 2017. Here are the top five health care trends to watch in the New Year. (Susan DeVore, 2/1)

Liza Bernstein survived breast cancer three times. But it took all she had. She lost her home and savings to the costs of tests and treatments. She's not technically bankrupt -- but that's only because she "couldn't afford the fees" to file the claim. Liza recently told her story to journalists at Seattle's Fred Hutchinson Cancer Research Center and explained why her medical bills proved ruinous. Insurers "kept increasing my out-of-pocket costs and my deductible and they kept reducing how much they would reimburse and the network so there was more chance I'd be out of network," she said. (Kenneth Thorpe and Patricia Goldsmith, 2/1)

While Suboxone is meant to help addicts, it鈥檚 spawning a new drug trade in correctional facilities.聽It鈥檚 time for government leaders to consider finding a new 鈥減referred鈥 burprenorphine treatment that is less concealable and will not find its way into our correctional facilities so easily. (Richard Jones, 2/1)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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