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Political Cartoon: 'Don't Give A Fig?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Don't Give A Fig?'" by Lee Judge, The Kansas City Star.

Here's today's health policy haiku:


New miracle drug!
Phrma dubs it "Covfefe" -
Just twelve bucks a cup!

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Summaries Of The News:

Health Law

GOP To Unveil New Version Of Health Bill On Thursday

And the score from the Congressional Budget Office would follow early next week.

The Associated Press: GOP Ready To Try Pushing New Health Bill Through Senate
In the face of unanimous Democratic opposition, the health care bill will crash if just three of the 52 GOP senators oppose it. McConnell suddenly canceled a doomed vote last month on an initial version of the legislation, and at least a dozen Republicans have said they oppose the initial package or distanced themselves from it. Since his June retreat, McConnell has been reshaping the measure in hopes of winning GOP votes. Even so, no GOP leaders were yet predicting passage. (7/12)

Politico: Reeling Republicans Take One Last Shot At Obamacare
New text of the proposal will be made public Thursday, and a Congressional Budget Office analysis is expected on Monday. “We’re in gridlock,” said Sen. John McCain of Arizona. He added sarcastically: “Now we’re going to look at a new approach. And we’re going to get a CBO estimate on Monday. Yay!” Sen. Ron Johnson, a conservative holdout, called it a "political blunder" that McConnell started the health care debate as a partisan, all-Republican effort. (Everett and Haberkorn, 7/11)

NPR: New Senate GOP Health Care Bill To Be Released Thursday
A revised Congressional Budget Office score, showing the costs and impact on coverage of the new version of the bill, is expected on Monday or Tuesday of next week. The CBO score of the first version found that the BCRA would leave 22 million more people uninsured by 2026. (Taylor, 7/11)

Senate's Recess Delayed So Lawmakers Can Tackle Health Care, Clear Legislative Backlog

Senate Majority Leader Mitch McConnell (R-Ky.) announced Tuesday that lawmakers will stick around through the week of Aug. 7.

USA Today: Senate Republicans Delay August Recess To Work On Health Care
Majority Leader Mitch McConnell, R-Ky., said Tuesday the Senate will delay the start of its summer recess to finish action on repealing Obamacare and other priority items. “In order to provide more time to complete action on important legislative items and process nominees that have been stalled by a lack of cooperation from our friends across the aisle, the Senate will delay the start of the August recess until the third week of August,” McConnell said in a statement. (Berry, 7/11)

Politico: McConnell: Senate Will Work Through First Two Weeks Of August Recess
Agitation from the Republican rank and file to cancel at least part of the annual August recess has been building for weeks with a small group of junior GOP senators pressuring their leadership to stick around in Washington to tackle not just health care but tax reform and other items on the party's agenda. (Kim and Everett, 7/11)

The Associated Press: McConnell Nixes Part Of Senate Vacation To Deal With Backlog
It’s not uncommon for backbench lawmakers to demand that a recess be canceled to play catch-up on unfinished work. But such efforts often amount to grandstanding, and most everybody in Washington is privately relieved when vacations aren’t canceled. “If you were going to school and you were getting failing grades in your spring semester, you better stay in school for the summer and go to summer school, not take a recess,” said freshman Sen. Steve Daines of Montana at a Tuesday news conference populated by mostly junior Republicans. (Taylor, 7/11)

The Last Draft Of GOP's Bill Failed -- So What's Different This Time?

Media outlets look at the changes leadership has made to try to woo senators, such as adding the option to let insurers sell cheaper, skinny plans. But one thing that hasn't been touched? The unpopular Medicaid cuts.

The Hill: Senate GOP Outlines Revised Health Bill 
The revisions are aimed at winning over additional support, but it remains deeply in doubt whether the bill can get 50 votes. Importantly, senators said the Medicaid sections of the bill would remain largely unchanged from the initial draft, a blow to moderates who had pushed for easing cuts to Medicaid. That means a new cap on Medicaid spending will still drop after 2025, leading to deeper cuts opposed by moderates. And funds for ObamaCare's expansion of Medicaid will still end in 2024. (Sullivan and Hellmann, 7/11)

The Associated Press: Senate Consumer Choice Idea Could Raise Premiums For Sick
A health care proposal from Senate conservatives would let insurers sell skimpy policies provided they also offer a comprehensive plan. It's being billed as pro-consumer, allowing freedom of choice and potential savings for many. But critics say it would split the sick and the healthy, leading to unsustainably high premiums for people with medical problems and pre-existing conditions, who may get priced out of the market unless taxpayers bail them out. (Alonso-Zaldivar, 7/11)

The Hill: Study: Cruz Amendment Could Raise Premiums For 1.5M With Pre-Existing Conditions 
One and a half million people with pre-existing conditions could face higher premiums under an amendment to the Senate's healthcare bill being pushed by Sen. Ted Cruz (R-Texas), according to a new analysis released Tuesday. The proposed amendment, which is being considered by GOP leadership, would essentially let insurers sell plans that don't meet Affordable Care Act (ACA) requirements as long as they also sell plans that do. (Hellmann, 7/11)

The Fiscal Times: Why Ted Cruz's Health Care Fix Can't Save The GOP's Bill
The Cruz-Lee version of the bill is being touted as a potential compromise that could bring together the warring sides of the GOP by finding a way to satisfy both the most conservative members of the caucus, who want to see the ACA destroyed root and branch, and the more moderate members who don’t want to be accused of throwing millions of Americans off of their health insurance coverage... The Cruz-Lee bill does offer generous subsidies to some Americans, but those aren’t available to people earning incomes that put them above the poverty level but well short of the “middle class.” (Garver, 7/11)

In Effort To Find A Way Forward, McConnell Contemplates Retaining Obamacare Taxes

The revised Senate health bill will likely retain certain taxes on wealthier Americans that helped finance the Affordable Care Act. This step would mark a big step back from a central GOP promise.

The Washington Post: McConnell May Be About To Break A Crucial GOP Promise On Obamacare
Last month, McConnell tried to advance a bill that would have cut future revenues by $700 billion over 10 years by eliminating a number of tax provisions in the ACA. This included a $172.2 billion cut over 10 years by repealing the “net investment tax” and another $58.6 billion by repealing the Medicare Tax Increase. Both of those tax cuts would primarily benefit wealthier Americans. The 3.8 percent net investment tax applied to capital gains and other investments for individuals making more than $200,000 in annual income or married couples making more than $250,000. (Paletta and Ehrenfreund, 7/11)

Bloomberg: GOP Drops Tax Cuts For Big Earners In Revised Health Bill, Sources Say 
Senate Republican leaders dropped provisions that would repeal two taxes on high earners in a revised draft of their health-care bill sent to the Congressional Budget Office, according to GOP senators. Republican leaders are now planning to retain Obamacare’s 3.8 percent tax on net investment income for people who earn more than $200,000 and couples with incomes over $250,000, as well as a 0.9 percent Medicare surtax on the same incomes. (Litvan and Dennis, 7/11)

The Washington Post: The GOP Health Bill Would Cut Benefits For Very Poor Households By An Average Of $2,500 A Year, Economists Say
The typical household with more than $200,000 a year in income would pay $5,500 less annually in taxes under the recent plan put forward by GOP senators. By contrast, households earning less than $10,000 a year would lose out on an average of about $2,600 in federal benefits annually, according to the analysis published Tuesday by the nonpartisan Urban Institute and Brookings Institution. (Ehrenfreund, 7/11)

There's No Real Buy-In From Republicans On Bill Making It Tough To Get To 50 Votes

The response has been tepid at best on the legislation, and lawmakers are struggling to get something they've been promising for seven years out the door. The New York Times offers a look at where they're still divided, while the Los Angeles Times considers what a fix to Obamacare would like.

The Washington Post: The Senate Health Bill Is Almost An Orphan With Few Real Supporters
The Senate did not author the proverb about success having many fathers while failure is an orphan, but the words often typify how senators react to legislation that is struggling to win approval. On Tuesday, after a roughly 90-minute huddle with his caucus, Senate Majority Leader Mitch McConnell (R-Ky.) began his weekly news conference on “the news of the day” — the struggling effort to pass health-care legislation that would repeal and replace portions of the Affordable Care Act. (Kane, 7/11)

CQ Roll Call: Senate GOP Leaders Struggle For Progress On Health Law Repeal
Senate Republicans expect to review two versions of legislation that would roll back the 2010 health care law Thursday, and GOP leaders still hope to bring a bill to the floor next week, though it remains unclear whether 50 Republicans will coalesce around a measure. Senators were briefed during a policy lunch Tuesday on what changes may be included in a revised measure. One version includes a proposal from Sen. Ted Cruz, R-Texas, that would allow insurers to sell policies on the federal exchanges that don’t comply with the health law’s regulations, while the other does not include that amendment. (McIntire, 7/11)

The Fiscal Times: Five Ways Republicans Can Regain Their Mojo On Health Care
The Senate needs to craft a workable bill and get it passed. It does not have to be the best bill ever written – it just has to be better than Obamacare, which improved over time thanks to more than 70 significant changes made to the original legislation and still came up short. The GOP can tinker with their healthcare effort too, as the need arises. (Peek, 7/12)

Los Angeles Times: Obamacare 101: Is There A Smaller Fix For The Affordable Care Act?
With Senate Republicans struggling to find votes for sweeping legislation to roll back the Affordable Care Act, several GOP lawmakers have raised the prospect of a more limited bill — passed with help from Democrats — to stabilize health insurance markets around the country. That may be heresy for conservative Republicans who’ve spent seven years demanding the full repeal of Obamacare, as the law is often called. (Levey, 7/12)

Meanwhile —

Politico: Graham Drafting Alternative Heath Care Plan
Sen. Lindsey Graham said on Tuesday that he’s working with other senators to draft an alternative plan to replace Obamacare — and he hopes to win Democratic support. The surprising comments by the South Carolina Republican come as Senate GOP leaders struggle to come up with the 50 votes necessary to pass their bill to repeal and replace the 2010 health law. (Wright, 7/11)

The Hill: Graham Working On Own Healthcare Plan 
Sen. Lindsey Graham (R-S.C.) is working on his own healthcare plan, his office confirmed Tuesday. Kevin Bishop, a spokesman for Graham, said the plan would take the form of an amendment to the current GOP repeal and replace bill. He did not say whether it would essentially be a substitute for the current bill, which does not appear to have the support to pass the Senate. (Sullivan, 7/11)

Columbus Dispatch: Portman In Crosshairs Of Heated Health-Care Debate
Even by the standards of the traditional D.C. summer, the heat is on Sen. Rob Portman. The Ohio Republican, re-elected easily in 2016, has seen protests inside his D.C. and Columbus offices, including one that spurred arrests over the July 4 recess. He’s been targeted by multiple ads from those urging him to oppose the current Senate health-care bill. And this week, the CEOs of five large Medicaid providers in the state sent a letter urging Portman to remain steadfast in his opposition to the bill. All this for a bill he currently opposes. (Wehrman, 7/12)

Denver Post: Michael Bennet Gives Animated Speech Against GOP Health Care Bill On Senate Floor
A fired-up U.S. Sen. Michael Bennet on Tuesday took to the Senate floor, where he called the GOP’s health care bill a “terrible” piece of legislation that virtually nobody in Colorado supports. The Democrat’s speech came just after Senate Majority Leader Mitch McConnell, R-Kentucky, announced he will delay the Senate’s August recess by two weeks to complete work on health care and other issues. Other Democrats also took to the floor Tuesday to lambaste the Republican legislation as the debate over the contentious bill heats up. (7/11)

Nearly 70 Percent Of Republican Voters Want GOP To Continue Repeal Efforts

The poll also suggests that Republicans want Senate GOP leaders to shift gears and work with Democrats to pass a new health care bill. But a separate poll also finds that health care is not necessarily going to be the only deciding factor in the elections.

Politico: Republican Voters To GOP: Keep Working On Obamacare Repeal
The Republican base wants Senate GOP leaders to continue trying to repeal Obamacare despite recent setbacks, according to a new POLITICO/Morning Consult poll. A clear majority of Republican voters, 67 percent, want the GOP to continue to work to repeal and replace the health care law, compared to only 21 percent who want party leaders to move on. Among all voters, 40 percent want congressional Republicans to continue to work on a new health care bill, and 47 percent want them to move on. (Shepard, 7/12)

Politico Pro: Politico-Harvard Poll: Voters Are Mad About Obamacare Repeal, But Other Issues May Sway Midterms
As Republicans struggle to patch together 50 votes on an Obamacare repeal bill in the next few weeks, the poll results indicate the next congressional election may be settled by a range of issues broader than health care. President Donald Trump’s efforts to protect the country from terrorism (39 percent), his Obamacare replacement effort (37 percent) and his proposed budget (34 percent) will rank among the most important issues when considering which congressional candidate to vote for next year, said registered voters surveyed in the poll. (Millman, 7/12)

Meanwhile, Senate Majority Leader Mitch McConnell (R-Ky.), who is up for reelection in 2020, could feel the ramifications from any potential failure —

The Hill: McConnell’s Health Gambit Ripples In Kentucky 
Senate Majority Leader Mitch McConnell is in a dicey spot in more ways than one when it comes to the Senate’s healthcare bill. If the Kentucky Republican fails in his effort to repeal and replace ObamaCare, his reputation as a master tactician of the Senate will take a hit, with lawmakers second-guessing his decisions on drawing up a bill largely behind closed doors. (Roubein, 7/12)

Ad Campaigns Urge Crucial Senators To Vote Against GOP Health Bill

The AARP, the Democratic National Committee and a trade group for safety-net health plans are launching campaigns targeting key Senate Republicans.

Roll Call: DNC Targets Louisiana, Cassidy On Medicaid Expansion
The Democratic National Committee is launching an ad campaign in Louisiana specifically focusing on Medicaid and putting pressure on one of its senators’ vote on the Republican health care bill. ... The ad comes as the state’s Republican Sen. Bill Cassidy is seen as a crucial vote for the Senate legislation. (Garcia, 7/11)

Morning Consult: Ad Campaign Urges Portman, Capito To Oppose Medicaid Cuts In Health Bill
A trade group for safety-net health plans is launching a six-figure ad campaign urging two key Republican senators to oppose any legislation to repeal and replace the Affordable Care Act that includes cuts to Medicaid. The Association for Community Affiliated Plans is running radio ads this week targeting centrist GOP Sens. Rob Portman of Ohio and Shelley Moore Capito of West Virginia. The ads focus on the potential economic consequences to constituents if they’re taken off their state’s Medicaid rolls. (Reid, 7/11)

The Hill: AARP Ads Target Five GOP Senators On Healthcare Bill 
The AARP is targeting five key Republicans senators in the healthcare debate with new radio and TV ads in their home states. The ads warn that seniors will pay "even more on premiums ... more for prescriptions ... and [your] family's coverage could be taken away" if the Senate GOP's healthcare bill passes. (Hellmann, 7/11)


Alaska To Set Up Reinsurance Program To Protect Consumers From Skyrocketing ACA Premiums

The state says the program will help save the government money in premium subsidies.

The Wall Street Journal: Alaska Gets Approval For Plan To Bolster Health Insurance Markets
The Trump administration on Tuesday approved a plan letting Alaska set up a federally funded reinsurance program to shore up the state’s Affordable Care Act marketplace, a model that other states will likely emulate. The state sought a waiver to use ACA money to reimburse insurers for their costliest customers. Customers receiving the subsidies wouldn’t know the government is footing the bill. (Hackman, 7/11)

In other news, a look at how the Affordable Care Act has affected income inequality and what would happen if it gets repealed —

Bloomberg: Ditching Obamacare May Worsen Income Inequality 
Since the 1970s, as America’s income gap has widened, one of the most powerful drivers of inequality has been the growing cost of health care. The ACA, President Barack Obama’s signature domestic achievement, expanded the safety net for people such as Harrod, who lived one bad turn away from financial disaster, extending coverage to about 20 million Americans and cutting the share of uninsured by almost half since 2013. Soon, it may be a thing of the past. Senate Republicans, having returned from their July 4 break, resumed negotiations to replace Obamacare with legislation that could lead to 15 million fewer people being insured next year, and 22 million fewer by 2026, according to the non-partisan Congressional Budget Office. (Tozzi, 7/11)

Oscar Teams Up With Humana In Pilot Project For Small-Business Insurance In Nashville

The partnership expands the startup insurer's interests beyond plans sold to individual market.

Nashville Tennessean: Humana, Oscar Health To Pilot Small Business Insurance Partnership In Nashville
Humana and Oscar Health, a health insurance startup, will launch a pilot product in January for small-business owners in the Greater Nashville area. Most Tennesseans get insurance through an employer, and leaders of the companies think the Humana-Oscar insurance plan coupled with a consumer-friendly portal would be appealing to business owners who are thinking about offering coverage as well as those who might want to switch carriers. (Fletcher, 7/12)


Former CMS Administrators Press Senate To Delay Making Changes To Medicaid

Andy Slavitt, who worked for President Barack Obama, and Gail Wilensky, who worked for President George H.W. Bush, urge lawmakers to take a more deliberate review of Medicaid issues. "Congress can and should commit to improving and modernizing Medicaid, but the process will take time to develop bipartisan support for the changes that are needed and should not be rushed," they wrote.

Modern Healthcare: Dump Medicaid Changes In ACA Repeal Bill And Consider Them Later, Former CMS Chiefs Urge 
Two former federal health program chiefs, one a Republican, one a Democrat, have proposed a way for Senate Republicans to break through their current logjam in passing a healthcare reform bill—dropping the controversial Medicaid changes for now and considering those issues later. Congress should separate reforms to the Medicaid program from the more pressing task of stabilizing and improving the individual health insurance market, wrote Andy Slavitt, CMS administrator in the Obama administration, and Gail Wilensky, Medicare and Medicaid chief in the George H.W. Bush administration, in a new JAMA Forum piece. (Meyer, 7/11)

The Hill: Healthcare Industry At Odds Over Senate Proposal 
The Senate’s ObamaCare repeal bill has turned the U.S. healthcare industry against itself. Hospitals and doctors have mobilized aggressively against the bill, sending letters to Republican Senate leaders and flooding Capitol Hill with lobbyists. Providers are primarily concerned about the $772 billion the bill would cut from Medicaid. ... On the other side of the debate are large insurers and their lobbying group, America’s Health Insurance Plans. (Weixel, 7/12)

Georgia Health News: Medicaid Adjustment Benefit? Bill Could Give Break To Georgia
Tucked inside the U.S. Senate health care bill is a little-discussed provision that could benefit Georgia, according to a conservative organization. ... the Medicaid overhaul also contains a provision that would allow the U.S. Health and Human Services secretary to adjust the federal Medicaid funding per state by up to 2 percent based on its spending levels. If a state’s per capita Medicaid spending is above the national average by 25 percent or more, its per capita cap would be decreased the following year by 0.5 percent to 2 percent. But if a state is below the average by 25 percent or more, its cap would be increased by 0.5 percent to 2 percent. Kelly McCutchen, president of the Georgia Public Policy Foundation, says that for Georgia, a traditionally low-spending state per Medicaid enrollee, the adjustment formula could bring large funding increases for its elderly and disabled populations. In those areas. (Miller, 7/10)

Pittsburgh Post-Gazette: Last-Minute Changes Would Add Medicaid Work Requirement As Part Of Pa. Budget
Pennsylvania’s Republican-controlled General Assembly is considering significant changes to the state’s Medicaid program. ... Among the changes: requiring the state’s Department of Human Services to seek a waiver for its Medicaid program so it could impose work requirements on able-bodied recipients, “lock in” Medicaid recipients to their managed care plans, and request a waiver from the federal government so it could charge premiums in Medicaid to families with disabled children whose income is above 1,000 percent of the federal poverty income limit. (Giammarise, 7/11)

Indianapolis Star: Advocates To Feds: Don't Let Indiana Impose Medicaid Work Requirement
Indiana could become the first state to require some Medicaid recipients to work, but it is facing a flood of opposition from health groups, advocates for the poor and others. Public comments filed with the federal government have been overwhelmingly against the idea — even as Congress debates whether to give states more leeway in running their Medicaid programs, along with a lot less funding. (Groppe, 7/11)

Boston Globe: Home Health Agency Officials Accused Of Cheating Medicaid
Two employees of a Boston home health care agency have been accused of defrauding the Massachusetts Medicaid program, the latest targets of a crackdown on what state officials say is widespread fraudulent billing within the industry. ... The charges follow an audit by the state’s MassHealth program last year that determined nine home care companies had defrauded the state of almost $23 million. (Feiner, 7/11)

Administration News

Home Health Agency Workers Get Extra Time To Prepare For New CMS Regulation

The Centers for Medicare & Medicaid Services delays the rule by six months. In other news on the agency, its Hospital Value-Based Purchasing program awarded bonuses to some lower-rated facilities, the Government Accountability Offices finds.

Modern Healthcare: CMS Delays Rule To Improve Home Health Agency Care 
Home health agencies are getting an additional six months to prepare for a new CMS rule aimed at improving quality and patient care. The rule, first proposed by the Obama administration, required new training for staff and administrators and more coordination of care. Industry stakeholders asked the CMS for more time to comply with the rule. The CMS responded by delaying the original effective date from July 13 to Jan. 13, 2018. (Dickson, 7/10)

Modern Healthcare: GAO Finds Value-Based Purchasing Program Rewards Lower-Quality Hospitals 
The U.S. Government Accountability Office found that the CMS' Hospital Value-Based Purchasing program provided bonuses for some lower-quality hospitals. The program, which gives Medicare bonus payments to hospitals that reach efficiency and quality benchmarks while decreasing payments for lower performing hospitals, creates incentives for about 3,000 participating hospitals as part of the Affordable Care Act. The GAO found that about 20% of the hospitals that received value-based bonuses between 2015 and 2017 had less than average quality scores. (Kacik, 7/11)

Public Health And Education

Justice To Target Opioid Treatment Programs Exploiting Affordable Care Act Insurance Plans

Sources say arrests will be carried out in cities including Miami, Chicago, Detroit and Los Angeles. Meanwhile, the department has reached a settlement with a pharmaceutical company over its failure to report potential abuse of its drugs.

Bloomberg: Sessions Said To Unveil Health-Care Fraud Crackdown This Week 
Attorney General Jeff Sessions is poised to announce a major law enforcement action this week targeting health-care fraud, focusing on opioid treatment programs exploiting Obamacare insurance plans, according to two people familiar with the matter. In what is described as a nationwide sweep with hundreds of arrests being carried out across the U.S., the Justice Department is cracking down on fraudulent claims made to some of the nation’s biggest insurers, said one of the people. People who run drug addiction treatment centers that have filed bogus claims and those who have filed reimbursement claims for drugs they then sell illegally are among those to be charged, the person said. (Smith, Edney and Schoenberg, 7/12)

And in other news on the opioid epidemic —

Chicago Tribune: Naperville Hospital Tackles Opioid Epidemic 
Edward-Elmhurst Health System recently opened a new medication-assisted therapy clinic for those who want to kick opioid addiction, and the system plans to work with its affiliated health professionals to reduce the number of opioid prescriptions. While previously open for doctor referrals, the clinic at Edward-Elmhurst-affiliated Linden Oaks opened last week to anyone who wants to discontinue the use of heroin and prescription painkillers such as Norco, Oxycodone and Fentanyl. (Baker, 7/11)

Columbus Dispatch: More And More Ohio Drivers Are Impaired By Drugs
The answer to how often an Ohio driver’s blood or urine sample tested positive for fentanyl used to be “never,” says a crime lab chief at the State Highway Patrol. But over the past three months, the powerful synthetic opioid — 50 times stronger than morphine and often mixed with heroin — has been detected in about 1 in 20 patrol tests. (Price, 7/12)

Treatment Using Patient's Own Immune Cells To Fight Cancer May Take Step Forward Wednesday

A Food and Drug Administration advisory committee will decide if it can recommend the "true living drug" that has shown impressive success in some patients to the full agency. In other public health news: syphilis rates, mental health, high-risk pregnancies, alcohol withdrawal and more.

The Washington Post: First Gene Therapy — ‘A True Living Drug’ — On The Cusp Of FDA Approval
When doctors saw the report on Bill Ludwig’s bone-marrow biopsy, they thought it was a mistake and ordered the test repeated. But the results came back the same: His lethal leukemia had been wiped out by an experimental treatment never before used in humans. “We were hoping for a little improvement,” remembered the 72-year-old retired New Jersey corrections officer, who had battled the disease for a decade. He and his oncologist both broke down when she delivered the good news in 2010. “Nobody was hoping for zero cancer.” (McGinley, 7/11)

USA Today: Syphilis Rates Are Rising, And Dating Apps May Be Playing A Role, Experts Say
Syphilis, a disease most people associate with the past, has returned with a roar, and public health experts think the rise in rates can be attributed at least partly to social media. Infection rates are the highest they have been in 20 years, said David Harvey, the executive director of the National Coalition of STD Directors. From 2014 to 2015 alone, the number of syphilis cases reported to the Centers for Disease Control and Prevention (CDC) rose by 17.7%, from 63,453 to 74,702. (Toy, 7/11)

NPR: Paid Peer Support Is Helping To Fill Treatment Gaps For Some With Serious Mental Illness
Recovery coaches and peer mentors – known in Alcoholics Anonymous as "sponsors" — have for decades helped people who are addicted to alcohol or drugs. Now, peer support for people who have serious mental illness is becoming more common, too. Particularly in places like Texas, where mental health professionals are in short supply, paid peer counselors are filling a gap. (Silverman, 7/11)

USA Today: Mental Health Day Tweet Shows What's Wrong With Mental Health Care
The Internet is fixated on a boss’s reply to an employee who took time off for her mental health, and the viral response reveals much of what is right and wrong about mental health care in America. Madalyn Parker, a Michigan web developer at live-chat platform Olark, who suffers from depression and anxiety, sent an email to her team saying she’d be off for two days to focus on her mental health. Afterward, her boss thanked her for the candor. She shared the exchange on social media in late June, and it's now been retweeted more than 12,000 times. (Dastigar, 7/11)

Kaiser Health News: Women With High-Risk Pregnancies Far More Prone To Heart Disease
Women who have high-risk pregnancies or complications in childbirth are up to eight times more likely to suffer heart disease later in life. And many mothers — and their doctors — are unaware of the danger. Emerging research shows heart disease is a long-term threat for women who develop diabetes or high blood pressure during pregnancy, for example, or those whose babies are born prematurely or precariously small. (Gorman, 7/12)

The New York Times: High-Intensity Workouts May Be Good At Any Age
Abbreviated, intense workouts may help people of any age become healthier, a new study of old mice that ran on treadmills suggests. Although the experiment involved rodents, not humans, the study found that old mice can tolerate high-intensity interval training and rapidly gain fitness and strength, even if they start off frail and exercise for only a few minutes a week. (Reynolds, 7/12)

The Washington Post: Real-Time Testing Of Drugs At Music Festivals Shows ‘Molly’ Often Isn’t ‘Molly’
Scientists, public health experts and volunteers working with them have started to show up at music festivals, concerts, raves and other public gatherings where illicit drugs are frequently used. Equipped with special chemical testing kits, they help attendees test pills and powder for purity in real time so that people can make better-informed decisions about whether to take them. (Cha, 7/11)

With Smoking In Movies On Rise, Experts Want All Films With Tobacco Use To Get An R-Rating

They say there's evidence that strongly suggests that depictions of smoking in movies can lead to youth smoking.

The New York Times: Tobacco Gets More Screen Time In Blockbuster Movies, Study Shows
Tobacco is appearing more in blockbuster movies, raising public health concerns, a new study finds. Depictions or suggestions of tobacco use in top-grossing movies rose 72 percent from 2010 to 2016, according to the report, published by the Centers for Disease Control and Prevention. The increase was especially large among top-grossing movies with R ratings, which saw a 90 percent rise in tobacco-use imagery, though researchers noted with special concern that movies rated PG-13 also saw a sizable increase: 43 percent. (Chokshi, 7/11)

Los Angeles Times: To Combat Teen Smoking, Health Experts Recommend R Ratings For Movies That Depict Tobacco Use
The study’s primary aim was to assess Hollywood’s progress in keeping “tobacco incidents” out of the movies most likely to be seen by America’s kids and teens. Researchers who focus on this area define such incidents as “the use or implied use of a tobacco product (cigarettes, cigars, pipes, hookah, smokeless tobacco products, and electronic cigarettes) by an actor.” If two characters are smoking during a conversation, that counts as two tobacco incidents. If one of those characters is holding a pack of cigarettes in another scene, that qualifies as another incident. (Kaplan, 7/11)

State Watch

State Highlights: Calif. Invests $5 Million In Diabetes Prevention Effort; Mass. Optometrists Continue Push For Scope-Of-Practice Changes

Media outlets report on news from California, Massachusetts, Michigan, Connecticut, Florida, Wisconsin and Missouri.

Los Angeles Times: With Diabetes Rising At Alarming Rate, California Puts Money Behind Prevention Campaign
California officials decided this week to dedicate $5 million to prevent people at high risk for diabetes from getting the disease, hoping to stem the huge numbers of Californians expected to be diagnosed in the coming years. Currently 9% of Californians have diabetes, but a study last year found that 46% of adults in California have prediabetes, a condition in which blood glucose levels are higher than normal but not high enough to be considered diabetic. (Karlamangla, 7/11)

Boston Globe: Mass. Optometrists Have All Eyes On Reforms
The Senate leadership had again approved a measure allowing them to prescribe medication for glaucoma and eye infections, tasks normally handled by ophthalmologists... But it was missing from the final package last week — despite another lobbying push from the optometrists and a radio ad campaign. (Chesto, 7/11)

San Jose Mercury News: Stanford Hospital Workers Highlight Hospital-Acquired Illness
Citing detailed federal data, Stanford Hospital union workers on Tuesday said patient and worker safety at the hospital is in jeopardy due to the risk of acquiring infections on site. At a news conference in front of the hospital, union leaders said the hospital system has been losing money since 2016 after the federal government reduced Stanford’s Medicare reimbursements​ 1 percent​ through 2017 as a result of the high infection rate. (Lee, 7/11)

The Associated Press: Michigan Imposes Prison Term For Female Genital Mutilation
Doctors, parents and others involved in female genital mutilation in Michigan will face up to 15 years in prison under new laws signed Tuesday that were sparked by an ongoing criminal case involving six young girls. The legislation stemmed from a federal case against six people connected to an India-based Muslim sect called Dawoodi Bohra who are accused of being involved in the genital mutilation of two girls from Minnesota and four from Michigan. The procedures were allegedly carried out by a doctor at a clinic in suburban Detroit. (7/11)

Stat: Iranian Scientist Traveling To Boston For Cancer Research Is Detained
An Iranian cancer researcher traveling to the U.S. to work as a visiting scholar at Boston Children’s Hospital has been detained with his wife and three children at Boston Logan International Airport. The researcher, Mohsen Dehnavi, holds a visiting work visa that was issued in May. His detainment comes just two weeks after the Supreme Court ruled that the Trump administration could largely enforce an executive order that would ban people from six Muslim-majority countries, including Iran, from entering the U.S. The court also ruled that the ban couldn’t apply to visitors who already held valid visas. (Thielking, 7/11)

The CT Mirror: ‘Connecticut In The Capitol’ Focuses On Health Care, Attacks On The Press
Dozens of Connecticut officials, business executives, policymakers and leaders of non-profits are here for two days to network and try to figure out what Congress and the federal government are doing, which is stumping even the most knowledgeable insiders lately. About 140 Connecticut residents accepted the invitation of Sens. Richard Blumenthal and Chris Murphy to attend a series of seminars on Tuesday and Wednesday as part of the “Connecticut in the Capitol” event. (Radelat, 7/11)

Sacramento Bee: CA Community Clinics Could Get $20 Million To Stay Open
On Monday, Gov. Jerry Brown signed the budget-related bill that included $20 million for 80 one-time emergency grants to help the clinics get by while they find long-term funding solutions so the more than 4 million Medi-Cal beneficiaries who get their care from community clinics still receive services. The grant program is an effort to preempt drastic changes to the nation’s longest-running health support system, providing funding for core operations at clinics that would be affected by cuts to Medicaid. (Svirnovskiy, 7/12)

St. Louis Post Dispatch: Meramec State Park Employee Dies After Catching Mysterious Tick Illness 
Tamela Wilson died June 23 from complications of the Bourbon virus, which she likely caught from a tick bite at Meramec State Park where she worked. A week later, the state Department of Natural Resources announced the park was “an area of interest” in an investigation of a case of Bourbon virus, and ticks were being collected for testing. The state health department confirmed the same day that a resident had contracted the virus, but did not mention the death. (Bernhard, 7/11)


Pharma's Money-Back Guarantees Sound Nice, But Experts See Them As A Ploy

News outlets report on stories related to pharmaceutical pricing.

The New York Times: Considering The Side Effects Of Drugmakers’ Money-Back Guarantees
More than a decade ago, Italy tried a novel approach to help bring down drug costs: asking pharmaceutical companies to return money to the national health system if some of their medicines failed to work as expected. The effort largely flopped. The Trump administration is now considering whether to encourage a similar approach. Pharmaceutical executives presented the idea to President Trump at a meeting in January, and the general concept was raised last month in a draft executive order aimed at combating rising drug prices. (Thomas and Ornstein, 7/10)

The Wall Street Journal: The Price Dilemma Over A $16,000 Drug
Novartis AG recently discovered that a drug it sells for a group of very rare diseases could be used to treat a much more common ailment. There is just one problem: its $16,000-per-dose price tag. The drug, called ACZ885, is already sold under the brand name Ilaris for certain rare inflammatory disorders affecting a very small number of people. But a recent clinical trial suggests it could also reduce the risk of serious complications like strokes in people who have suffered a heart attack. (Roland, 7/12)

The New York Times: The Private Equity Firm That Quietly Profits On Top-Selling Drugs
Cashing in on rising drug prices often unleashes an outcry from consumers and politicians. But a little-known private equity investor, Royalty Pharma, has built an unusual investment portfolio valued at $15 billion — it buys up the rights to royalties on future drug sales — while largely avoiding public controversy. By its own count, Royalty Pharma owns partial rights to seven of the 30 top-selling drugs in the United States, including giants like Humira, the arthritis treatment that is the single biggest-selling medication in America. And its deals have been getting larger. (Smith, 7/8)

Stat: A Proposal Would Limit Prices On Meds Developed With Defense Dollars
A U.S. senator is trying to lower prices for medicines that are discovered with taxpayer dollars, and his effort amounts to a new twist to unraveling a complicated controversy that has embroiled the U.S. Department of Defense, large drug makers, numerous lawmakers, and consumer groups. (Silverman, 7/6)

The CT Mirror: Malloy Signs Pharmacy Bill — And A Withering P.S.
Gov. Dannel P. Malloy signed a consumer-protection bill into law Monday, but not before penning an unusual letter reviving his criticism of how the law’s influential sponsors, the top Democratic and Republican leaders of the Senate, rebuffed his insurance commissioner’s efforts to shape a bipartisan measure intended to cut the cost of prescription drugs... Senate Bill 445 will outlaw “gag clauses” in pharmacy benefit-manager contracts that now bar pharmacists from telling consumers when they could save money by paying out of pocket for generic drugs that can cost less than the co-pay for a covered brand-name drug. (Pazniokas, 7/10)

Boston Herald: Legislation Aims At Drug Price-Gouging
State lawmakers are waging war against skyrocketing drug prices — backed by powerful patient groups and doctors — with legislation that would pinpoint and investigate the costliest medications from inhalers to diabetes treatments. “It’s about time,” said Dr. Zoe Tseng, a Brigham and Women’s Hospital doctor who has testified in favor of the bill. “Even as doctors, we have no idea if a medication will be covered or if it’ll be reasonably priced. Sometimes it just feels like a game.” (Kalter, 7/12)

Lowell Sun: As Drug Prices Rise, Lawmakers Continue Search For Solutions
Amid efforts at the state level to find a way to control health care costs, prescription drugs have been singled out as one of, if not the, biggest drivers of growth in spending for consumers and businesses. But whether increasing transparency of drug pricing can serve as a catalyst for lower prices, or if the market itself can be trusted to respond to public pressure remains a point of contention. (Murphy, 7/11)

Stat: U.K. Pharma Trade Group Sues Government Over New Drug Cost Test
Drug makers in the United Kingdom have gone to court in hopes of preventing the country’s National Health Service from imposing pricing limits on medicines. The Association of British Pharmaceutical Industry is responding to a move by the government to limit funding for any prescription drug that will cost the NHS more than roughly $25 million in any of the first three years of use. (Silverman, 7/11)

CBS News: What You Can Do To Help Lower Prescription Drug Prices
A new survey suggests some Americans could do more to cut the cost of their prescription drugs. The University of Michigan poll shows 27 percent of people between ages 50 to 80 call the cost of their medications a burden, and only 51 percent say they bring it up with their doctor. But for those who did discuss the issue, 67 percent say their physician recommended a drug that cost less. Thirty-seven percent also got similar recommendations from pharmacists. (7/6)

Stat: FDA Rejects Ocular Therapeutix Eye Drug, Citing Manufacturing Issues
Ocular Therapeutix failed for a second time to secure approval of its eye drug Dextenza. On Tuesday, the FDA rejected the drug, citing unresolved problems with manufacturing and quality control testing. Shares of Ocular were halted at $7.60 in Tuesday’s after-market session. The company has approximately $2 per share in cash on hand. As previously reported by STAT, FDA inspection of Ocular’s manufacturing facility raised concerns about batches of Dextenza contaminated with particulates, including aluminum. (Feuerstein. 7/11)

Stat: Teva Says Former Exec Gave Trade Secrets To Boyfriend — Who Runs Apotex
A former Teva Pharmaceuticals executive allegedly shared a raft of trade secrets with the head of a rival generic drug maker — who happened to be her boyfriend, according to a lawsuit by the Israeli company. Barinder Sandhu, who worked as senior director of regulatory affairs for Teva in New Jersey, made copies of numerous documents that she gave to Jeremy Desai, who heads Apotex, a generic drug maker based in Canada, according to the lawsuit, which was filed in federal court last week in Philadelphia. (Silverman, 7/11)

Stat: Gilead Faces Whistleblower Lawsuit Over Contaminated HIV Drugs — Again
In a setback for Gilead Sciences, a federal appeals court reinstated a whistleblower lawsuit filed by two former employees, who accused the company of misleading regulators about contaminated ingredients used in various HIV medicines and falsifying data to win marketing approval for the drugs. In arguing their case, which was filed in 2011, the former employees alleged Gilead defrauded the government, because the company did not disclose its drugs were defective and, as a result, federal health care programs paid billions of dollars for contaminated medicines/ (Silverman, 7/11)

Stat: FDA Approves First New Sickle Cell Drug In 20 Years
The FDA approved a new medicine Friday to reduce the complications associated with sickle cell disease, a rare blood disorder. The drug, Endari, is made by privately held Emmaus Medical and is the first new treatment for sickle cell disease to secure FDA approval in almost 20 years. However, the active ingredient in Endari — L-glutamine — is an old chemical that can be purchased over the counter, which could complicate Emmaus’s ability to obtain insurance coverage. (Feuerstein, 7/7)

Perspectives: More Transparent Pricing System Would Help Untangle Confusion Around High Costs

Read recent commentaries about drug-cost issues.

Forbes: Price Transparency Is Critical To Drug Pricing Solutions
Prescription drug costs are a hot political issue, not as much because of the share of the U.S. health care dollar they consume but because consumers pay a larger share of their drug costs out of pocket than they do for other health care. The lack of price transparency for prescription drugs is a large part of the problem, and making pricing more transparent throughout the process could help in finding viable solutions. (Grace-Marie Turner, 7/11)

Business Insider: Trump Drug Refund Policy Doesn't Work
Last month we got a glimpse at what's inside the Trump administration's draft executive order to control drug pricing, and overall it was a pretty big win for drug companies. They would be in line to get more power to charge monopoly prices overseas and be allowed to give even fewer discounts to hospitals with poor patients. (Linette Lopez, 7/11)

The Baltimore Sun: Marylanders Misled By Drug Pricing Bill
In May, Maryland Attorney General Brian Frosh declared victory when the General Assembly passed House Bill 631, giving him the power to sue certain drug companies for “excessive” price increases. In doing so, unfortunately, Marylanders were misled about these new powers to police drug prices. In reality, this legislation will decrease competition and raise prices, neither of which will benefit patients, employers or taxpayers in the state. (Chester Davis, 7/11)

JAMA: Value-Based Pricing And State Reform Of Prescription Drug Costs
Faced with increasing prescription drug costs and congressional gridlock, some states have enacted meaningful reforms. In April 2017, New York State became the first public payer in the United States to authorize limits on prescription drug costs based on their therapeutic benefits.1 Under its new budget legislation, the state can identify high-cost drugs, determine a value-based price, and use enhanced powers to negotiate supplemental rebates to achieve this target price for its Medicaid program. (Thomas J. Hwang, Aaron S. Kesselheim and Ameet Sarpatwari, 7/10)

Bloomberg: Celgene Is Tardy To This Cancer-Drug Party
For once, Celgene Corp. is late to the party. Celgene's frequent and aggressive pursuit of partnerships with other companies is one of its hallmarks. It's helped power the biotech to a $100 billion market cap from near $30 billion five years ago. But its latest deal, announced Wednesday evening -- a potential billion-dollar-plus tie-up with BeiGene Ltd. of China, to access an immune-boosting cancer drug candidate -- won't do much to enhance its dealmaking reputation. (Max Nisen, 7/6)

San Antonio Press-Express: Taxpayers Paid For The Research, Deserve Low Drug Prices
When American taxpayers finance drug research, they have earned the right to buy the resulting medication for a reasonable price. ... Instead, taxpayers’ wallets are hit twice for too many medications — once when they pay for drug research through their hard-earned tax dollars and again when a pharmaceutical company, which used that research, engages in price gouging. (Rep. Lloyd Doggett, R-Texas, 7/5)

Editorials And Opinions

Viewpoints: Reasons To Defend Medicaid; For Congress, Recess Isn't The Problem... It's The Games

Opinion writers offer their analysis of the ongoing debate on Capitol Hill and across the country over health care reforms and issues.

The New York Times: Don’t Assume That Private Insurance Is Better Than Medicaid
As we recently wrote, it’s better for patients to have Medicaid than to be uninsured, contrary to critics of the program. But is having Medicaid, as those critics also say, much worse than having private insurance? This idea has become a talking point for conservatives who back big changes to Medicaid, as the Senate health bill proposes. The poor would benefit simply by being ushered off Medicaid and onto private insurance, they write. (Aaron E. Carroll and Austin Frakt, 7/12)

The Washington Post: Republicans Trying To Destroy Medicaid Have Only Made It Stronger. Take Note, Democrats.
This debate over health care has educated the entire country about what Medicaid does. The prospect of millions losing their coverage has helped make the Republican health-care bill the most unpopular piece of legislation in recorded history, with polls showing it supported by as little as 12 percent of the public. ... The disaster of the Republican plan has opened the door for Democrats to advocate for more sweeping change to the health-care system in order to cover everyone and rein in costs. And the next wave of Democratic proposals is unlikely to center on complex, technocratic fixes to the existing system the way the ACA was. (Paul Waldman, 7/11)

New Orleans Times-Picayune: Medicaid Expansion Is Key To Healthier Louisiana
Almost 22 percent of Louisiana residents had no health insurance in 2013. Today, that number has fallen to 12.7 percent, according to state statistics. That is a dramatic change and could be transformative for people who are newly insured. The main reason for the improvement in coverage, Gov. John Bel Edwards said Friday, is that more people here have access to Medicaid. ... U.S. Sens. Bill Cassidy and John Kennedy should think of those Louisianians as they consider health care legislation proposed to replace President Barack Obama's Affordable Care Act. (7/12)

Miami Herald: Frontline Caregivers Predict Tragedy In Senate’s Proposed Medicaid Cuts
Frontline healthcare workers in South Florida are performing their jobs in fear. Doctors, nurses, nursing-home staff and other dedicated caregivers are in distress over the GOP’s healthcare plan that will make Miami Ground Zero for lost coverage and Trumpcare tragedy. In particular, the proposed $800 billion Medicaid cut will deliver special pain to local seniors, children, disabled, veterans, and many others. In Florida, almost 4 million residents are enrolled in Medicaid, 60 percent of whom are children. More than 60 percent of long-term care and nursing-home costs are covered by the program; and 675,000 elderly Floridians rely on Medicaid supplements to their Medicare coverage. (Monica Russo, 7/10)

Roll Call: Don’t Skip The Recess, Skip The Games
The reality, of course, is that it’s not Democrats slowing down progress on the health care bill, but Republicans, whose wildly diverse state populations are leading them to have wildly diverse reactions to the legislation that came over from the House in June. More broadly, the hurdle to moving legislation through the Senate right now also has nothing to do with how many days they’re in session. Instead, it has everything to do with what the Senate is doing (or not doing) while they’re in session. (Patricia Murphy, 7/12)

Louisville Courier-Journal: Consumer Not King - Rand Paul's Association Plans Worsen Protections
In a recent press conference and op-ed "Make the consumer king" in the Courier-Journal, Sen. Rand Paul proposed expanding the “association health plan” (AHP) provision in the Senate health repeal bill, claiming it would help ensure “every Kentuckian” can have “good, inexpensive coverage” and protections like those for pre-existing conditions. In fact, his proposal would create a race to the bottom on such protections that would worsen problems with affordability and leave more Kentuckians at risk in plans that do not cover the treatments they need for better health. (Ashley Spalding, 7/10)

Arizona Republic: Jeff Flake Trades Sick People For Votes
[Sen. Jeff] Flake says he now backs an amendment by Sen. Ted Cruz that is meant to rescue the Republican replacement bill for the Affordable Care Act... Cruelty to our most vulnerable brothers and sisters apparently is considered a necessary position for any candidate hoping to win the Republican senatorial primary in Arizona in 2018, a sad and sorry situation if true. (EJ Montini, 7/11)

The Kansas City Star: When Will The Senate Really Get To Work On Health Care?
We look forward to the day when the U.S. Senate finally turns its attention to health care. And no, we’re not talking about the current Republican bill beloved by next to no one. That’s for good reason. It’s a deceptively named tax cut that would solve exactly none of the current system’s problems, but would be quite effective if the goal were to make a flawed health care system far worse. So by all means, vote that hodge-podge of bad ideas down, and never look back. (7/10)

The Associated Press: Death As A Social Privilege? How Aid-In-Dying Laws May Be Revealing A New Health Care Divide
The California Department of Public Health has just released a report that detailed the number of terminally ill patients over the past year who took advantage of the California End-of-Life Options Act (EOLA), a law that allows certain patients to request a lethal dose of medication to end their lives. This report comes a year after EOLA went into effect on June 9, 2016. (Jill D. Weinberg, 7/11)

The Charlotte Observer: Denial No Longer An Option At Mecklenburg Health Department
Serious and widespread problems have festered in Mecklenburg County’s Health Department for far too long, and plenty of people share the blame. But now county commissioners and County Manager Dena Diorio have an opportunity to make things right. Commissioners meet Tuesday to discuss internal and external reports that detail troubles within the department that have directly affected the quality of patient care. They and Diorio should use this opportunity not to be defensive or continue their political sniping, but to get serious about fixing one of local government’s most essential functions. (7/10)