Daily on Healthcare, sponsored by SBEC: Deadline closes in on Obamacare open enrollment

By | December 13, 2019

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DEADLINE CLOSES IN ON OBAMACARE OPEN ENROLLMENT: The last day to sign up for marketplace coverage is Sunday, at least in most states. This open enrollment under healthcare.gov was rocky on the first day due to technical glitches, but so far it’s chugging right along, with 2.9 million signups so far.

While it’s slightly behind last year’s enrollment, it’s important to remember that a lot of people simply don’t like shopping for health insurance, so they leave their account alone and get automatically re-enrolled at the end of the signup period.

That probably isn’t the best option, because they may be able to find a less expensive plan if they took a look at their options, but in general there has been a huge surge each year at the very end as people are rolled automatically into the same or similar plans.

Here’s something we noticed this year: Centers for Medicare and Medicaid Administrator Seema Verma, who is opposed to Obamacare but oversees the open enrollment period in her role, has been tweeting about the signup period more frequently this year than in the other years she oversaw the program.

What we’re watching next:

* Did states that invested in the law have better enrollment? Some states added a fine on the uninsured and put a lot of money into getting the word out about open enrollment. California even boosted subsidies, and its open enrollment doesn’t end until Jan. 31.

* How many people paid premiums? We won’t know until about a month after open enrollment ends. That’s one thing about auto-enrollment: Some people may end up getting charged more than they used to pay — either the plan changed or their income changed — and they end up dropping out.

* How many more stories will we see about people with insufficient coverage? The Trump administration allowed people to buy plans outside of Obamacare’s rules, such as short-term plans, that don’t have to cover pre-existing conditions. That has caused some confusion and expensive bills among people who tried to escape Obamacare’s higher premiums, or who didn’t realize they weren’t buying a plan from the exchange.

What every health reporter is watching: A decision on the constitutionality of Obamacare from the 5th Circuit. Last year, Federal Judge Reed O’Connor ruled just a day before the end of open enrollment that the entire law could be thrown out as a result of Congress zeroing out the fine on the uninsured, which he said was key to making the rest of the law work.

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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.

GRASSLEY: ‘NOW THE SENATE MUST ACT’ ON DRUG PRICES: Finance Committee chairman Chuck Grassley urged the Senate to take up his committee’s bipartisan drug pricing legislation shortly after the Democrat-controlled House approved its partisan measure that would authorize the government to negotiate the prices of 50 of the most expensive medicines. Republicans are against direct negotiation, so Grassley said the House bill “misses the mark” because it would lead to fewer drugs getting developed, but he’s trying to put pressure on the upper chamber to act on the issue soon. “Any solution must be bipartisan if it’s going to stand a chance of becoming law… the moment is ripe for compromise,” he said.

WHAT PHRMA HAD TO SAY ABOUT THE HOUSE BILL: The Pharmaceutical Research and Manufacturers of America, which represents the prescription drug industry, called the bill “unprecedented in size and scope” and warned that it would reduce revenue to the industry by $ 1 trillion, costing between 30 and 100 cures and treatments. (The Congressional Budget Office projected it would result in 38 fewer medicines over 20 years, but that was an earlier score of the bill that came before last-minute changes.)

They’d rather payers take the hit. The industry supports capping out-of-pocket costs in Medicare and overhauling the business model of pharmacy benefit managers, the middlemen that negotiate rebates and costs.

FCC APPROVES SUICIDE HOTLINE: The Federal Communications Commission has approved 988 as the number people should dial when they’re having suicidal thoughts, and now the idea is headed for a 60-day public comment period. Trump signed a bill into law last year that authorized the agency to take a look at a new number, given that people now tend to dial 911, and that the current, 10-digit number (1-800-273-TALK) is harder for people to remember. The new number comes as suicides, the 10th leading cause of death in the U.S., have climbed 30% in two decades.

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SENATE CONFIRMS HAHN TO LEAD FDA: By a vote of 72-18, the Senate on Thursday confirmed Dr. Stephen Hahn, an oncologist and top official at MD Anderson Cancer Center in Houston, as Commissioner of the Food and Drug Administration. Hahn will enter a maelstrom of critical healthcare issues when he takes the job. Those include the teen vaping epidemic, which he said at his confirmation hearing was an “important, urgent crisis,” but didn’t commit to any specific policy approaches.

Amid dispute, health chiefs tweet out their congratulations. They stressed how much the FDA chief would be able to help carry out the president’s agenda, at a time when the president would like to keep them both on as part of his cabinet. Verma tweeted, “The @CMSGov team & I look forward to building on our strong partnerships with @US_FDA and working with you to execute on @POTUS’s vision for ensuring all Americans have access to high-quality healthcare.” Similarly, Health and Human Services Secretary Alex Azar said having Hahn as commissioner “will be a major boost to the already rapid pace of @POTUS’s aggressive public health agenda.”

VAPING LUNG INJURY CASES HIT NEW HIGH: The Centers for Disease Control and Prevention reported 52 people have died and 2,409 people have been hospitalized because vaping-related lung injuries. For the last couple of weeks, the CDC has been reporting only cases where people have been hospitalized, so that’s changing the count a little. The CDC is still warning against using THC products or e-cigarettes containing nicotine, but all signs point to vitamin E acetate in THC vaping liquids as the culprit. For example, CDC researchers sampled fluid from 29 patients’ lungs in 10 states, and vitamin E acetate was found in every sample. What’s more, they identified THC in 82% of samples, and nicotine was present in 62%. The CDC still won’t single out vitamin E acetate, and said there could be another cause of the injuries or even multiple causes, though.

SOUTH CAROLINA GETS APPROVAL FOR MEDICAID WORK REQUIREMENTS, WITHOUT EXPANDING MEDICAID: CMS approved South Carolina’s request to enact work requirements for Medicaid beneficiaries Thursday, while also raising the income threshold to include more people eligible for benefits. “Competition for workers is fierce, and businesses are struggling to fill vacancies. In this economy, there is no excuse for the able-bodied not to be working,” GOP Gov. Henry McMaster said. The plan is unusual because it isn’t coupled with a Medicaid expansion plan under the auspices of Obamacare, but rather provides modest benefits to South Carolinians making 100% of the Federal Poverty Line, whereas previously the the income threshold was 67% of the poverty line.

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To qualify for benefits, all those earning up to the federal poverty line will be required to work for at least 80 hours per month, be a full-time student, or consistently take part in public service, including volunteering with charitable corporations. The program will allow exemptions for those who are pregnant, have disabilities, are the primary caregiver to a child, or receive treatment for substance abuse problems.

DEMOCRATS SAY GILEAD IS GAMING THE PATENT SYSTEM: Gilead, manufacturer of the only FDA-approved HIV prevention treatments, may be extending patents for its second drug, Descovy. Democratic Senator Debbie Stabenow and Congresswoman Carolyn Maloney have called on Andrei Iancu, Undersecretary of Commerce for Intellectual Property, to investigate Gilead’s request to extend Descovy’s patent for another three years, given that Gilead may have delayed release of the second treatment to maximize profits from the first drug, Truvada. Gilead has touted Descovy as a safer treatment with fewer adverse side effects, but the lawmakers say the company may have delayed its release on purpose. Every year, Gilead sells more than $ 11 billion worth of HIV prevention drugs, so if the patent for Descovy is extended through 2025, the patent could be worth as much as $ 30 billion. The company stands to make a lot of money through Descovy, especially if the patent is extended to 2025.

FDA APPROVES FIRST TEST TO SCREEN BABIES FOR MUSCULAR DYSTROPHY: The FDA announced approval of the first test to screen newborns for Duchenne Muscular Dystrophy, a very rare disease that causes progressive muscle weakness. A newborn screening card is used to collect a small amount of blood from a prick of the baby’s heel, and now using that test doctors will be able to check for DMD, which will provide parents more time to consider treatment plans as the disease progresses.

The Rundown

Bloomberg Flu season is here, and it’s targeting your kids

The New York Times Federal watchdog questions billions of dollars paid to private Medicare plans

Kaiser Health News In the fight for money for the opioid crisis, will the youngest victims be left out?

Atlanta Journal-Constitution Georgia-based health insurance alternative under investigation

WBUR The state’s vape ban has ended. But some shops are still looking to rebrand — or relocate


SUNDAY | Dec. 15

Final day of healthcare.gov open enrollment.