Daily on Healthcare: Pelosi vows openness to universal coverage plans…Trump pledges to stop surprise medical bills

By | January 25, 2019

Smart content. Deeper culture. Better access.  Become a subscriber to the Washington Examiner magazine.

SIGN UP! If you’d like to continue receiving Washington Examiner’s Daily on Healthcare newsletter, SUBSCRIBE HERE: http://newsletters.washingtonexaminer.com/newsletter/daily-on-healthcare/

Pelosi vows to be open to policies that will move toward universal coverage. House Speaker Nancy Pelosi vowed Thursday “to consider all options to have us reach healthcare to all Americans,” alongside promises to preserve Obamacare, lower the costs of prescription drugs, and expand Medicaid. Speaking at the Families USA conference in Washington, D.C., Pelosi laid out the Democratic agenda in the House and tore into the Trump administration for its “assaults” on Medicaid, likely referring to ideas to move the program to a block grant and to obligate certain beneficiaries work or train for work as a condition of being allowed to remain in the program. She praised Families USA for advocating against Obamacare’s repeal and repeated her conviction that healthcare had been a winning issue for the party during the Midterm Elections. “The most important issue of the campaign was the issue of healthcare, whether it was the cost of prescriptions, whether it was the pre-existing condition benefit being protected, whether the cost of healthcare in general or access to it,” she said. “That was the most important issue in the campaign.”

Welcome to Philip Klein’s Daily on Healthcare, compiled by Washington Examiner Executive Editor Philip Klein (@philipaklein) and Senior Healthcare Writer Kimberly Leonard (@LeonardKL).  Email dailyonhealthcare@washingtonexaminer.com for tips, suggestions, calendar items, and anything else. If a friend sent this to you and you’d like to sign up, click here. If signing up doesn’t work, shoot us an email and we’ll add you to our list.

Trump pledges to stop surprise medical bills. President Trump and his health chief pledged Wednesday to tackle the issue of eye-popping surprise medical bills, raising the prospect of bipartisan action on a major healthcare problem. “We are here today to discuss how the healthcare system too often harms people with unfair surprises… in a very negative sense, medical bills and the like,” Trump said at a meeting at the White House with patients who had faced such circumstances. “The pricing is hurting patients and we have stopped a lot of it, and we are going to stop all of it, and it’s very important to me.” The roundtable appeared to represent an emerging area of focus for an administration that has primarily dedicated itself to changing Obamacare and lowering the price of prescription drugs, though Trump boasted about achievements in both areas ahead of the meeting. Congress has held hearings on the issue of high medical bills, but has not advanced legislation to curb its prevalence. Still, it’s considered to be an area of bipartisanship at a time when Republicans and Democrats have reached an impasse on other healthcare issues. Some have proposed requiring doctors to notify patients when they could rack up high medical bills or providing more information to patients so they can make informed choices about where to receive care.

The issue of surprise medical bills. People can receive an unexpected big bill if they are administered a pricey medication that their health insurance won’t cover or if a doctor who assists in surgery at a hospital turns out to be outside of their network, an occurrence that can happen even when a patient is under anesthesia or in the emergency room for a traumatic injury. The 10 people who met with Trump Wednesday had either personally suffered, or had a loved one suffer, from massive bills after visiting a medical facility. One patient, Eric Ferguson of North Carolina, received a $ 89,227 bill for an 18-hour hospital stay after a snake bite. Another White House guest, Dave Altman of Colorado, received a $ 169,600 bill from his insurance company after his wife had surgery to treat back pain that turned out to be ineffective. The daughter of Dr. Paul Davis, a retired family physician, received a $ 17,850 bill for a urine sample from a medical lab.

Hints about the direction the administration might go in tackling the problem of high medical bills. The Trump administration said the roundtable mostly would focus on price transparency, or making sure that people understand what different costs are involved in their care. Alex Azar, Health and Human Services Secretary, said at the meeting that the way to bring down costs and improve quality was to “empower consumers and to employ market forces.” “People should have the right to know what a service or a drug will cost them before they have to buy that service or drug,” Azar said.

Utah lawmakers try to roll back ballot to expand Medicaid. Republicans in the state legislature are drafting a bill that would roll back the planned expansion of Medicaid under Obamacare that voters approved through a ballot measure during the midterm election. The plan is to have Medicaid cover people making 100 percent of the federal poverty level or less, rather than 138 percent, and it’s not clear that the Trump administration would approve it. Should federal regulators give it the green light, a lawsuit is expected to ensue. The expansion as written under the terms of Obamacare would cover more than 150,000 low-income people in the state, and Utah’s portion would be paid for by a tax on non-food items while the federal government picks up the majority of costs. Lawmakers say that the revenue the tax is expected to bring in will fall short, so it will need to adjust the expansion to what was funded. According to the Deseret News, the tax increase will bring in $ 88 million, but $ 105 million will be needed. Lawmakers previously tried to draft a plan to partially expand Medicaid, as other states have tried to do as well, but the plan was never approved. If the partial expansion moves forward then 70,000 people in the state would receive coverage.

Californians want better mental health: Poll. Better mental health access ranks in the top two health priorities for Democrats, Republicans, and independents in California, according to a survey out this morning from Kaiser Health News and the California Healthcare Foundation. Fifty-two percent of Californians say their community does not have enough mental health providers to serve local needs. “We have never before seen the public place such strong emphasis on access to mental health treatment in our national or state polls,” Drew Altman, Kaiser Family Foundation president and CEO, said in a statement. The poll was conducted through surveys with 1,404 California residents before Democratic Gov. Gavin Newsom was sworn into office earlier this month.

GOP Oversight wants more information on Medicaid managed care. Rep. Jim Jordan of Ohio, the top Republican on the Committee on Oversight and Government Reform, and Rep. Mark Meadows, R-N.C., sent a letter to the Centers for Medicare and Medicaid Services Wednesday asking for more details about how the agency oversees state contracts on Medicaid that are conducted with private health insurance companies. These partnerships, known as Medicaid managed care,  accounted for half, or $ 171 billion, of federal spending on Medicaid in 2017. The lawmakers pointed to issues that government watchdogs have identified regarding data collection, fraud, and abuse.

HHS gives South Carolina Christian group foster care waiver. The waiver will allow an organization called Miracle Hill Ministries to only place children with heterosexual parents who also espouse the Christian faith, while still being allowed to receive federal funding. Under the Obama administration, Miracle Hill had been considered to be in violation of a regulation that said organizations couldn’t discriminate against a person’s sexual orientation or religion. HHS is considering a similar request in Texas.

New Ohio governor will sign abortion ‘heartbeat bill’ Kasich vetoed. Ohio’s new Republican governor, Mike Dewine, said on the Hugh Hewitt show that he would “absolutely” sign a bill that bans abortion six weeks into a pregnancy. He said it was likely to be contested in court, but that it should be allowed to move through the litigation process and eventually reach the Supreme Court. His predecessor, GOP Gov. John Kasich, had vetoed the bill because he said it was likely to be struck down. Kasich did sign a bill into law that bans an abortion method frequently used in the second trimester known as dilation and evacuation.


Robert Wood Johnson Foundation What’s behind 2018 and 2019 marketplace insurer participation and pricing decisions?

Washington Post Federal workers affected by partial shutdown to be billed for dental, vision coverage

Milwaukee Journal Sentinel Tony Evers reverses course, won’t direct Josh Kaul to withdraw from Obamacare lawsuit after all

STAT News In a sign of its concerns about Atul Gawande’s new venture, Optum sues over trade secrets

The Wall Street Journal Bristol-Myers reports higher sales but another lung cancer setback

Kaiser Health News Doctors call California’s probe of opioid deaths a ‘witch hunt’

FierceHealthcare Study: Firearms injuries present large opportunity for violence interventions

THURSDAY | Jan. 24

House and Senate in session.

Jan. 24-26. Families USA Healthcare Action conference. Agenda.

Jan. 22-25. Davos-Klosters, Switzerland. World Economic Forum. Live feed.

Jan. 23-26. American Physical Therapy Association Combined Sections Meeting. Details.

10 a.m. Rayburn 2123. House Energy and Commerce Committee to hold organizational meeting. Details.

TUESDAY | Jan. 29

10 a.m. 1100 Longworth. House Ways and Means Committee hearing on “Protecting Americans with Pre-existing Conditions.” Details.

10:25 a.m. 215 Dirksen. Senate Finance Committee hearing on “Drug Pricing in America: A Prescription for Change, Part I.” Details.

House Committee on Oversight and Reform hearing on drug prices. Details TBD.


10 a.m. 1775 Massachusetts Ave NW. Brookings Institute event on “Reforming Stark/Anti-Kickback Policies.” Details.