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Daily on Healthcare: HHS nominee to face questions on drug prices and Obamacare during confirmation hearing

Daily on Healthcare: HHS nominee to face questions on drug prices and Obamacare during confirmation hearing
Daily on Healthcare: Obamacare emerges as wildcard in tax debate
Daily on Healthcare: Obamacare emerges as wildcard in tax debate

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HHS nominee to face questions on drug prices and Obamacare during confirmation hearing. Alex Azar, President Trump’s pick to lead the Department of Health and Human Services, is headed into his second round of confirmation hearings Tuesday morning. He’ll face the Senate Finance Committee, where he will be asked about whether his ties to the drug industry will affect his ability and commitment to advance policies that will lower costs of medicines. He also is expected to face questions on Obamacare. During his confirmation hearing before the Senate Health, Education, Labor and Pensions Committee in November, Azar pushed back against accusations from Democrats that the Trump administration was working to “sabotage” Obamacare.

Welcome to Philip Klein’s Daily on Healthcare, compiled by Washington Examiner Managing Editor Philip Klein (@philipaklein), Senior Healthcare Writer Kimberly Leonard (@LeonardKL) and Healthcare Reporter Robert King (@rking_19).  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.

Obamacare group presses Senate to oppose Azar. A top Obamacare group is demanding that the Senate oppose Azar because he will continue efforts to sabotage the law. “Alex Azar is ready to lead the Republican war on healthcare into its second year, sabotaging and repealing the ACA and Medicaid, raising premiums and gutting protections,” according to a digital ad from the group Protect Our Care released Monday. The ad plays up Azar’s time leading the U.S. division of drug maker Eli Lilly. It also charges Azar will continue to “sabotage” the law. Critics point to several moves by the Trump administration to “sabotage” Obamacare, including cutting ad funding by 90 percent from $100 million to $10 million for the 2018 open enrollment period that ended Dec. 15. The Trump administration counters that it doesn’t need the $100 million in ad funding that was spent in 2016 because more people know about Obamacare.

Koch-backed group urges passage of ‘Right to Try’ law. Freedom Partners Chamber of Commerce, a conservative nonprofit associated with the Koch brothers, has launched a media campaign to urge Congress to pass legislation that would allow terminally ill patients to try medicines that haven't been approved by the Food and Drug Administration. The policy, referred to as "Right to Try," has been passed in more than 38 states. An experimental medicine would need to pass the first phase of review, the one determining that it is safe for people but not whether it works, before patients could try it. The latest campaign will involve digital ads as well as a lobbying effort, and is being started alongside Americans for Prosperity, the primary political advocacy group for David and Charles Koch. “It’s hard to think of a better way to start the new year than by delivering hope to millions of terminally ill patients and their families by passing Right to Try legislation," Freedom Partners executive vice president Nathan Nascimento said. "Congress is at the one yard line of approving this common-sense legislation that will make it easier for terminally ill patients to access increased medication and treatment options that could make a difference. The last step is to move the legislation out of committee and it will pass.” Freedom Partners also sent a letter Monday to Rep. Greg Walden, R-Ore., House Energy and Commerce chairman, urging him to advance the bill out of committee. The legislation passed the Senate last summer, and Vice President Mike Pence has been urging its passage in the House as well.

Appeals court strikes down Baltimore law requiring disclaimers at pregnancy centers. A federal appeals court unanimously found Baltimore’s ordinance to make pregnancy centers post signs about abortion unconstitutional. The 4th Circuit U.S. Court of Appeals affirmed a lower court’s ruling that the ordinance, which requires pregnancy care centers run by anti-abortion groups to post notices that they don't provide abortions in their waiting rooms, violates the First Amendment. The three-judge panel ruled that the ordinance compelled a “politically and religiously motivated group to convey a message fundamentally at odds with its core belief and mission,” according to the opinion written by Judge J. Harvie Wilkinson III, a President Ronald Reagan appointee.

CBO: Repeal of individual mandate lowers cost of children’s insurance program. The repeal of Obamacare's individual mandate penalties in the tax bill has lowered the projection for how much the government will spend on medical coverage for children, according to a government report released Friday. The Congressional Budget Office and the Joint Committee on Taxation predict that the repeal of the penalties for the individual mandate, which required people to buy health insurance or pay a fine, will lower the cost of the Children's Health Insurance Program, or CHIP. The agencies project in their report that without the mandate fewer parents will sign their children up for CHIP than otherwise would have if it had remained in place. The program covers about 9 million middle- and low-income children, and the penalties are zeroing out beginning in 2019.

AHIP expresses concern over proposal on association health plans. America’s Health Insurance Plans said it is worried that the proposed rule by the Department of Labor that would allow individuals or small business to band together for the purpose of buying insurance would weaken the individual market or undo some of the protections offered under Obamacare. “Americans deserve affordable choices, and we are concerned that the changes proposed would lead to higher prices and weaker consumer protections in the small group and individual markets, where nearly 40 million Americans get their coverage,” said Kristine Grow, spokeswoman for AHIP. “We will continue to participate in the formal rulemaking process to recommend alternative solutions to increase competition, choice and affordability.” The group has urged state regulators to act if the Trump administration proposal takes effect.

America’s Essential Hospitals urges Congress to delay DSH cuts. America’s Essential Hospitals, whose patients are largely low-income, has started a lobbying and advertising effort to get Congress to delay cuts to Medicaid disproportionate share hospital payments, known as DSH payments, for two years. The group is hoping that the delay might be part of the government funding bill due Jan. 19. DSH payments help hospitals recoup the costs of providing medical care to people without health insurance or with inadequate coverage. The fiscal year ahead will involve $2 billion in cuts, and will grow to $8 billion in cuts in 2024. The cuts were delayed since 2013, but went into effect in October.

Trump lied about height to dodge ‘obese’ category: book. A new book claims that President Trump has been lying about his height in order to avoid being categorized as obese. "An overweight seventy-year-old man with various physical phobias (for instance, he lied about his height to keep from having a body mass index that would label him as obese), he personally found healthcare and medical treatments of all kids a distasteful subject," Michael Wolff wrote in Fire and Fury: Inside the Trump White House. This isn't the first time Trump's height has come under scrutiny. A copy of his New York driver's license in Politico records his height as 6-foot-2, but in a letter dated Sept. 13, 2016, Trump's longtime physician, Dr. Harold Bornstein, wrote that Trump's height was 6-foot-3 and that he weighed 236 pounds. The latter combination makes his body mass index 4 pounds short of "obese," and instead makes him "overweight." More than 70 percent of U.S. adults have a body mass index categorizing them as overweight and nearly 37 percent are categorized as obese, according to the Centers for Disease Control and Prevention. If Trump's height is 6-foot-2, then his weight would place him in the "obese" category. Trump is scheduled to undergo a routine medical exam Jan. 12 that is likely to include his height and weight.

Adam Schiff: Everyone in Congress is concerned with Trump's mental fitness for office. Rep. Adam Schiff, D-Calif., said everyone in Congress is concerned with Trump’s mental fitness for office, after Fire and Fury, as well as news articles, called his mental fitness into question. “Well, look, I don't think anyone is particularly surprised by what has been revealed in the Wolff book in terms of the questions people working closest with the president have about his capacity to do the job,” Schiff, the ranking Democrat on the House Intelligence Committee, told CNN host Jake Tapper. “I don't think there is anyone in Congress, frankly, of either party who does not concur at least privately with those observations and concerns. Certainly very few are willing to express them publicly in Congress, and I think that's to the detriment of our institution.”

Former Obama administration official heads to Protect Our Care. Marjorie Connolly, the former press secretary for HHS under the Obama administration, will be the communications director for the pro-Obamacare group Protect Our Care. Connolly was serving as the communications director for Rep. Carol Shea-Porter, D-N.H. She served as HHS press secretary during the last open enrollment under the Obama administration.

Pharmacy benefit managers all over the place on paying for specialty drugs: report. Pharmacy benefit managers, which manage an insurer’s drug plan and negotiate discounts with a drug maker, lack consistency over the handling of the priciest drugs on the market. A report from the consulting firm Segal looked at how a PBM handled 10 specialty drugs that account for a disproportionately large share of prescription drug spending. The drugs include new and costly treatments for various ailments such as Humira, which is used to treat arthritis and Crohn’s disease and has a price tag of $5,249 per month. To rein in costs, insurance plan sponsors rely on PBM strategies. A key strategy is called prior authorization, when a PBM reviews a prescription to ensure appropriate use of the drug. The PBM’s staff will review the prescription and talk with the doctor to ensure the prescription meets the clinical need, according to Segal. However, there is no standard when a drug is denied through prior authorization, the report found. “Consequently, potential savings may depend on which PBM a plan sponsor uses,” Segal said. For instance, the prior authorization denial rate was high for a hypertension drug in four of five of the PBMs examined, while one was low. PBMs are starting to receive more scrutiny from Congress as their role in setting drug prices starts to get more attention.


Politico How Trump’s HHS nominee’s drug company ‘gamed’ the system.

The Hill Pfizer ends research into new Alzheimer’s and Parkinson’s drugs.

Bloomberg America’s home nursing shortage is stranding kids.

Axios Taxpayer-funded medical research is gaining bipartisan support.

Kaiser Health News An opioid remedy that works: Treat pain and addiction at the same time

Associated Press On healthcare, Democrats are shifting to offense

Washington Post Will the new blood pressure guidelines lead to ‘overzealous medication?’

Los Angeles Times Severe flu brings medicine shortages, packed ERs and a rising death toll in California


MONDAY | Jan. 8

Jan. 8-11. San Francisco. 36th annual JP Morgan conference. Details.

TUESDAY | Jan. 9

9 a.m. 215 Dirksen. Senate Finance Committee to hold a confirmation hearing for Alex Azar, President Trump’s pick for Health and Human Services Secretary. Details.

10 a.m. 430 Dirksen. Senate Health, Education, Labor and Pensions Committee hearing on “The Opioid Crisis: An Examination of How We Got Here and How We Move Forward.” Details.

THURSDAY | Jan. 11

8:30 a.m. Kaiser Family Foundation. 1330 G St. NW. Event on “Health Reform 2020: Towards Affordable, Quality Care for All Americans.” Details.

FRIDAY | Jan. 12

Walter Reed National Military Medical Center. President Trump to undergo routine medical exam. Details.