Erin Mershon

Sen. Mike Lee: House Proposal to Replace Obamacare a ‘Horrible Idea’
Repeal first, then decide what’s next, Utah Republican says

BY ERIN MERSHON AND JOE WILLIAMS, CQ ROLL CALL

Utah Republican Sen. Mike Lee on Wednesday criticized a House proposal to include provisions that would “replace” the 2010 health care law in a repeal measure, calling it “a horrible idea.”

Groups Join Forces to Protect Job-Provided Health Insurance

Republicans are ramping up their consideration of a controversial policy to reduce tax breaks for employer-sponsored health insurance, drawing increasing ire from a diverse coalition of business and labor groups.

The idea of scaling back the tax benefits for the more than 155 million people who get their coverage at work is generating so much concern that it has united those groups in staunch opposition. 

Trump States Hit Hardest if Obamacare Cost-Sharing Help Ends
But funding subsidies is tough choice for Republicans

By ERIN MERSHON and JOE WILLIAMSCQ Roll Call

The constituents with the most to lose if Congressional Republicans cut funding to Obamacare overwhelmingly live in the parts of the country that President Donald Trump won in last year’s election.

Drug Industry Spending Jumped As Cures Crossed Finish Line

The pharmaceutical and biotechnology industry lobbying giants ramped up their advocacy spending in the final three months of 2016, just as Congress was finalizing a new law aimed at speeding drug development and research.

The Pharmaceutical Research and Manufacturers of America dropped $4.9 million in the fourth quarter of 2016, up from $3.8 in the same quarter in 2015, a CQ analysis of new lobbying filings shows. The Biotechnology Innovation Organization spent $2.3 million to influence policymakers over the same three months, up from $2.1 million the year before.

States Could Keep Obamacare Under Cassidy-Collins Replacement

Two key Senate Republicans introduced a proposal Monday that would let states choose whether to keep their existing health insurance marketplaces or forge ahead with a new, more conservative plan.

The proposal, from Sens. Bill Cassidy of Louisiana and Susan Collins of Maine, is the first Senate replacement plan proposed this year and takes a more moderate approach to repealing and replacing the 2010 health care law.

House Leaders Emphasize Executive Branch's Power Over Obamacare

House Republicans on Thursday emphasized that their efforts to repeal and replace the health care law will rely heavily on revised interpretations of the law that they can make administratively, a sign of the challenges in writing replacement legislation that can overcome the Senate’s 60-vote threshold.

“Let’s not forget, we now have an HHS, an administration, that is ready to work with us to fix this problem,” House Speaker Paul D. Ryan, R-Wis., said at his weekly press conference. “What I think people are beginning to appreciate is we have lots of tools in front of us. It’s not just a one-and-done bill kind of a thing. That is what we’ve been walking our members through — all the options available to us to get this done.”

Interest in Obamacare Coverage Surges With Arrival of Trump Era
Calls pour in from people nervous about losing their plans

Insurance agents are facing an uptick in calls from people nervous about losing their health care coverage under a Trump administration, industry officials said Monday.

“With the election, people are hearing about this repeal and they want to know: ‘Does this mean it’s all going away and we’re going to lose everything?’” said Scott Leavitt, an agent in Boise, Idaho. “People are uncertain about what’s going to happen because of the election. The point is we don’t know.”

Republicans Likely to Heed Trump's Call to Repeal Obamacare
Reconciliation could be used to strike parts of the law with 51 votes

 Congress is all but certain to seek to repeal parts of the health care overhaul, unwinding the signature achievement of the Obama administration and delivering on one of the Republican Party’s key campaign promises.

The health care law established state-based public health exchanges to encourage a competitive market for individuals who do not receive coverage through their job or another public program like Medicare. The fourth open enrollment period began last week for coverage that begins in January.

7 Races That Could Affect Health Policy
Watch out for 4 Senate and 3 House races

The 2016 election will have a dramatic impact on health policy. The future of the Obama administration’s signature health care law is at stake in the presidential race. Senate races across the country could deliver control of the upper chamber to a new party with an ambitious health policy agenda — or keep it in Republican hands for looming debates over drug pricing, children’s health insurance and the review process for new treatments at the Food and Drug Administration.

There are also a handful of individual House and Senate races that will impact the health care conversation on Capitol Hill. Below, we round up seven races that stand to impact the industry.

Health Care Premiums to Jump by 25 Percent in 2017
Administration says coverage on Healthcare.gov will remain affordable

Premiums will spike by an average of 25 percent next year for plans purchased on HealthCare.gov, according to a Monday report from the Obama administration.

Even with the dramatic increase for the so-called benchmark plans, more than two-thirds — 72 percent — of the Americans who get their health insurance through HealthCare.gov will be able to find plans for less than $75 per month, the report said. About 77 percent will be able to purchase plans under $100 per month.

Clinton, Trump Health Plans Differ in Impact on Uninsured, Cost
But both would add to the federal deficit

The health care policy proposals of Hillary Clinton and Donald Trump would have dramatically different impacts on the uninsured rate in the United States and on out-of-pocket health care costs. But they share one trait: Both would add to the federal deficit, according to a study released Friday.

Trump's plan, which centers on repealing and replacing the 2010 health law, would increase the number of uninsured Americans by somewhere between 16 million and 25.1 million people, depending on which parts were enacted, and would drive up out-of-pocket costs for enrollees currently benefiting from the health law.

Shimkus Outraises Walden in K Street Cash as Energy and Commerce Fight Looms
Both contenders have powerful ties to the influence industry

Rep. John Shimkus of Illinois raised about $200,000 more from lobbyists in the first half of this year than Oregon Rep. Greg Walden, a potential signal of fundraising strength that could further distinguish the two Republican lawmakers in their fight for the House Energy and Commerce Committee gavel.

​Shimkus brought in nearly $1.1 million for his leadership political action committee and his personal campaign committee from lobbyists in the first six months of this year, according to a Roll Call analysis of this summer's lobbying disclosures. Walden raised $864,000 from K Street during the same period.

Aetna Drops Out of 11 Obamacare Insurance Markets
Health plan's withdrawal follows UnitedHealth decision to pull out of 30 states

The big health insurer Aetna Inc. announced late Monday it will largely withdraw from state exchanges set up under the 2010 health care overhaul, citing financial losses attributed in part to a controversial premium stabilization program the law established.

Aetna's exodus from 11 state-based exchanges comes after a more dramatic 30-state withdrawal by UnitedHealth, the nation's largest health insurer. The departures will reduce the market competition that authors of the health law envisioned to keep premiums low and care affordable.

State Health Exchanges Wrestle with Budgets
Early federal grant money from 2010 health care law has largely run out

State-based marketplaces survived startup problems with botched technology and political threats but continue to grapple with a fundamental challenge: financial sustainability.  

The 13 states that run their own exchanges face challenges in raising enough money, through user fees or state funding, to maintain their operations now that about $5 billion in early federal grants has largely run out. As states establish those budgets, they are testing decidedly disparate approaches to investments in priorities like marketing, technology and operations.  

Poll: Clinton's Health Policy Positions Align With More Voters
Voters say rival Trump is not spending enough time on health care

Hillary Clinton may have the edge over Donald Trump when it comes to health care issues, a new poll found.  

About 46 percent of voters said the presumptive Democratic nominee for president best represented their views on health care, according to a July poll from the nonpartisan Kaiser Family Foundation. That compares to 32 percent who said the same for Trump, the presumptive Republican nominee. That could be because voters feel Trump isn't spending enough time on the issue: 56 percent said he didn't pay enough attention to health care, compared to 35 percent who said the same for Clinton.  

Republicans Say Democrats Obstructing Fetal Tissue Probe
Democrats ramp up efforts to disband panel leading the investigation

Republican members on a controversial panel investigating fetal tissue donation practices plan to double down on their efforts to uncover documents from those providers. They slammed their Democratic counterparts Tuesday for what they called "inappropriate" attempts to obstruct those efforts so far.  

The panel, formed after the release last summer of sting videos allegedly showing Planned Parenthood officials discussing the sale of fetal tissue, outlined in an 88-page report Thursday industry practices it says are more motivated by profit than women's health. In a news conference, Chairwoman Marsha Blackburn of Tennessee said many of the committee's efforts have been slowed by Democratic obstruction.  

Insurers Rally to Defend Obamacare Risk Payments
GOP-sponsored bill seen as another bid to undermine health law

Insurers are ramping up lobbying to defeat legislation that would limit their payments under one of the 2010 health law's stabilization programs, according to congressional staff and outside experts.  

The bill (S 2803), from Nebraska Republican Sen. Ben Sasse would slash in half the Department of Health and Human Services general management budget, unless the agency pays certain funds from the so-called reinsurance program to the Treasury Department. Until now, the agency has prioritized its payments to insurance companies and not yet paid into the Treasury, a practice it has justified under the health law (PL 111-148, PL 111-152).  

Abortion Rights Advocates Laud High Court Decision
Women's health battle reverberates on campaign trail

The Supreme Court ruling Monday that voided Texas requirements that abortion clinics meet certain safety standards and that providers be affiliated with nearby hospitals is reviving a fight over women's health that is reverberating on the campaign trail.  

The 5-3 decision in Whole Woman's Health v. Hellerstedt refocused attention on the Supreme Court vacancy caused by the death of Justice Antonin Scalia. Senate Republicans have refused to consider President Barack Obama's nominee, Judge Merrick Garland, to fill the position, leaving the court with eight justices.  

Medicaid Plans Succeed in Obamacare as Others Struggle
Some smaller insurers are outperforming broader industry on exchanges

Smaller insurers with experience in Medicaid, such as Centene Corp. and Molina Healthcare, are outperforming the broader insurance industry on the federal health exchanges. Their success is putting a spotlight on their business model as the Obama administration and other insurers seek to stabilize the fledgling individual market.  

If Medicaid-like plan features become the norm, consumers and medical providers would be substantially affected. Such plans are often popular in the exchanges for their low premiums, but consumers have criticized limits on their access to medical providers such as doctors. And physicians fault the plans for low reimbursement rates.  

What You Missed: House Fetal Tissue Hearing
 

The House Energy and Commerce Select Investigative Panel held a hearing on the pricing of fetal tissue Wednesday, April 20. Roll Call summarizes the three-hour hearing in two minutes....