September 4, 2018 

Volume 5, Number 12

In This Issue

Pre-Ex Conditions Take Center Stage

Drug Cost Effectiveness

Uninsured Rates Hold Steady

Development of Non-Opioid Pain Meds

CA Gov Candidate Backs Universal HC

McCain’s HC Legacy

Cigna-Express Scripts Deal Approved

Senate Backs $854B Bill

MD Officials Approve Health Reinsurance

MS To Test Medicaid Work Requirements

TJG On Facebook

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The Hill: Washington's Fall Agenda: Pre-Existing Conditions Fight Takes Center Stage In Midterms 
Health care is one of the issues taking center stage in this November’s midterm elections as Democrats press Republicans on preserving protections for pre-existing conditions under ObamaCare. But there is also plenty of unfinished work for Congress and the administration this fall, from passing opioid legislation to tackling drug costs. (Hellmann and Sullivan, 8/30)

Source: The Hill

Stat: CVS Exec: Our New Reliance On Cost Effectiveness Should Make Drug Makers 'Think About Launch Prices'
In a bid to dampen rising drug costs, CVS Caremark plans to allow its clients — such as health plans and employers — to exclude from their formularies any new medicine that has a higher price than a particular benchmark for determining value. The pharmacy benefit manager will set a threshold of $100,000 per QALY, or quality-of-life years, a barometer that measures both the quantity and quality of life generated by providing a treatment or some other health care intervention. The move, which begins Jan. 1, comes as PBMs are under pressure to demonstrate their own value at a time of rising drug prices. We spoke with Dr. Troyen Brennan, an executive vice president and chief medical officer at CVS Health (CVS), the parent company, about the implications. (Silverman, 8/31)

Source: Stat

The Hill: CDC: Uninsured Rates Hold Steady After One Year Of Trump
The uninsured rate in the first three months of 2018 held steady compared to the same time frame last year, according to new numbers released Wednesday by the Centers for Disease Control and Prevention (CDC). In the first three months of 2018, 8.8 percent of people of all ages were uninsured, or 28.3 million people, according to the report. (Hellmann, 8/29)

Source: The Hill

The Washington Post: FDA Pushes For Development Of Non-Opioid Pain Medications
The Food and Drug Administration is planning new steps to encourage the development of nonaddictive alternatives to opioid pain medications, Commissioner Scott Gottlieb said in an interview. As part of the effort, the agency plans to withdraw its existing 2014 guidance to the drug industry on pain medicines. That document is overly broad, Gottlieb said, and is sometimes a barrier to new products and innovations. The current guidelines call for a large number of studies to get FDA approval for general use for chronic pain, he added. (McGinley, 8/29)

Source: The Washington Post

The Hill: California Gov Candidate Backs Universal Healthcare For Undocumented Immigrants 
California Lt. Gov. Gavin Newsom (D), who is running for governor, said in an interview released Tuesday that he would like to see the state pay for universal healthcare for all illegal immigrants. “I did universal healthcare when I was mayor — fully implemented, regardless of pre-existing condition, ability to pay, and regardless of your immigration status,” Newsom told the podcast Pod Save America, referencing his stint as San Francisco's mayor. “I’d like to see that extended to the rest of the state. (Keller, 8/28)

Source: The Hill

Kaiser Health News: McCain’s Complicated Health Care Legacy: He Hated The ACA. He Also Saved It
There are many lawmakers who made their names in health care, seeking to usher through historic changes to a broken system. John McCain was not one of them. And yet, the six-term senator from Arizona and decorated military veteran leaves behind his own health care legacy, seemingly driven less by his interest in health care policy than his disdain for bullies trampling the “little guy.” (Huetteman, 8/25)

Source: Kaiser Health News

The Wall Street Journal: Shareholders Approve Cigna-Express Scripts Deal
Cigna Corp. and Express Scripts Holding Co. shareholders overwhelmingly supported Cigna’s $54 billion purchase of the pharmacy-benefit manager, a deal that activist investor Carl Icahn initially sought to block. The deal received the backing of about 90% of Cigna shareholders, the health insurer said Friday, citing a preliminary vote tally. Of the Express Scripts ESRX 0.21% shareholders who voted Friday, 99% approved the deal. (Chin, 8/24)

Source: The Wall Street Journal

The Associated Press: Senate Backs $854B Bill To Fund Health, Education, Military
The Senate approved an $854 billion measure Thursday that funds much of the government, including $675 billion for the Defense Department. The bill combines military spending with disbursements for Health and Human Services, Education, Labor and other agencies. The bill was approved, 85-7, and now heads to the House. (8/23)

Source: The Associated Press

The Associated Press: Maryland Officials Announce Health Reinsurance Approval
Maryland officials on Wednesday announced federal approval of a waiver to create the nation’s largest health reinsurance program, a step designed to protect insurers from skyrocketing claims and hold down rates in the struggling individual market of the state’s health care exchange. The federal Centers for Medicare and Medicaid Services approved the waiver, Republican Gov. Larry Hogan and leading Democrats of the General Assembly announced at a news conference. (Witte, 8/22)

Source: The Associated Press

The Hill: Mississippi To Test Limits Of Medicaid Work Requirements 
The Trump administration is facing a key test with Mississippi’s Medicaid program as the state seeks permission to be the first ever to impose work requirements without expanding Medicaid under ObamaCare. Already one of the poorest states in the nation, advocates say work requirements for “able-bodied” beneficiaries could decimate the health coverage that tens of thousands of residents depend on. (Weixel, 8/23)

Source: The Hill

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