Axios - Health Care
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New Trumpcare amendment would require states to define essential health benefits

(Alex Brandon / AP)

A final amendment to the American Health Care Act was introduced Thursday night by the authors of the legislation, a last-minute attempt to win conservatives over by requiring states to define what services insurers must offer enrollees.

Here's what's in the amendment, which will be voted on in the Rules Committee tomorrow before the bill heads to the House floor for a final vote:

  • Beginning in 2018, states will determine essential health benefits. There are currently 10 federal ones under Obamacare, which apply to the individual and small group markets.
  • The repeal of the Medicare payroll tax on high earners would be delayed until 2023.
  • The original bill's Patient and State Stability Fund would get an extra $15 billion to be used for maternity coverage and newborn care, as well as mental health and substance abuse disorder treatment.
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Featured

New skin cancer drug to cost $156,000/yr

Andrew Harnik / AP

The Food and Drug Administration on Thursday approved Bavencio, a drug that treats a rare form of skin cancer called Merkel cell carcinoma. The breakthrough drug also received orphan drug status from the FDA, meaning it has seven years of market exclusivity.

Bavencio's list price: $13,000 per month, or $156,000 per year. A spokeswoman for EMD Serono, the maker of the drug, confirmed the list price to Axios. However, that price does not reflect rebates or discounts. The amount patients will pay depends on their health insurance.

In 2014, Pfizer and EMD Serono's parent company, the German-based Merck KGaA, agreed to jointly develop and sell the drug.

Featured

Trump's ultimatum: If vote fails, Obamacare stays

AP

Budget Director Mick Mulvaney has just laid down a gauntlet to House Republicans on behalf of President Trump: pass this bill, or Obamacare remains in place.

Members of the conservative Freedom Caucus want more concessions but, according to Mulvaney, Trump will not negotiate further.

The president demanded a vote tomorrow, and now it appears he will get it. He is all but daring Republicans to vote no.

Featured

White House pressures leadership for Friday vote

J. Scott Applewhite / AP

The White House is insisting to House Republican leadership that they vote on the GOP health care bill tomorrow — and it looks like it's going to happen.

President Trump's message to leadership: give me your vote list and tell me which members campaigned since 2010 to repeal Obamacare and then wouldn't vote to do it, said a source privy to the private conversations. The plan now is for the House to vote tomorrow, and the latest changes to the bill — stripping out the law's "essential health benefits" — will be made through a rule to be written overnight.

The GOP leadership's view was that they're still short on the vote count, and they wanted to be assured of 216 votes before putting it on the floor. They think if the bill comes to the floor with less than the required number, the vote will collapse on them. They say simply calling a vote is not going to cause the whip count to go up. Members don't want to vote on something that will fail.

The White House took a different view, according to two sources familiar with the conversations happening at the highest level. Top administration officials believe the vote is close, that it needs to happen tomorrow, and that if they get a deal with Freedom Caucus chairman Mark Meadows it will give them enough momentum to get it done.

Members made "battle" pitches: At a GOP conference meeting tonight, Rep. Tom Cole told his colleagues that "this is not a test for President Trump, he's already leading. This is not a test for our leadership. This is a test for us," according to a source in the room. "If you vote against this because you think it's 'not good enough,' that's not legislating, that's not leading."

And Rep. Brian Mast, an Army veteran, got a standing ovation when he told Republicans that while he's never been in battle with a perfect plan, he's never lost a battle when the troops were unified.

Featured

Here are the AHCA changes demanded by the Freedom Caucus

Alex Brandon / AP

The key changes to the Republican health care bill demanded by the conservative Freedom Caucus:

  • A repeal of ACA's Essential Health Benefits (like emergency or maternity treatment) guaranteed under Obamacare
  • An elimination of the "single risk pool," which prevents insurers from splitting the market into healthy and sick groups
  • An elimination of rating restrictions, which allow insurers to base premiums only on age, area, tobacco use and family vs individual plan
  • A repeal on lifetime or annual limits
  • A reversal of standard documentation mandates, which make it easier to compare insurance plans
  • A reversal on Medical Loss Ratio standards, which force large insurers spend at least 85% of premiums on claims

Why it matters: These changes would appease the Freedom Caucus, but could see moderates abandon the bill.

Featured

Valeant's ousted CEO made $72.5 million in 2016

Manuel Balce Ceneta / AP

Michael Pearson, former CEO of Valeant Pharmaceuticals, cashed in $72.5 million worth of stock and severance pay in 2016 even as he and the drug company were under federal investigation for accounting fraud and a billing scheme tied to a specialty pharmacy it secretly owned.

Pearson took home $60.5 million in stock and the rest in severance pay and other benefits, Valeant disclosed Thursday to the Securities and Exchange Commission. He also still used Valeant's corporate jet. Joseph Papa replaced Pearson last year, and Papa earned $62.7 million even though Valeant remains mired in trouble.

Valeant's stock has cratered since the middle of 2015, and it has become a pariah in the pharmaceutical industry. Pearson led Valeant since 2008, building the company up on the controversial practice of acquiring drugs and jacking up the prices.

Featured

Updated Trumpcare estimate: less savings, same number uninsured

Andrew Harnik / AP

The Congressional Budget Office released a new estimate of the impact of the American Health Care Act this afternoon, showing less federal savings than the original bill but roughly the same coverage loss over 10 years. It was updated to include the proposed amendments to the legislation that were released on Monday night, but not any of the additional changes the White House has been discussing with the Freedom Caucus.

The takeaways:

  • The bill would save $150 billion between 2017 and 2026. The original bill would have saved $337 billion.
  • In 2018, 14 million people would lose coverage. This number would increase to 24 million in 2026. This number did not change.
Featured

Trumpcare vote not happening today

J Scott Applewhite / AP

The House will not hold a vote on the American Health Care Act today.

However there will be procedural votes tonight, and the GOP will hold a conference meeting at 7 pm to discuss the next steps.

The White House has expressed confidence the bill will pass tomorrow morning, and claims the delay was because they wanted to hold the vote "in the light of day." However, GOP members say there's been no decision on whether to hold a vote tomorrow.

Featured

Paul Ryan delays press conference, again

Paul Ryan's weekly 11:30 am press conference got bumped to 3:30 pm due to President Trump's meeting with the Freedom Caucus, but it's just been postponed again until further notice.

You don't do that because things are going smoothly as your signature health care bill hangs in the balance.

Featured

Just 17% of Americans support GOP health care plan

Damian Dovarganes / AP

The Republican plan to replace Obamacare is very, very unpopular. Here's what Quinnipiac found in a new poll:

  • 17% approve of the plan, with 53% opposed.
  • Among Republicans, 41% support and 24% oppose. Just 3% of Dems support it.
  • 14% of Americans believe they'll lose their coverage if the plan becomes law.