Axios - Health Care
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Universal Health Services dismisses impact of Buzzfeed reports

Kevin Iinuma / U.S. Air Force

Universal Health Services, the country's largest chain of behavioral health hospitals, does not believe Buzzfeed's investigative series into its billing practices, admissions standards and violent culture has had an effect on its business. The company has not seen changes in behavior from referring doctors or people who work at UHS facilities, CFO Steve Filton told investors Wednesday.

"The single biggest external reaction that we've gotten to the media reporting has been from the investor community, not from clinicians themselves. I think clinicians have tended to discount that reporting as being largely anecdotal and not an accurate depiction."

OK, but: UHS' stock price has fallen more than 6% since Buzzfeed's first investigation was published in December. The CtW Investment Group, a pension fund adviser tied to unions, also sent a letter last Friday asking UHS shareholders to change the company's "outdated and entrenched" board over concerns from the reports.

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The Global List: abandoning ISIS

Welcome to the The Global List, Axios' daily international news roundup. Check out the Axios STREAM here for more smart brevity in politics, health care, tech, and business.

1. Abandoning ISIS

Raqqa Media Center via AP

Foreign fighters are abandoning ISIS in droves as the organization's structure and hold on its territory begins to crumble.

An estimated 30,000 foreign fighters have joined ISIS, but the U.S. government estimates that up to 25,000 of them have been killed. An expert on radicalization told The Guardian: "As the caliphate begins to crumble, that same appeal simply isn't there anymore. Its potency and relevance has been diminished."

Not all good news: Some senior ISIS members might be using this opportunity to move into Turkey and into the West for revenge acts of terrorism as ISIS declines.

2. Freedom of the press failing

Reporters without Borders

Reporters without Borders issued their annual World Press Freedom Index today, saying the world in 2017 has reached a "tipping point in the state of media freedom, especially in leading democratic countries." The United States is down 2 places to #43.

The sum-up: "We have reached the age of post-truth, propaganda, and suppression of freedoms — especially in democracies."

What's to blame: "The obsession with surveillance and violations of the right to the confidentiality of sources have contributed to the continuing decline of many countries previously regarded as virtuous."

Worth noting: The press release has an option to read it in Russian.

3. Papal TED Talk

TED

Axios' Ina Fried was at TED2017 in Vancouver and reported on the conference's biggest surprise — a video TED talk from Pope Francis, centering on the global collision of technology and social work.

From His Holiness: "How wonderful would it be if the growth of scientific and technological innovation would come along with more equality and social inclusion? How wonderful would it be, while we discover faraway planets, to rediscover the needs of the brothers and sisters orbiting around us?"

Read Ina's full dispatch here.

4. France: 11 days to go

Thibault Camus / AP

Emmanuel Macron made a stop at a Whirlpool factory in his northern hometown of Amiens that's threatened with outsourcing to Poland — but Marine Le Pen beat him there by a few hours. That led to jeers from Le Pen supporters when Macron arrived, but he held a 90-minute dialogue to calm the waters and explain his positions.

One French newspaper's summation: "From chaos to dialogue"

Read Steve LeVine's report here.

5. 1 fun thing: Nessie's missing

AP

Per NPR, 2016 was the biggest year for Loch Ness Monster sightings in history — but she hasn't been seen in eight months. Gary Campbell, who keeps a list of Nessie sightings, says that "she seems to have disappeared."

Thank you for reading! If you want the news that matters in newsletter form, be sure to sign up for Mike Allen's Axios AM, which arrives in your inbox in time for your morning coffee. Sign up here and follow both Axios and me on Twitter.

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GOP chairman: Remember that insurer subsidy lawsuit?

Lauren Victoria Burke / AP

Rep. Mark Walker hasn't forgotten about the pending House lawsuit challenging the legality of Affordable Care Act insurer subsidies — the very same ones the Trump administration said Wednesday they'll continue to pay for the time being. A district court judge has ruled in favor of the House, but the Obama administration had appealed the decision.

"Congress has made no appropriation for Obamacare cost sharing reduction payments," Walker said in a statement. "We believe making these payments without congressional approval is both clearly illegal and unconstitutional."

The continued payments, which bring down the costs of deductibles and out-of-pocket costs for low-income exchange enrollees, have widely been received as a way to keep a fight over the subsidies from shutting down the government. Democrats have eased off their demands for putting the funding in the spending bill currently being negotiated.

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White House, Dems reach truce on insurer payments

Carolyn Kaster / AP

There's been a lot of buzz this afternoon about the White House supposedly promising to continue the Affordable Care Act's insurer payments. The reality is that it's only going to continue the payments "for now," per a White House official.
But that was enough to convince House Minority Leader Nancy Pelosi, who had clashed with Office of Management and Budget Director Mick Mulvaney over the issue, to dial down the threats of a government shutdown.
From the White House: "While we agreed to go ahead and make the CSR payments for now, we haven't made a final decision about future commitments."
From Pelosi: "Our major concerns in these negotiations have been about funding for the wall and uncertainty about the CSR payments crucial to the stability of the marketplaces under the Affordable Care Act. We've now made progress on both of these fronts ... Our appropriators are working in good faith toward a bipartisan proposal to keep government open."
Behind the scenes: Pelosi talked to White House chief of staff Reince Priebus this afternoon, who has been more conciliatory on the spending bill negotiations than Mulvaney.
Featured

House, White House considering Friday health care vote

Evan Vucci / AP

There is now discussion on the Hill and in the White House about a health care vote this Friday. The House whip team is busy counting moderate votes and gauging support within the caucus, and there should be a clearer picture of where things stand tonight.

A Friday health care vote isn't "outside the realm," Republican Study Committee Chairman Mark Walker told Axios, adding that people are discussing a Friday vote and things are "even trending that direction."

"Most of them like what they see, so we're considering to grow the vote, and when we're ready, we'll move," said House Majority Whip Steve Scalise.

Yes, but: Both the White House and GOP House leadership are cautious about setting artificial deadlines. That's what they did last time and it backfired. They believe a vote this week is possible, though they're unwilling to say "likely."

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Trump tax plan repeals Affordable Care Act tax on wealthy

(Carolyn Kaster / AP)

The plan guts the Affordable Care Act's 3.8 percent tax on investment income, according to a summary obtained by CNN's Jim Acosta. This is one of the sources of revenue for the health care law, which the GOP is still trying to repeal after its first effort failed last month.

What it means: The move suggests that the Trump administration is looking for other vehicles to knock out some of the taxes in the Affordable Care Act and isn't counting on the repeal effort, even as House Republicans try to revive it.

Featured

Senate Dems stonefaced on ACA insurer subsidies

Alex Brandon / AP

Senate Democrats were noncommittal today when asked if the removal of ACA insurer subsidies was a deal-breaker for any spending bill ahead of this weekend's possible government shutdown. One common refrain on the Hill today: it's an executive branch issue — and it's up to the Trump administration to fund the subsidies.

Between the lines: The comments suggest that House Minority Leader Nancy Pelosi isn't getting a lot of support from her Senate colleagues as she tries to push the Trump administration to include the subsidies. Senate Democrats aren't voicing a willingness to trigger a shutdown over insurer subsidies. Their play right now looks to be to make it Trump's problem while avoiding getting the blood of a shutdown on their hands.

A view across the Senate Democratic spectrum — from leadership to moderate to liberal:

  • Minority Whip Dick Durbin: "It's a disappointment because it puts in jeopardy health insurance for 7 million Americans."
  • Sen. Patty Murray, member of leadership: "[Trump] can do it from an administrative point of view as they always have — not fight it in the courts — and continue the stability of the markets."
  • Sen. Claire McCaskill: "First of all, this is a responsibility of the executive branch. It's mandatory spending. I don't know why this has been turned into an appropriation problem."
  • Sen. Chris Murphy: "I don't buy the idea that the only way this gets done is if it's in the budget. The president ultimately has the power to allocate this money and I don't think Trump is going to take the blame for 7 million people losing their insurance because he refuses to allocate the money."
Featured

Paul Ryan excludes ACA payments to insurers in spending bill

Evan Vucci / AP

House Speaker Paul Ryan said this month's spending bill wouldn't include payments for insurers that would lower their additional ACA cost burden — by reimbursing them for lowering deductibles, copayments, and coinsurance — according to the WSJ.

Why it matters: This could cause a collapse in health plans this year, according to insurers. This move brings additional uncertainty to the healthcare marketplace, as insurers' deadlines to decide on the framework for 2018 plans looms in a few weeks.

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Three major conservative groups back GOP health care plan

Ed Cunicelli / Children's Hospital of Philadelphia via AP

Club for Growth and FreedomWorks will support the updated GOP repeal and replace plan even though they opposed the original AHCA bill, the groups announced Wednesday, per The Hill.

The change of heart: Club for Growth President David McIntosh said the amendment — which would let states use waivers to avoid some ACA regulations — would allow for more choice and lower insurance premiums.

Three's company: Americans For Prosperity released a statement this afternoon joining the aforementioned conservative groups in backing AHCA thanks to the new amendment. "Pending the inclusion of the MacArthur amendment, the latest healthcare bill is a positive improvement over the previously proposed version in the House," AFP President Tim Phillips wrote. "It takes steps to improve access and curb rising costs by allowing states more flexibility and expanding consumer choice."

One caveat: All three groups maintained that "there is still much work to be done" to fulfill the promise to fix healthcare and to address all of their concerns.

Featured

Dems launch ads on GOP health plan's exemption for Congress

(David Zalubowski / AP)

The DCCC capitalized overnight on an unpopular provision of a new GOP health care amendment, launching ads in 30 Republican districts accusing members of exempting themselves from new waivers that could be added to their health care plan.

The waivers allow states, under limited circumstances, to opt out of the Affordable Care Act's essential health benefits and ban on charging sick people higher premiums, but doesn't apply to members of Congress as originally written. It's currently being rewritten to subject members of Congress to the same rules as everyone else.

The five-figure digital ad buy is in Republican districts being targeted by Democrats, including those of the amendment's author, Rep. Tom MacArthur, and many members who announced their opposition to the original bill.