Feb 22, 2018

Axios Vitals

Good morning ...

Situational awareness: In case you missed it, President Trump had this to say yesterday about gun violence and mental health:  "Today, if you catch somebody, they don't know what to do with them. He hasn't committed the crime, but he may, very well. And there's no mental institution, there's no place to bring them."

How pharma is using its tax windfall
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Data: Company documents; Chart: Andrew Witherspoon / Axios

The pharmaceutical industry is using a large portion of its windfall from Republicans' corporate tax cuts to boost its stock prices, my colleague Bob Herman reports this morning.

What's happening: 9 drug companies are spending a combined $50 billion on new share buyback programs, a sum that towers over investments in employees or drug research and development.

The bottom line: All of those buybacks were announced during or after the passage of the Republican tax bill. That money is enriching hedge funds, other Wall Street investors and top drug company executives, but isn't necessarily helping patients.

That's not all: Some drug companies also increased quarterly dividends following the tax overhaul. For example, AbbVie increased its cash dividend by 35% while at the same time committing to a new $10 billion share repurchase program.

Go deeper: Bob has all the details.

When there are more opioid overdoses than doctors who can help
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Data: Avalere Health; Chart: Chris Canipe / Axios

In several states, deaths from opioid overdoses outnumber doctors who are able to provide buprenorphine, a drug that helps treat addiction, according to a new Avalere analysis. Nationally, there's an average of 1.6 opioid overdose deaths per provider certified to prescribe buprenorphine.

Why it matters: This is a case for expanding “scope of practice” laws — allowing more nurses and physicians’ assistants to prescribe buprenorphine to help get the epidemic under control — Avalere tells Axios’ Caitlin Owens.

CAP has a “Medicare for all” plan

The liberal Center for American Progress is out this morning with its plan for a Medicare buy-in — one version of the “Medicare for all” promise that has become both a rallying cry and a litmus test on the left.

The details:

  • CAP’s plan would not immediately transition the whole country into one single-payer system. Rather, it would let all Americans choose to buy into a beefed-up Medicare program.
  • Employers would be allowed to pay for their workers to join Medicare, rather than providing their own health benefits.
  • But newborns would be automatically enrolled in the new program, so it would likely take over soon enough.

Between the lines: CAP is well within the mainstream of the Democratic party. The existence of this document is more important than its details, which obviously aren't going to be enacted any time soon.

  • It’s a sign of how successfully the Bernie Sanders wing has pulled Democrats toward some broad embrace of “Medicare for all” — and also of the considerable variation in what that phrase means to different people.
  • CAP’s plan is more gradual and less robust than Sanders’, but it reflects the same basic trajectory, and that alone is a big change.
Medicaid work requirements are catching on

Now that Kentucky and Indiana have gotten federal permission to add work requirements on their Medicaid programs, more state-level Republicans are joining the party.

The latest:

  • Republicans in Missouri's state legislature have introduced a bill to impose Medicaid work requirements, the Columbia Missourian reports. The measure would require 80 hours per month of community engagement, which could include work, job training or community service (about the same definition Kentucky and Indiana used).
  • The Alaska legislature is considering similar requirements, per The Hill.
  • Work requirements have already been floated as a potential compromise to help pass Medicaid expansion in Virginia's newly divided statehouse.

This will continue. These efforts will succeed in at least some states, and more GOP governors and legislatures will get on board as work requirements become an increasingly popular way to trim the Medicaid rolls.

What's on your mind? I welcome your tips and feeback: baker@axios.com.