Feb 10, 2017

Axios Vitals

By Caitlin Owens
Caitlin Owens

Happy Friday, health care people. Tom Price is the new HHS secretary, Regeneron actually wants the Food and Drug Administration to be tougher, and an Oregon health insurer won a big Obamacare court case over "risk corridor" payments. And we have some smart reads for you from the Axios board of independent experts.

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Tom Price struggles across the finish line

He finally got confirmed as Health and Human Services secretary — around 2 a.m. this morning. It was a party-line vote, 52-47, after a debate dragged out by Democrats' attacks on his record and his numerous stock scandals, per Caitlin Owens. Here's how Price's vote tally compares to the confirmation votes of the last six HHS secretaries:

Senate Minority Leader Chuck Schumer called the vote the beginning of the "war on seniors." That said, Price will start the job with a lot of good will from his former Republican colleagues in Congress, who respect his knowledge of health care policy and his front-line experiences as an orthopedic surgeon. Senate Finance Committee chairman Orrin Hatch called him an "exceptional nominee."

What we learned about Price in the floor debate: Nothing. Better to spend your time reading this Atlanta Journal-Constititution profile.

Here's one drug company that wants a tough FDA

President Trump and some of his allies have called for slashing regulations and making it easier to get drugs through the Food and Drug Administration. But Bob Herman reports that the pharmaceutical company Regeneron doesn't want the teeth to be pulled from the agency.

"I want a tough FDA because I want a high bar," Regeneron CEO Dr. Leonard Schleifer said on a conference call Thursday. He doesn't want the drug industry to devolve into the "infomercial business and anything you can say is fine and doesn't matter whether the product actually works or not."

Why this matters: Although this isn't the first time Schleifer has advocated for strong standards at the FDA, it's a reminder that any Trump FDA pick who wants to gut the rigor of drug review won't have the backing of the entire industry.

Yale New Haven responds to Brill's hospital CEO piece

You knew Steven Brill's piece this week on big hospital CEO salaries wouldn't go over well with those CEOs. Within hours after the piece had posted, Yale New Haven Health System wrote to us to challenge Brill's reporting on Norman Roth, the CEO of Greenwich Hospital, whose salary for each day a patient spent in the hospital was the highest of all the hospital CEOs he researched.

Yale New Haven believes Brill drew the wrong conclusions, and Brill wrote a response that addressed their objections. We stand by Brill's reporting, but we posted both articles in full here so you can judge for yourself.

A big court ruling resets the "risk corridor" battles

You'll hear a lot more about this one: the U.S. Court of Claims told the U.S. government to pay up $214 million in Obamacare "risk corridor" money to Moda Health, an Oregon health insurer, per the Oregonian. Judge Thomas Wheeler wrote that the government "made a promise in the risk corridors program that it has yet to fulfill." There have been other lawsuits, but this is the first victory for an insurer. Read Caitlin Owens' story on the ruling here.

The week's smartest Obamacare reads

One of the things we want to do at Axios is give you a good dose of smarts from our board of outside experts. Here's what they've been reading this week — and writing — that can give us some new insights on Obamacare and the replacement effort:

  • Jon Kingsdale, a consultant who ran the Massachusetts health insurance exchange that inspired the Affordable Care Act, sends over this New England Journal of Medicine piece about the insurers that did well in the law's marketplaces and the ones that didn't. The lesson, Kingsdale says, is that the ACA marketplaces "are doing just what markets should do: weeding out less effective competitors and rewarding successful ones."
  • Lanhee Chen of Stanford University, Mitt Romney's former policy director, co-wrote this piece encouraging California to make common cause with the Trump administration and Congress on two issues: helping the working poor and bringing down health care costs.
  • Harvard's John McDonough, who worked on Obamacare as a Senate Democratic aide, recommends this article about the program's premium increases. It's proof, he says, that the claim that the ACA marketplaces "are collapsing and cannot be successful — repeated now and over the past 7 years — is just wrong."

We also had our first post yesterday from a member of the board of experts, Venrock's Bob Kocher, who writes about why it's short-sighted for health plans to focus on earnings and not the customer experience. Read his post here.

Sorry, conservatives, we've got to have a replacement

That was Senate Republican Conference chairman John Thune's response to the conservative leaders who laid out their "wish list" for Obamacare repeal on Wednesday — and who insisted, among other things, that Congress should get rid of the law first and pass the replacement later. "We gotta have some, at least elements in place of the replacement to maintain some stability in the market, some continuity," the third-ranking Senate GOP leader told Caitlin Owens.

Still, the conservative rebellion seems to be spreading, as National Journal's Daniel Newhauser reports that more than a quarter of all House Republicans may be in the repeal-now-replace-later camp after attending a conservative members' retreat in New York.

Ex-CMS chief's kind words for his likely successor

Seema Verma, President Trump's nominee to run the Centers for Medicare and Medicaid Services, can expect to get a lot of grief from Democrats next week at her confirmation hearing over her Medicaid reform policies and other issues. But her predecessor, former acting CMS administrator Andy Slavitt, isn't about to pile on.

When I asked what his experience was with Verma, here's what Slavitt wrote: "Seema strikes me as a very smart, thoughtful woman who seems intent on doing a very good job for the American people if confirmed. In that goal, she has my full support. She's certainly an expert on Medicaid policy and other state-driven health care initiatives." It's a carefully worded statement, but it suggests that she won't have to worry about much criticism from the guy who held the job in the Obama administration.

Caitlin Owens

What we're watching next week: Senate Finance Committee confirmation hearing for Seema Verma, Thursday, Feb. 16.

See ya. Tell us what else we should cover and what we can do better: david@axios.com.