Good morning ... Y'know, if we're going to be stuck living in the political version of "Groundhog Day," we should at least get to hang out with Bill Murray. Give us something.
Throughout this summer's effort to repeal and replace the Affordable Care Act, Republican senators outlined a treasury of specific provisions they needed to see tweaked, added, or eliminated in order to win their support.
The latest effort, from Sens. Lindsey Graham and Bill Cassidy, addresses almost none of them. Here's a quick rundown of some one-time "must-haves" that have gone missing from this bill:
Arizona Gov. Doug Ducey shook up Washington yesterday with a statement that endorsed Graham-Cassidy in pretty strong, unequivocal terms. But just a few hours later, Arizona Sen. John McCain was still sounding pretty down on the bill, returning to his concerns about process and partisanship.
A boost for Alexander: One side effect of Graham-Cassidy's momentum, as Axios' Caitlin Owens points out: It'll put more pressure on Democrats to strike a deal with Sen. Lamar Alexander to stabilize the ACA. Fear of Graham-Cassidy could give Democrats a pretty strong incentive to swallow Alexander's more minor changes in the hopes of showing McCain that a bipartisan alternative is viable.
As if on cue: A senior Democratic aide told Caitlin last night that Sen. Patty Murray has agreed to “significant state flexibility" to get closer to a deal.
Costs are rising in employer-based health plans, according to new data from Mercer. Early responses to Mercer's survey of employer plans point to a 4.3% rise in per-employee costs — the biggest since 2011. Underlying health care costs have grown faster, but employers have responded with a shift toward lower-premium, higher-deductible policies.
Why it matters: More than 150 million Americans — about half the country — are covered by employer-sponsored insurance.
What's next: We'll get a fuller picture of the changes in employer-sponsored coverage when the Kaiser Family Foundation releases new data later today.
A handful of health policy wonks over at the New York Times' Upshot got together and tried to determine, via a tournament-style elimination challenge, which country has the best health care system in the world.
The winner: Switzerland — whose system has a lot in common with the ACA. (Unlike its single-payer neighbors, Switzerland relies on highly regulated, mandatory private insurance.) The experts gave it high marks for access and outcomes, and said its higher costs seemed to be worth it.
Go deeper: Harvard professor Ashish Jha, one of the experts who participated in the NYT's experiment (and who voted for Switzerland as the best system in the world), wrote a separate piece on his own, breaking down the objective markers we can use to measure access, quality and innovation. Keep the tab open for a good coffee-break/lunchtime/anything-but Graham-Cassidy read.
Single-payer system: Lanhee Chen, the policy director to Mitt Romney's 2012 presidential campaign, has an op-ed in the NYT today with ACA ally Micah Weinberg arguing that single-payer's proponents often overstate how well it works.
Catholic Health Initiatives and Dignity Health have been kicking the tires on a possible merger for almost a year now. Axios' Bob Herman reports CHI provided an incremental update to bondholders: The two parties "are in the final stages of the due diligence process…and are pleased with the progress made to date."
Between the lines: Both sides have been tight-lipped about the deal — one of the largest pending in health care right now. It's plausible the systems will give it a go since they don't have many overlapping hospitals. The combined not-for-profit system would have almost $28 billion of annual revenue, making it larger than companies like McDonald's.
One number to keep in mind: $957 million. That's how much money CHI has lost in its last two fiscal years. Cost-cutting measures, such as slicing jobs, would likely be a priority in any deal.
The Food and Drug Administration is approving biosimilars — akin to generic versions of complex biologic drugs — and touting the potential savings in the process. But most of those drugs aren't actually available to consumers, Bloomberg reports — which means their potential savings aren't real, either.
The reason: "Basically, there's a gazillion patents," Avalere's Gillian Woollett told Bloomberg. As brand-name manufacturers figure out how to use complex patents to keep cheaper competitors off the market, the FDA's emphasis on approving those drugs won't have much effect on costs.
Correction: Due to a math error, the graphic at the top of yesterday's Vitals understated how much money some states would lose under Graham-Cassidy. An updated version is here. We apologize for the error.
What we're watching today: The Senate. Always the Senate.
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