Good morning … Thoughts and prayers to the people of Puerto Rico, who will likely be without power for months in the wake of Hurricane Maria. Meanwhile, it's do-or-die week for Sens. Lindsey Graham and Bill Cassidy's bill to repeal much of the Affordable Care Act.
Graham and Cassidy are set to release an updated version of their bill today. Luckily for you, my colleague Caitlin Owens and I have already read it. The biggest differences this time around:
The bottom line: These new payment calculations are complex. The political calculation is not — it's more money for the moderates (Sens. Lisa Murkowski and Susan Collins) and more regulatory rollbacks for the conservatives (Sen. Rand Paul and perhaps Sen. Ted Cruz, who said he was on the fence yesterday).
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The substance of the Senate's latest health care bill is different from the one before it, but — in part because only a few Republican senators care what the substance of the bill is — the politics are not.
As much as the Graham-Cassidy process might feel like a new thing playing out, with new developments, it's largely a repeat of July:
The next ACA open-enrollment period is just a little more than a month away. The Health and Human Services Department told outside enrollment organizations that it's planning some relatively significant downtime for HealthCare.gov during the enrollment window.
Context: There's some downtime in every open-enrollment period, and HHS said it scheduled this year's site maintenance for the times HealthCare.gov gets the least traffic. These windows are also maximums, a department spokesperson said — the actual downtime could be shorter.
Yes, but: The Trump administration has already taken several additional steps that will likely limit the number of people who sign up. It has:
What we're watching: This is a lot of time for site maintenance. Will it be enough to prevent unplanned outages at times of high traffic — which tend to come around the sign-up deadline?
There's a lot of talk about how artificial intelligence can change the practice of medicine, with new initiatives being launched to take advantage of the technology (we wrote about the Human Diagnosis Project here). But it's already clear that there are limits to how useful it will be in the doctor's office. In today's Axios Expert Voices feature, we asked four medical experts to help us game out the pros and cons.
The bottom line: AI may be able to help with some diagnoses and free up time for doctors by handling some of the time-consuming tasks. But it will never replace what's unique about a doctor listening to a patient. Check out the discussion with these experts:
Humira, the blockbuster anti-inflammatory drug that is routinely blasted on TV commercials, netted $13.6 billion in gross U.S. sales last year — the most of any brand-name prescription drug. Overall, Axios' Bob Herman reports, the 20 top-selling drugs generated more than $98 billion in gross U.S. sales in 2016, or about $20 billion more than what the Department of Transportation spent last year.
Why it matters: The biggest drug sellers, which are heavily advertised on TV, treat conditions that affect millions of Americans. But the growth in pharmaceutical spending continues to be well above inflation, putting many people in a bind when they pick up their medicine at the pharmacy.
What we're watching today: Finance Committee hearing on Graham-Cassidy, at 2 pm (livestream here).
What we're watching this week: Possible floor votes and further machinations on Graham-Cassidy.
JPMorgan Chase Institute panel discussion on new report on out-of-pocket health care spending, Tuesday, 8 am Eastern. RSVP to Kelly Benoit at firstname.lastname@example.org.
Wednesday: Deadline for insurance companies to finalize their contracts to sell plans in the exchanges next year.
Got a tip? Or just some thoughts? Let me know: email@example.com