This is the last edition of Trump in 30 Seconds. For more on politics and policy, subscribe to D.C. Diagnosis. For more on biopharma, subscribe to Readout. And for a broad look at the world of health and science each morning, try Morning Rounds. Thanks! 


On Thursday, President Trump nominated Dr. Jerome Adams to be the next surgeon general, replacing the ousted Dr. Vivek Murthy, who left in April. Adams is the health commissioner of Indiana and was appointed by Vice President Mike Pence. Adams is an anesthesiologist who oversaw the state’s public health response during an HIV outbreak linked to sharing needles, bringing both praise and criticism. Unlike his future boss, he has praised the expansion of Medicaid and took a measured tone in response to the Ebola crisis.

In the tweet of the moment

President Trump had repeatedly said the two need to happen simultaneously, and many members of Congress agree. Some have argued anything else is a nonstarter because the replacement may never come.


Under pressure

Democrats on the House science committee are asking for an investigation after the head of an EPA board of science advisers said the organization’s chief of staff tried to pressure her into telling Congress that officials were still deliberating over how to fill open positions, when in fact they were not going to be filled. Deborah Swackhamer, chairwoman of the EPA Board of Scientific Counselors, told the congressional committee questioning her that half the board’s appointments would not be renewed in the mostly academic committee and voiced concern that would lead to inappropriate industry influence.

Number of the day: 10

That’s the length of the congressional recess upon us, after the Senate put off a vote on health care reform. We’ll see what happens when everyone reconvenes later in July.

Read on

June 29, 2017

Let the dealmaking begin

As Senate Republicans try to revive their efforts to pass health care reform, they have agreed to add at least $45 billion to address the opioid crisis. That happens to be the amount sought by Sens. Rob Portman (Ohio) and Shelley Moore Capito (W.Va.), whose states have been hard-hit by the epidemic and who had expressed concern about an earlier draft of legislation that included only $2 billion.

Congress ignores Trump proposals

Under legislation unveiled by a House spending subcommittee, the National Science Foundation would receive $7.3 billion, a 1.8 percent decrease, from 2017 spending levels but a significantly smaller decrease than the 11 percent cut that Trump had proposed.

In defense of Medicaid reform

Seema Verma, the head of the Centers for Medicare and Medicaid Services under the Trump administration, argues in a new op-ed that lawmakers have a rare chance to transform Medicaid. Despite concerns that legislation in Congress would dramatically cut funding for the program, Verma says reform can only be achieved by giving states “more flexibility and less hassle from the federal government.”

Read on

June 29, 2017

Science orgs speak out

A group of science organizations including the American Association for the Advancement of Science sent a letter to the White House Tuesday urging President Trump to keep intact and to heed the advice of scientific advisory boards. The letter comes on the heels of reports that the EPA is not renewing the contracts of dozens of scientists that serve as advisers to the agency.

Pesticide politics

EPA head Scott Pruitt met with the CEO of Dow Chemical just a few weeks before announcing that the agency wouldn’t continue trying to ban the company’s pesticide, the Associated Press has found. An EPA review of the pesticide, called chlorpyrifos, concluded that even minuscule amounts of the chemical can interfere with the brain development of fetuses and infants. In March, Pruitt said that a decade-old petition by two environmental groups to ban all uses of chlorpyrifos had been denied.

Read on

June 27, 2017

Trump and HIV

Bipartisan leadership in the Congressional HIV/AIDS Caucus is asking the White House for answers after six members of President Trump’s HIV advisory group abruptly walked away a few days ago. Reps. Barbara Lee (D-Calif.) and Ileana Ros-Lehtinen (R-Fla.) join the chorus of people asking Trump to stem HIV budget cuts and to name an AIDS policy director. The White House, for its part, says the people who left were Obama appointees and that other members of the administration have strong experience in the issue.

In the tweet of the moment

The Congressional Budget Office analysis of the Senate health care bill finds a $772 billion cut to Medicaid by 2026.

Trump and opioids

The White House commission on opioids was supposed to have a report with recommendations on how to battle the addiction epidemic by today, but STAT’s Lev Facher reports that the commission won’t make the president’s deadline. By many accounts, 90 days was ambitious — even members of the committee said at the 90-day mark that they’d need more time. But, when the committee, chaired by New Jersey Gov. Chris Christie, was formed, some people said there was no need to study the problem further; the previous administration had already laid it out pretty bare.

Number of the day: 30 million

That’s the number of children in the U.S. who are covered by Medicaid, and who might see their coverage change as a function of President Trump’s proposed budget cuts, the House’s and Senate’s health care bills’ proposed budget cuts, and, depending on how states could rejigger their Medicaid programs, the CBO analysis of the Senate health care bill.

Read on

  • Remember the biotech stock that threatened to hang up Tom Price’s HHS nomination? Its drug tanked. So did the stock.
  • OPINION: The NIH Grant Support Index is a good thing
  • One thing about the Senate health care bill? Eventually most individual insurance policies could come from states with waivers
  • Some lawmakers are mad that the drug pricing executive order could weaken hospital discounts

June 26, 2017

Today in repeal and replace

As with the House health care bill, the Senate version is also really unpopular. More moderate Republicans are saying they may not be able to vote for it, this week or any week. The Koch brothers say it isn’t conservative enough. HHS Secretary Tom Price is defending it, telling CNN that people won’t fall through the cracks. And with countless ways states can use waivers, experts are hesitant to weigh in, and it remains to be seen how the Congressional Budget Office will calculate its impact, which could be announced as early as today.

He said this

“Healthcare’s a very complicated subject from the standpoint that you move it this way, and this group doesn’t like it. You move it a little bit over here, you have a very narrow path.”

— President Trump on “Fox & Friends” Sunday, talking about health care reform. Repealing Obamacare was a major campaign promise, and it’s going slower than he promised. Some of his supporters aren’t convinced it will happen. But they don’t blame him.

She said this

“I’m against Trump and McConnell, [pushing to] vote on it this week. Go home to your constituents and talk about it. … Once you do this, you can’t go back.”

— Leigh Ann Wilson, a West Virginia Trump voter, on proposed Medicaid cuts in the Senate health bill. She lost her daughter, Taylor, to an overdose, while waiting for a treatment bed to open up, and Medicaid, more often than not, foots the bill for addiction treatment.

In the tweet of the moment

Read on

June 23, 2017

Drug pricing. What happened?

As the health care effort in the Senate picks up steam, two Dems who’ve met with President Trump on drug prices are worried by reports that a forthcoming executive order essentially caves to pharma’s demands. Reps. Peter Welch of Vermont and Elijah Cummings of Maryland sent the president a letter with their concerns. They say Trump’s prolonged silence on drug pricing, followed by the pharma influence reports, amount to a voter betrayal.

Number of the day: 2 billion

That’s the dollar amount in the Senate health care bill allocated to fight against opioid addiction as a one-time bolus in 2018. It’s a far cry from the $45 billion over 10 years requested by Sens. Shelley Moore Capito of West Virginia and Rob Portman of Ohio, whose states have been hit hard the opioid epidemic and stand to lose a lot in the bill because of proposed Medicaid cuts.

He said this

“… if there’s a chance you might get sick, get old, or start a family — this bill will do you harm. And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation.”

— Former President Barack Obama, in a long Facebook post about the GOP repeal and replace effort and President Trump’s reference to the House version of the health care bill as “mean.” President Trump voiced his support for the Senate draft.

Read on

June 22, 2017

Have a heart

The Senate health care plan was released Thursday morning to much fanfare — and grumbling. The take home? Major cuts to Medicaid. Preexisting conditions are spared. Subsidies for people in the individual market are tied to income, not age. But, Obamacare tax penalties are out the window, as are a bunch of taxes that helped pay for the Affordable Care Act. President Trump wanted the Better Care Reconciliation Act to have more “heart.” Whether it does depends on if your are comparing it to the House version or Obamacare itself. Or, your tax bracket.

Number of the day: 18

That’s the percent of the U.S. economy made up by health care, and what will be affected by health care reform.

She said this

“What I hear from the candidates that I talk to over and over again is that ‘I no longer can just sit by and wait to be tapped for my expertise. I can’t just sign another letter or polite petition. I need to actually do something.’”

— Shaughnessy Naughton, a chemist and founder of 314 Action, an organization devoted to helping people in STEM fields run for office

Summer reading

CDC Acting Director Anne Schuchat and National Institutes of Allergy and Infectious Diseases Director Anthony Fauci were kind enough to offer recommendations for STAT’s summer reading list. Their choices? A book about a female disease detective and the works of a famous global health advocate. Also on the list? Recommendations from a former FDA leader, STAT staff, our readers, and Chelsea Clinton. Her recommendation might surprise you.

Read on

  • Biotech stocks continue to rise on the hope that the Trump executive order on drug prices will be pharma-friendly
  • Health care stocks in general are on a bit of a tear with the release of the Senate bill
  • Hospitals are not pleased with the health care bill. They are mobilizing their staffs to fight against it

June 21, 2017

A blunted bite

The much-discussed drug pricing executive order will likely come after the Senate calls a vote on the AHCA, CNBC says, and biopharma investors are not as worried as they were before. With early information that the EO will likely give pharma a break on pricing, stocks that had tumbled are recovering nicely. Meanwhile, a nonprofit is forming to help states, should they decide to take drug pricing matters into their own hands. And in India, where many generics are manufactured, Trump protectionism won’t have a lasting impact, this CEO says.

Tomorrow, tomorrow

If you hear the signature tune from “Annie” in the halls of Congress today, it’s because the Senate version of the AHCA is supposed to surface on Thursday. The frustration over secrecy is making even Republicans angry. How much time the Senate will have to discuss the bill is in limbo, because it appears draft will go straight to the Congressional Budget Office in hopes of ensuring a vote before the July 4 recess. The sun will come out tomorrow, but probably not long enough to clear any cobwebs. Or maybe any (GOP) sorrow.

Number of the day: 52.7

That the percent of votes cast for Karen Handel, who won a wildly expensive congressional race in Georgia on Tuesday for the seat vacated when Tom Price left to become head of HHS. Here’s how she might impact health care reform.

A scientific shakeup

The Environmental Protection Agency has a board of scientific advisers that are appointed for one term, but typically get to serve two. The Washington Post is reporting that for dozens of members of the EPA Board of Scientific Counselors, those reappointments aren’t happening. EPA officials and industry spokespeople say it’s to open the board up to a broader pool of applicants and to reduce “bias.” But others worry the purge will allow EPA to stack the committee with people who will take a more business-friendly view of EPA activities.

Read on

June 20, 2017

Health care reform — a poem

The Senate version of health care reform
Crafted in secret, against many norms
We aren’t sure what’s going to be in it
Advocates say, wait just a minute
Medicaid will surely be cut
Taxes will get a punch in the gut
On Monday, the Dems protested hard
Susan Collins remains a wild card
Yet McConnell is pushing to vote
While Newt Gingrich says “whoa” in this note
Insurers are coming and going
With little to no way of knowing
If payments will come any faster
While Trump claims Obamacare. A disaster.

He said this

“It’s basically fluff. For them to really do anything meaningful requires legislation, not an executive order. And therein lies the problem — the Republicans who control the Congress don’t favor legislation.”

—  Ira Loss, of Washington Analysis, who tracks the pharmaceutical industry for investors. He’s responding to reports that pharma is helping craft an executive order on drug pricing that might do little to curb prices

Biotech goes boom

These are good times for biotech stocks — and STAT’s Adam Feuerstein takes at a look at why. One theory? A former lobbyist from Gilead Sciences is among the biopharma folks helping craft an executive order on drug prices.

Read on

  • Here’s how President Trump is influencing meditation
  • Here’s who is challenging New Jersey Rep. Tom MacArthur
  • Here’s what Energy Secretary Rick Perry thinks of carbon dioxide and climate change
  • Here’s what FDA chief Scott Gottlieb had to say about his budget

June 19, 2017

Pharma: charging ahead

President Trump may have said some famously harsh things about pharma and drug costs, but behind the scenes, it’s business as usual for the industry in Washington. Industry representatives appear to be helping fashion a long-awaited drug pricing executive order. In addition, STAT’s Erin Mershon tells us how pharma is working hard and spending money to ensure it gets what it wants from the FDA in “user fee” legislation. Its efforts might soon pay off handsomely.

Number of the day: 5

As in, here are five things that might show up in the Senate version of AHCA that could ultimately cause some headaches in getting it passed.

HIV/AIDS advocates: The president doesn’t care

The President’s Advisory Council of HIV/AIDS lost six of its 18 members last week, and issued a blistering editorial in Newsweek explaining why. Among their charges? President Trump and his administration “simply do not care.” They say he has no strategy, does not consult experts on how best to handle the issue, and pursues legislation that would harm HIV-positive Americans. One of their more serious charges? President Trump has not appointed anyone to lead HIV policy in the White House.

She said this

“I was just so relieved.”

— Lori Wing-Heier, Alaska’s insurance commissioner, on a plan that reduced significantly the percentage that Obamacare plans were supposed to go up in the state. Her efforts at using reinsurance to blunt staggering increases has been lauded, but other states may not have the resources to do what the 49th state did.

Read on

  • Bills on using ACA and AHCA health insurance subsidies that affect veterans and people seeking COBRA coverage pass the House
  • The massive BIO conference might be good recruiting ground for pharma and biotech companies wanting to woo scientists spooked by the American political climate
  • HHS Secretary Tom Price says that cuts to the HHS budget will lead to better care, but offers little in terms of how
  • Democratic senators are tweeting a lot about health care. It may not be enough

June 16, 2017

A congressional race in Georgia

The fight over HHS Secretary Tom Price’s seat in Congress is turning into a battle over health care. The vote is Tuesday, and all the talk is about preexisting conditions. Democrat Jon Ossoff points to the medical bills of a young boy with a heart condition as why Obamacare needs to stay. Republican Karen Handel shares her sister’s birth defect as why Obamacare needs to go. This is Georgia’s 6th District: affluent, purple, and a veritable referendum on health care.

A presidential move on drug pricing

Trump administration officials are meeting Friday to talk about an executive order on drug pricing, potentially helping the president fulfill a goal to lower drug prices. The order, whatever it may say, won’t change any laws, but will likely inform HHS, FDA, and other agencies’ regulatory and rulemaking work. Possibly on the table? A plan to price drugs based on how well they work.

Mark your calendar

Wednesday. That’s the last day insurers can decide whether to take part of the individual insurance exchanges for 2018. Why will this decision for some companies go right to the deadline? Things like cost-sharing payments and the fate of the AHCA. The uncertainty has led some companies to bow out of entire state exchanges. And there’s little that Congress can do about it right now.

He said this

“Holy smokes. I feel like I’ve died and gone to heaven.”

— Bradley Merrill Thompson, a lawyer who specializes in digital health and the FDA, on new moves by the agency to regulate medical devices under Scott Gottlieb

Read on

June 15, 2017

Every state for itself

One tension in the health care battle in the Senate is how the GOP is stuck between party goals and the needs of state constituencies. In this case, it plays out most readily in the form of Medicaid expansion: the senators from those states, whether they would in theory be more hard-line about block grants and other ways to cut Medicaid spending, have to, in reality, be more moderate. West Virginia is a great example.

Number of the day: 95

That’s the percent of people in a survey who a) are OK with the idea of a national health plan and b) want it to cover everything from mental health to preexisting conditions to preventive care and other essential health benefits covered under ACA. Interestingly, about 35 percent of people in this same survey are OK with states opting out of a national plan, but they don’t want their state to do so.

Trump, the Army, and Zika

Months after Sen. Bernie Sanders urged the Trump administration not to ink a deal between the Army and Sanofi over a Zika vaccine, a bipartisan group of House members is also chiming in with requests for public meetings. The fear? Affordability — the vaccine was created through taxpayer dollars and the Army says it can’t control price. The consolation? It’s not the only Zika vaccine deal, so a competitive market may control prices naturally.

He said this

“I can’t talk about it, sorry.”

— Kapil Bharti, a researcher at the National Eye Institute, part of the National Institutes of Health, about proposed budget cuts to the agency. Bharti is ushering a new stem cell treatment for macular degeneration at the institute. When prodded further by STAT, he simply shook his head.

Read on

June 14, 2017

Happy birthday, Mr. President

It’s President Trump’s 71st birthday, and STAT takes a look at his health. For the most part, Trump is healthy — but he is overweight, which you would think would lead to other health problems. But it turns out, maybe not. Read on.

She said this

“… it has become progressively — and distressingly — more acceptable to set transparency aside in lawmaking over the years.”

— Julie Rovner of Kaiser Health News, on her decades-long career reporting on health policy. As the Senate is refusing to share any details of its draft of the AHCA, she notes that the ball has been steadily rolling in this direction.

Word of the day: mean

This is how the president described the House version of the AHCA that he had once called “a great plan,” in a meeting with Senate leaders on Tuesday. He’s asked them to be more generous. In the meantime, jobs data has come out: A new report finds that about 1 million jobs would be lost under the House version of the AHCA, and Axios reports this link between health care jobs and Obamacare.

Number of the day: 12.6 million

That’s the number of people predicted to be uninsured in an analysis of the House version of the AHCA released by CMS’s actuaries. This is about half the number that the CBO estimated would fall off the insurance ranks in its analysis of the bill. Why the big discrepancy? Assumptions that feed into each organization’s calculations. One spot of agreement: Premium prices could really go up.

Read on

  • Scott Gottlieb asks the public for help in scrutinizing opioids with abuse-deterrent properties
  • Attorney General Jeff Sessions is going after medical marijuana. But science refutes some of his ideas
  • ARPA-E (Advanced Research Projects Agency-Energy) hasn’t proved itself yet. Why should it be on the budget chopping block?

June 13, 2017

He said this

“Either you’re going to make it hard to get in, or you’re going to make it, ‘in unless you’re out.’”

— Louisiana Sen. Bill Cassidy, at a health care event sponsored by The Atlantic and STAT, on the idea of automatic enrollment of people in health insurance. He and other members of the GOP say the Obamacare enrollment process is cumbersome. The question: is auto-enrollment another way to enforce an insurance mandate?

Confused? You’re not alone

Keeping track of who’s doing, saying, and planning what in the GOP-led effort in health care reform is tough. We put together this list of people on Twitter to follow who are really good at parsing out the day-to-day and the big picture in the push to repeal Obamacare. Check it out. And tell me who else should be on it: @meghas,

He said this

“Well, I hope so.”

— Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, in response to the question: Is the Trump administration prepared for a pandemic? He went on to talk about how having a flexible budget helps with the kinds of on-the-ground surveillance that helps public health officials respond to outbreaks.

Number of the day: 2 million

That’s the number of people who fell off Obamacare rolls between Jan. 1 and mid-March. President Trump is citing it as evidence of the ACA “death spiral.” But the drop is because people didn’t pay their premiums after picking plans during open enrollment.

Read on

  • Delayed: An FDA rule that would change nutrition labels to make calorie counts bigger, among other things
  • Worsened: Veterans’ health care, if we don’t have immigrant physicians at the VA because of a travel ban
  • Increased: The use of crowdfunding sites to offset health care costs, and it could get higher under Trumpcare
  • Promised: Action on drug prices. A Senate committee is meeting Tuesday to talk drug pricing, one of President Trump’s campaign promises

June 12, 2017

Planned Parenthood’s heroes

In all the hubbub this week over the Senate version of the AHCA, its CBO score, and Mitch McConnell’s hemming and hawing that the votes may not be there, are these two votes, which may not be there, depending on how Planned Parenthood funding shakes out in the bill. It’s Sens. Susan Collins of Maine and Lisa Murkowski of Alaska versus the Senate’s anti-abortion faction, with $555 million sitting in the middle. Another wild week in health care reform is about to begin.

STAT and The Atlantic

Join Trump in 30 Seconds on Tuesday, as STAT and The Atlantic join forces here in Boston to talk health care, politics, and innovation. On the docket? Sen. Bill Cassidy of Louisiana, National Institute of Allergy and Infectious Diseases chief Anthony Fauci, STAT reporters Sharon Begley and Damian Garde, and many more. Can’t be there? Grab some coffee and follow #AtlanticPULSE on Twitter. We’ll try to save you a bagel.

She said this

“They’re sending legislation through the Congress that is only supported by one party … and somehow thinking it’s going to have a different outcome. It’s like, really, why would you think that?”

— Republican economist Gail Wilensky, on the GOP health care reform effort. The Republican Party has many hurdles in getting its landmark repeal legislation passed. Here’s how it could pan out.

Read on

June 9, 2017

FDA’s subtle shift

On Thursday, the FDA asked an opioid maker to stop selling its product, not because it doesn’t work, but because it’s too easy to abuse. Bloomberg notes that this is a shift in the way FDA does its business — not just looking at the patients a drug is supposed to treat, but those at risk of abuse. This move could be one way FDA chief Scott Gottlieb fulfills his promises to tackle opioid abuse, but don’t expect the drug maker, Endo International, to readily agree.

In the tweet of the moment

#hlp17: Health law professors from all over the map are in Atlanta this weekend for their annual conference. On the schedule? Medicaid, free speech, and mental health parity.

She said this

“What kind of voodoo math are you using to justify your statements claiming to help Americans when you’re taking over a trillion dollars out of the system to pay for tax cuts for the rich?”

— Rep. Linda Sanchez of California, a Democrat, at a hearing with HHS head Tom Price before the House Ways and Means Committee on Thursday. Price defended both efforts to repeal the Affordable Care Act and the White House proposed budget.

The McConnell way

Listening. Working for each vote. Not celebrating until the “fait” is “accompli.” This is how people describe Senate Majority Leader Mitch McConnell, who has promised the president and his party a big win with the repeal of Obamacare. The Washington Post takes a look at the Senate’s leader, the task at hand, and whether he has the votes to make his party’s many-year dream come true.

Read on

June 8, 2017

Meet Andy Harris

Congressman Andy Harris
Rep. Andy Harris (R-Md.) Mark Wilson/Getty Images

He’s a politician. He’s also a doctor. Rep. Andy Harris is an anomaly in Congress — he is a Republican whose livelihood at one point was based on NIH funding. But in a conversation with STAT Plus, he talks about indirect funding, his concern about how research dollars are spent, and whether or not we should fund what he calls “sanctuary campuses.”

With all eyes on Comey …

Other hearings are going on, including this one: On Thursday, HHS Secretary Tom Price is expected to defend President Trump’s budget proposal in front of both members of Senate Finance and House Ways and Means. On the docket? Explaining drastic cuts to Medicaid, public health programs, and biomedical research. Sure to come up: the Affordable Care Act and the American Health Care Act.

He said this

“The Democrats are destroying health care in this country.”

— President Trump, at a speech Wednesday in Ohio, where Anthem has pulled out of the individual insurance market, leaving several counties without an insurer. But while the president blames his rival party, Anthem blames uncertainty in subsidies that insurers are supposed to get to help defray the cost of insuring lower-income Americans. That uncertainty comes from the White House and a Republican-led lawsuit.

Number of the day: 85

That’s the percent of top science positions in the Trump administration that have yet to have a nominee. The president still has no science advisor.

Read on

  • ICYMI: The head of the U.S. patent office has resigned, leaving another position in the Trump administration open
  • Trump’s nominee to run the FBI has represented pharma companies, including in this whistleblower suit
  • Here’s how the Senate plans to deal with Medicaid expansion in its version of the AHCA

June 7, 2017

A holdover at NIH

Francis Collins, the head of the National Institutes of Health, is staying on under President Trump, despite a push from an anti-abortion faction of the House GOP to have him replaced. It’s been a rare event for the Trump administration to keep any high leadership from the Obama administration on, and as Collins has spoken out about NIH funding, it’s worth noting that his job is at the will of the president, and may not last the entire four years.

A W(r)ay to the top

President Trump nominated Christopher Wray to head the FBI Wednesday morning via Twitter, the day before former FBI head James Comey is expected to testify on the Hill. Wray’s a criminal law expert and former Department of Justice leader, but as a private attorney, he’s represented pharma in off-label promotion cases and False Claim Acts cases, and has represented a health care company in regulatory investigations.

Today in health care reform

The text of the AHCA, as passed by the House, has survived the Senate budget reconciliation process. But, individual aspects of the bill can still be debated, and the Byrd rule still applies.

Mark your calendar: July 4

That’s the day Sen. Mitch McConnell told President Trump that the Senate version of AHCA would be ready, scored by the CBO, and voted on by.

Read on

  • The president, his son’s foundation, and rerouting donations from a children’s cancer charity (Forbes)
  • The president will be talking health care at 12:55 p.m. Wednesday (Reuters)
  • Despite repeal and replace uncertainty, this insurer is riding pretty high (Forbes)

June 6, 2017

Action on drug pricing

FDA chief Scott Gottlieb tells Bloomberg that he’s thinking about wielding his agency’s sword to cut drug prices for generics. How? By pushing competitors’ applications to the front of the approvals line, especially in cases in which there are few generics for the same drug on the market. (See: Daraprim). His other plans? Eliminate the backlog of 2,640 generic drug applications.

Number of the day: 5,400

That’s the minimum suggested donation for a fundraiser hosted by President Trump for New Jersey Rep. Tom MacArthur, whose amendment to AHCA helped it squeak through the House. The max requested donation? $100,000

A health care limerick

There once was a health reform bill
Being discussed over lunch on the Hill
The GOP wants a vote soon
As early as June
But the parliamentarian could signal “kill”

Tuesday at lunch. That’s when GOP leaders are supposed to be showing off some of their thinking on their version of AHCA, the Wall Street Journal says. After that, it’s off to the White House for a conversation with the president on health care and tax reform, with the hopes of a vote asap.

In the tweet of the moment

Read on

June 5, 2017

States taking charge

There’s been much concern that if AHCA passes, states will opt out of Obamacare provisions, but California and New York are taking steps to make sure their residents have comprehensive insurance, no matter what. In New York, Gov. Andrew Cuomo is trying to make sure essential health benefits will be included in policies. In California, efforts to pass universal health care are underway.

Number of the day: 800,000

That’s the dollar value of health care stock bought this year by Rep. Tom MacArthur, while he was working on AHCA. Some people are saying it’s unethical. His staff says it was managed money, and MacArthur had no idea.

She said this

“The biggest loser from the decision could be the United States itself…while the Paris agreement is a climate treaty, a triumph for evidence-based decision-making, it’s also much more: a trade agreement, an investment blueprint, and a strong incentive for innovation in the energy and the economy of the future.”

— Katharine Hayhoe, director of the Climate Science Center at Texas Tech University, on President Trump’s decision to pull the U.S. out of the Paris climate deal. MIT researchers say the president misunderstood their climate research in justifying his decision.

He said this

“In some ways, it’s become yet another of the long list of litmus test issues that determine whether or not you’re a good Republican.”

— Whit Ayers, a Republican strategist, on a nearly 10-year pivot in the Republican party from discussing how to fight climate change to saying it’s not real.

Read on

June 2, 2017

Today in health care reform

First it was a few weeks, then a few months, but now, some senators are thinking that replacing Obamacare may not happen this year. The Senate is trying to stabilize the Obamacare markets in the meantime, and other senators are pushing piecemeal efforts to change other aspects of the law. The May cost-sharing reduction payments have been made, but as always, it’s not clear if the June check is in the mail.

Number of the day: 85

That’s the percent of people who live in states where Medicaid was not expanded who think the U.S. should continue to fund expansions in any health care replacement plan.

In the tweet of the moment

The day after President Trump said he’d pull the U.S. from the Paris climate talks, health experts are fighting back, saying climate change is a public health issue. What’s at stake? Increased air pollution, a broader spread of infectious disease, and possible rises in cancer rates.

She said this

“Employers are going to be hesitant to pick benefits that will help one gender over another. That’s an HR nightmare that would reduce morale.”

— Chatrane Birbal, senior adviser of government relations at the Society for Human Resource Management, on a draft rule from the Trump administration that would exempt employers from the ACA birth control mandate, as some GOP senators consider taxing employer-based plans as part of health care reform

Read on

June 1, 2017

A preexisting condition loophole

A bipartisan group of legislators has penned a plea to HHS Secretary Tom Price to try and get a loophole closed that allows insurers to deny coverage to people if they receive help paying for their insurance from charities and churches. Qualified health plans have been able to reject patients who have chronic and rare (read: expensive) conditions because they don’t have to accept charity subsidies. The claim is that, in doing so, insurers steer patients to public insurance (at taxpayers’ expense). But, this is an issue that CMS has been concerned about in the past, with the worry that some of the groups helping pay for premiums might steer people onto health insurance plans that are less comprehensive than public plans, but where reimbursement rates would be higher.

In the tweet of the moment

He said this

“The White House is continuing to be thought-provoking and thoughtful around these issues, looking for ways to increase competition but also encourage investment in R&D.”

— Allergan CEO Brent Saunders, who, along with the CEO of Novartis, expects President Trump to unleash a drug price plan soon. Despite talk of price-gouging, pharma is enjoying a good reputation right now.

Sharp criticism of the CBO

Mick Mulvaney, the White House budget director, was sharply critical of the Congressional Budget Office, which predicted about 23 million more Americans would lose health care if the House version of the AHCA becomes law. He accused the office of partisanship and suggested that his office, as well as partisan nonprofits, should be the ones to score legislation. It’s worth noting that CBO is supposed to be nonpartisan; its head is a Bush-era official and its health care analysis team is led by a Clinton-era official.

Read on

  • OPINION: Trump’s proposed budget would mean ruin for infectious disease response. A county in the VP’s home state of Indiana is proof
  • Tom Price bought shares in pharma stocks. Then he went to Australia to try and press for industry protections as part of the Trans-Pacific Partnership
  • What are you reading this summer in health and medicine? Tell us.
  • The stock for eHealth, an online insurance broker, is up, way up, after policy changes allowing people to buy ACA-approved plans directly online

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