OVERNIGHT HEALTHCARE: Cantor makes no mention of O-Care alternative

by Ferdous Al-Faruque - 06/11/14 7:58 PM ET

Outgoing House Majority Leader Eric Cantor (R-Va.) made no mention of an ObamaCare replacement bill on Wednesday in another sign that the House may not pass an alternative before the August recess.

At a Capitol Hill press conference, Cantor failed to bring up future plans for healthcare as he discussed his legislative priorities for the next seven weeks, before he steps down as majority leader on July 31.

{mosads}Passage of an ObamaCare alternative plan was already seen as unlikely despite numerous GOP promises to “repeal and replace” the healthcare law. A busy floor schedule and an imminent leadership transition further complicate the possibility.

Other Republicans are wary of the political risks of passing a replacement bill and giving Democrats a target for criticism. http://bit.ly/1n6B1Vk

DRUGMAKERS VS. INSURERS: The most powerful drug and insurance lobby groups continued their heated fight over rising healthcare costs with each side blaming the other.

The Pharmaceutical Research and Manufacturers of America joined patient advocacy groups Wednesday to release a new report that says patients with chronic diseases are being discriminated against. http://bit.ly/1hPwCJb

The report from Avalere Health found many insurance plans available through the federal and state marketplaces were requiring higher co-payments for drugs to treat diseases such as HIV/AIDS and cancer, putting a higher burden on patients.

The groups say this violates the nondiscrimination provisions of the Affordable Care Act and urged the Department of Health and Human Services to release guidance specifically banning the practice.

But insurers didn’t take the accusation lying down.

Responding to PhRMA, America’s Health Insurance Plans said the blame lies with rising prices of specialty drugs. http://bit.ly/1hPwJEp

Brendan Buck, AHIP spokesperson and former aide to Speaker John Boehner (R-Ohio), said drugmakers are trying to deflect the issue of increasing healthcare costs by blaming everything but drug prices.

“Drugmakers have no straight-face explanation to justify the increasingly astronomical prices they have been charging for their medications,” he said. “That’s why they want to talk about anything – ANYTHING – other than the prices they are charging.”

BARE-BONES COVERAGE: AHIP also urged lawmakers Wednesday to widen the availability of cheap, bare-bones coverage under ObamaCare that they say could entice more consumers to enter the marketplaces.

AHIP said that creating a cheaper tier of coverage, also known as “catastrophic plans,” on the exchanges that is available to everyone would “further the public policy goal of affordability.”

Under the group’s proposal, the Affordable Care Act would allow consumers to purchase a health plan with an actuarial value slightly lower than the current lowest “bronze” tier of coverage.

The policies would comply with other rules under ObamaCare, such as the minimum benefit standards and the requirement for free preventive care, but would likely be cheaper than the exchanges’ current options. http://bit.ly/1l9Zkit

PAYING FOR RISK CORRIDOR: Republican lawmakers are questioning new Health and Human Services (HHS) Secretary Sylvia Burwell’s authority to help some insurers cover the costs of risky consumers.

Rep. Fred Upton (R-Mich) and Sen. Jeff Sessions (R-Ala.) wrote to Burwell on her second day in office, stating that while she has the authority to operate the risk corridor program under the Affordable Care Act, there is no provision stating where she can pull the funding from.

The administration’s fiscal year 2015 budget states funding for the program would come from the Centers for Medicare and Medicaid Services (CMS), but Upton and Sessions say that is illegal, citing opinions from the Congressional Research Service (CRS) and the Government Accountability Office (GAO).

Instead, they said, Congress would have to authorize any transfer of funds from CMS budget before insurers could be paid. http://bit.ly/1l2gxjx

BILL TO EXTEND CHIP: Sen. Jay Rockefeller (D-W.Va.) introduced legislation Wednesday that would fund the Children’s Health Insurance Program through 2019. While the program is currently authorized through that year, its budget is set to expire next September.

Rockefeller, who helped craft the program in 1997, praised CHIP for helping reduce the number of uninsured children. Advocates for children praised the legislation and vowed to help move it through the process.

In addition to extending funds, Rockefeller’s bill provides incentives for states to expand CHIP coverage and offer improved dental care for kids. http://bit.ly/1hPAdqA

QUALITY OVER QUANTITY: A new report by McKesson Research, finds the healthcare system is rapidly moving from a volume-based model to a value-based model.

This means payers and hospitals are putting more emphasis on reimbursements based on quality over quantity of care. More than two-thirds of reimbursements are expected to be based on value measurements in five years, up from just one third today according to the report. http://bit.ly/1n6Dn6F

STATE BY STATE:

Maryland hospitals to get less money for uninsured patients: http://bit.ly/1hPyxNX

New federal rules likely to impact Kansas assisted living facilities: http://bit.ly/1hPyAcm

Virginia budget on the fast track without Medicaid expansion: http://bit.ly/1pIPGbY

State’s uninsured reduced 40 percent post-Obamacare: http://bit.ly/1pISoOz

Republicans jump into Florida campaign against medical marijuana: http://reut.rs/1oVvphW

READING LIST:

Burwell asked to lift barriers on Telehealth reimbursement: http://bit.ly/1pIQSMm

Medicare patients: Beware of ‘observation’ status in hospitals: http://reut.rs/1lokZrt

FBI has begun criminal inquiry in VA scandal: http://nyti.ms/1l2mPjo

AMA: Don’t require surgery for transgender people to change birth certificates: http://slate.me/1hPDfLs

WHAT YOU MAY HAVE MISSED AT THE HILL: