Subject: POLITICO Pulse, presented by PhRMA: House to vote on Zika package today — Senate advances Zika funding, but senators split — E&C threatens subpoena over reinsurance documents
From: POLITICO Pulse <[email-masked]>
To: <[email-masked]>
Date: Wed, 18 May 2016 08:03:13 -0600

By Dan Diamond | 05/18/2016 10:00 AM EDT

A major investor is retreating from health care, and the White House just finalized a long-awaited overtime rule. But first: The Zika funding fight continues today.

HOUSE TO VOTE ON $622 MILLION ZIKA PACKAGE TODAY - The House is planning to vote today on the $622 million Zika package introduced by House Appropriations Chairman Hal Rogers. 

Expect the package - about one-third of the White House request - to get broad GOP support and little backing from Democrats, Pro's Jen Haberkorn reports. Republicans will argue that they're minding the store and that the Zika funding should be offset with cuts.

The White House on Tuesday said the measure could face a veto from President Barack Obama.

SENATE ADVANCES ZIKA FUNDING - The Senate on Tuesday approved a bipartisan deal to partially fund the Obama administration's request for emergency funding to fight Zika, signing off on $1.1 billion - not as much as Obama wants, but nearly twice what the House is offering.

The Senate approved the funding on a procedural vote and nixed two related measures - one to fully fund the administration's $1.9 billion request and another smaller package that would have been paid for by cutting Obamacare. 

The POLITICO Pro story: http://go.politicoemail.com/?qs=12e319443906fbed6d5d1fa2e3023ebf4dbccf0518b1ea63da7859bdb990a025 

RUBIO: MAY HAVE TO REVISIT ZIKA FUNDING - Sen. Marco Rubio (R-Fla.) told our Budget colleagues that he thinks the Senate "is going to have to re-visit [Zika funding] at some point, especially if we have an outbreak." 

Rubio co-sponsored a bill to approve the full $1.9 billion. "I wanted us to do more but at least something's happening," he said. Earlier on Tuesday, the senator said that the House plan was "playing with fire."

- Florida feeling Zika heat: Rubio's home state already has more than 100 of the 500 confirmed travel-related cases in the United States.

JEANNE SHAHEEN WANTS WHO TO REVIEW ZIKA THREAT TO OLYMPICS - "[W]ith an estimated 10,000 athletes from as many as 200 countries, and 500,000 spectators from around the world traveling to Brazil, I have serious concerns about the potential for the Olympics to greatly accelerate the global outbreak of the Zika virus," the New Hampshire senator writes in a letter to WHO chief Margaret Chan.

GRASSLEY FACING FLAK FOR FIGHTING ZIKA FUNDING - The Iowa senator voted against several funding packages, and the Democrat running for his Senate seat is turning it into a campaign issue. 

"Instead of working across the aisle on commonsense solutions to help address the looming public health threat, Chuck Grassley voted multiple times today against bipartisan proposals to provide emergency funding to combat the Zika virus," Patty Judge said in a statement. "Iowans expect their Senators to put their health and safety above partisan posturing."

WELCOME TO WEDNESDAY PULSE - Where if you have the night off, you can still catch Ferris Bueller's Day Off in local theatres. Tips to [email-masked] or @ddiamond on Twitter.

With help from Paul Demko (@pauldemko), Brianna Ehley (@briannaehley), Jen Haberkorn (@JenHab), Marianne LeVine (@marianne_levine) and Brett Norman (@BrettNorman).

WHITE HOUSE FINALIZES OVERTIME RULE - The final rule, which extends overtime protections to more than 4 million workers, raised the salary threshold under which virtually all workers are guaranteed time and a half pay to $47,476, more than double the current threshold of $23,660. 

- Medicaid-funded providers get concessions: Some health care providers that rely predominantly on Medicaid funding won't be subject to the new overtime rule until March 2019, Pro's Marianne LeVine notes. 

Those providers serve people with intellectual and developmental disabilities in homes and small facilities, and their advocates had long argued that their limited funding made the proposed rule unfeasible. In response, the Labor Department issued a non-enforcement policy, giving them a little more than two years to comply. 

- Post-docs get some coverage under OT rule: It was never clear how the Labor Department would apply the new overtime rule to post-doctoral fellows - those newly minted PhDs who perform scientific research round the clock for universities and research organizations like National Institutes of Health. The Labor Department said last night that the new salary threshold would apply to post-doctoral fellows who do not primarily teach. (Teachers have long been exempted from overtime).

See the White House fact sheet: http://go.politicoemail.com/?qs=12e319443906fbed7133693cced30229b4e15fefdf93bd30fb86c11e2f6bd013

It's a busy week on the Hill. Key moments as we look ahead to another packed Wednesday.

HOUSE BILL WOULD FUND OPIOID PROGRAMS - House appropriators would fully fund $103 million in grants programs authorized by the opioid legislation that passed the chamber last week under the Commerce, Science, Justice Appropriations bill released yesterday. It's set for subcommittee markup Wednesday and the opioid funding is a priority for Appropriations Chairman Hal Rogers. The subcommittee approps bill: http://go.politicoemail.com/?qs=12e319443906fbedd8955606033e74d346a52dac2e5b56c90f4b63f8680e00ab

APPROPS SUBCOMMITTEE GIVES LITTLE BOOST TO FDA - The Senate Appropriations Agriculture-FDA subcommittee approved a bill Tuesday that provides a modest lift to FDA's discretionary budget for medical product safety: $11.9 million. The topline discretionary figure for the whole agency is $2.759 billion.

... The legislation itself won't be released before Thursday, when the full committee marks it up. That's when there could be fireworks around various amendments and/or riders - such as the House appropriators' provision to undercut FDA's oversight of e-cigarettes.

E&C COMMITTEE THREATENING TO SUBPOENA REINSURANCE DOCUMENTS - In a letter to HHS Secretary Sylvia Mathews Burwell and CMS Acting Administrator Andy Slavitt, House GOP legislators expressed frustration at the administration's lack of follow through on its document requests. 

The "lack of transparency about the status of the responses to the Committee's document requests is unacceptable," wrote chair Fred Upton and allies. At issue is whether CMS is improperly diverting $3.5 billion that should go to the federal treasury to reinsurance payments for health plans competing in the Obamacare marketplaces. 

Read the letter: http://go.politicoemail.com/?qs=12e319443906fbed8b03b4b16e132100afcd6f493839a165932907ed767f9cbd

WHAT'S NEXT ON PART B DEMO? - Tuesday's House E&C hearing split along party lines, with Republicans arguing that Medicare's initiative harms patients and Democrats addressing why the payment experiment should be kept but improved. Still, Wall Street expects CMS to stick with the controversial pilot. The demo is "80 percent likely to be adopted by CMS in July 2016 and implemented in fall 2016," Evercore ISI wrote in an investor's note on Tuesday.

- Two Part B critics wrote the exact same complaints in their testimony, Rep. Jan Schakowsky noted. "Quite a coincidence," Slavitt tweeted.

** A message from PhRMA: PhRMA member companies invested $58.8 billion in research and development in 2015, up 10.3 percent from 2014, new data show. For more than 30 years, the U.S. biopharmaceutical industry has led the world in the development of medicines, and PhRMA member companies continue to be at the forefront. Learn more. **

HOUSE LEADERSHIP NAMES CARA CONFEREES - Twenty-one Republicans and 14 Democrats will represent the House in a conference committee with the Senate on the Comprehensive Addiction and Recovery Act. Majority Leader Kevin McCarthy will lead the Republicans and Energy and Commerce Committee Ranking Member Frank Pallone leads the Dems. The Senate has not named conferees yet. 

The differences between the two chambers' legislation to address the opioid epidemic are not deal-breakers, Pro's Brett Norman notes. A final bill is expected to go to the president's desk in July.

AAP UNHAPPY ABOUT TODAY'S CHILD NUTRITION MARKUP - The House Education and the Workforce Committee is marking up its child nutrition reauthorization bill, and the American Academy of Pediatrics says the bill would hurt families living in poverty. 

"The bill would significantly weaken access to healthy, nutritious foods for our nation's children and now includes a deeply troubling three-state block grant proposal that compromises the integrity of the school breakfast and lunch programs and their ability to serve all children in need," writes AAP head Benard Dreyer.

Read the letter: http://go.politicoemail.com/?qs=12e319443906fbed706c84bd13c5f933f5b60221735db3f726da04bc7f571f29 

ON THE HILL TODAY - About 600 members of the American Society of Anesthesiologists are lobbying lawmakers about allowing safe anesthesia care for veterans.

Meanwhile, in the insurance markets: 

HIGHMARK SUES FEDS TO COLLECT NEARLY $200M IN RISK CORRIDOR FUNDS - The Blue Cross Blue Shield plan filed a lawsuit on Tuesday in the U.S. Court of Federal Claims. Highmark is the second insurer to sue over the shortfall in risk corridors payments, following a class-action lawsuit brought by a nonprofit insurer in Oregon that went out of business.

SOME CO-OPS SHOW SIGNS OF STABILITY ... Three of the surviving plans - Maryland's Evergreen Health, New Mexico Health Connections and Massachusetts' Minuteman Health - turned modest profits in this year's first quarter, according to new financial filings analyzed by Pro's Paul Demko.

... BUT MOST ARE STILL STRUGGLING. As a whole, the nonprofits lost nearly $30 million in the first three months of 2016 after losing more than $400 million in 2015.

More context from Paul for Pros: http://go.politicoemail.com/?qs=12e319443906fbed82e32676e835980730b796b6cd6b90af6e96b7566f9aac82 

 - Sign of the times. It's seen as a victory that Community Health Options, the co-op plan operating in Maine and New Hampshire, lost less than expected, Paul notes. The startup was a poster child in 2014, the only plan to operate in the black right out of the gate. But last year it ran into deep problems, with losses of more than $70 million, putting state insurance regulators on high alert. 

The co-op did slightly better than anticipated in the first quarter of this year. Community Health Options utilized $8.5 million of its premium deficiency reserve to mitigate first quarter losses, less than the anticipated drawdown of $9.7 million. "Things are marching along according to plan," Kevin Lewis, the co-op's CEO, tells PULSE. "We're beating the model."

OSCAR ASKING FOR 30 PERCENT RATE HIKES - That's according to our colleague Dan Goldberg, who writes for POLITICO New York that the start-up insurer is proposing to increase rates between 8 percent and 30 percent on individual plans in New York, according to a letter sent to brokers. 

While venture capitalists have valued Oscar as a $2 billion start-up, "breaking into the market has proven costly, and original assumptions about population health have proven incorrect," Goldberg writes. More: http://go.politicoemail.com/?qs=12e319443906fbed84f5e44e2fa74ea9a3608e9a23ea9f6bdf6068479fd07430 

Oscar lost another $45 million across its various markets in the first quarter of 2016, according to the latest filings.

POLITICO Pro Health Care Report - Reaching the Tipping Point: Health Care Delivery Reform: A conversation about regional variation in health care delivery system reform. How are different parts of the country responding to the push for value-based payment in the public and private sectors? Why do delivery and payment reforms take root in some markets but not others?

I'll be moderating this with POLITICO's Executive Editor for Health Care, Joanne Kenen. Thursday, May 19 - Doors at 8:00 a.m.; W Hotel - 515 15th St NW.RSVP: http://go.politicoemail.com/?qs=12e319443906fbed6fb2be8ab350ebe38d899b1426dc39a97849ddbb0f9944e5

IS LARRY ROBBINS GIVING UP ON HEALTH CARE? - The hedge fund titan lowered Glenview Capital's ownership stake in 11 of 16 health care companies in the first quarter of 2016, Modern Healthcare's Bob Herman reports. 

With health care stocks stumbling, Glenview sold off all of its 11.59 million shares of Community Health Systems and its 1.21 million shares of Universal Health Services. Glenview also reduced its ownership of Aetna, Anthem, Cigna and Humana.

The only health care companies where Glenview maintained or grew its stakes: hospital operators HCA and Tenet, pharma firm AbbVie, inpatient rehab operator HealthSouth Corp. and post-acute care provider Kindred Healthcare.

More: http://go.politicoemail.com/?qs=12e319443906fbed53afdb0233c6e4cb83c105bce3898fa27ede855862d1fa2f 

BARBARA STREISAND WANTS SENATE TO PASS MEDICAL RESEARCH BILL - The Hollywood star, who's also the co-founder of the Women's Heart Alliance, is sending a letter to all senators today to encourage them to pass the Advancing NIH Strategic Planning and Representation in Medical Research Act. The legislation is intended to improve researchers' understanding of how diseases uniquely affect women, among other goals.

Read Streisand's letter: http://go.politicoemail.com/?qs=12e319443906fbeda0382874f868daf4c4869a5a7fb85cd6b998ce15f5351610 

EMPLOYERS SHOULD PLAY KEY ROLE IN PUSHING HEALTH REFORMS - That's according to a new report from the American Health Policy Institute and the Pacific Business Group on Health, which concludes employers should help drive the move toward value-based care.

"To date, employers have relied on relatively blunt instruments for managing health care costs - selecting health plans based on network discounts and provider access, and increasing consumer cost-sharing to mitigate cost trends," the report reads. But "employers' tool box is changing" thanks to pilot programs like medical homes, the use of telehealth and tiered networks

Read the report: http://go.politicoemail.com/?qs=12e319443906fbed69c013d2354abb6dd3f595e1b60c46014278d4910d869d4f 

JEB BUSH IS BACK - IN HEALTH CARE. The ex-presidential candidate and former Florida governor has rejoined the board of Jackson Healthcare, a health care staffing company, in one of his first post-campaign career moves: http://go.politicoemail.com/?qs=12e319443906fbed0c2eb0de1a902666b21a040351fe7098d5bd9e5d5caec9ef (h/t Nancy Cook)

WASHINGTON, D.C., NAMED 'FITTEST CITY' IN NATION - It's the third straight year that the District has claimed the honor, awarded by the American College of Sports Medicine today.

WHAT WE'RE READING by Nancy Cook

Zika virus should not halt Olympics in Brazil, says top WHO official: http://go.politicoemail.com/?qs=12e319443906fbedbdf943f62c691d104e0749434422b41c7d9616b09a3c6195 

Opinion: NIH Director and Secretary of Labor on how administration's new overtime rules will help young scientists: http://go.politicoemail.com/?qs=12e319443906fbed3980d54c01d30d303c3aa3303269ead6dbbbaf8686e745cf 

Rating hospitals by the stars: The feds' latest plan to measure quality is the most controversial: http://go.politicoemail.com/?qs=12e319443906fbedd0a46364f1fcdb6c42ea2b3971cd71c12f53329722753c84 

Johnson & Johnson to stand behind talc's safety at upcoming trial: http://go.politicoemail.com/?qs=12e319443906fbed8f9d6e6ef94e3acff7306ebaafddb48d9ca1424f7ae23338 

The coder who rescued the Obamacare website has a new project - Streamlining veterans' access to benefits online: http://go.politicoemail.com/?qs=12e319443906fbed68a181274022b146655d1fb975013cf3f416b84994cec9be 

Affordable Care Act implementation at three years: What's working and what's not working via a roundtable on the Diane Rehm Show: http://go.politicoemail.com/?qs=12e319443906fbed7b7a553187c269fc6396ab15a6ba71261205147fda138662

** A message from PhRMA: The biopharmaceutical industry continues to be the most research and development-intensive industry in U.S. economy, and PhRMA member companies are at the forefront. New data show PhRMA member companies invested $58.8 billion in research and development in 2015, up 10.3 percent from 2014. The biopharmaceutical industry's long-term research and development investments have led to more medicines in clinical development than ever before, more than 7,000 medicines globally. From 2000 to 2015, more than 550 new medicines were approved by the U.S. Food and Drug Administration - including a record 56 new medicines in 2015. Given just 12 percent of medicines in clinical
 trials ever make it to patients it is critical we have pragmatic, pro-innovation policies to sustain the long-term investments needed to develop tomorrow's cures. Learn more about the industry's commitment to researching tomorrow's treatments and cures here. **

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