Subject: POLITICO Pulse, presented by PhRMA: Zika forecast: 500 million people in the Americas are at risk — Obama's in Flint today — Iowa sues the feds over co-op
From: POLITICO Pulse <[email-masked]>
To: <[email-masked]>
Date: Wed, 4 May 2016 08:01:59 -0600

By Dan Diamond | 05/04/2016 10:00 AM EDT

Three Oregon insurers are asking for average rate hikes of at least 29.6 percent, and researchers say medical errors could be the nation's third-leading cause of death. But first: A dire new warning of the risk of Zika virus.

PAHO ON ZIKA: 500 MILLION PEOPLE IN THE AMERICAS AT RISK - Dr. Sylvain Aldighieri, the Zika incident manager for the Pan American Health Organization, said Tuesday that half a billion people in the Americas are at risk of being infected by the Zika virus. 

Aldighieri and NIAID Director Anthony Fauci briefed reporters at PAHO headquarters in Washington on the status of the Zika response. Both warned that they expect to see an influx in cases in the coming months, Pro's Brianna Ehley reports.

- Vaccine developments: Researchers are preparing a vaccine study to begin in September and should be able to determine if the vaccine is ready to test on groups of people at the beginning of 2017, Fauci said. If so, the vaccine will be tested first in an infected country and might be ready for widescale use in anywhere from one to three years.

Fauci repeated warnings that Congress must approve the full sum requested by the administration if it is to be prepared to respond to Zika and other health crises. "We cannot do the job that's necessary to be done," he said. "The president asked for $1.9 billion because we need $1.9 billion."

WELCOME TO WEDNESDAY PULSE - Where we hope you're not having these side effects from Abilify. (But if you are, you're somehow enjoying them.) Tips to [email-masked] or @ddiamond on Twitter.

With help from Brianna Ehley (@BriannaEhley)

IOWA v. FEDS: STATE FILES LAWSUIT OVER COLLAPSED CO-OP - Iowa on Tuesday sued the federal government to recover millions it believes are owed to a nonprofit insurance startup seeded with Obamacare loan dollars that collapsed after running up huge losses, Pro's Paul Demko reports.

- How it quickly went bust: CoOportunity Health received $147 million in startup loans from the federal government under the Affordable Care Act. It collapsed in December 2014 after losing $163 million that year.

- Details of the lawsuit: Iowa's insurance commissioner says that CoOportunity is owed $130 million in "risk corridor" funds, but has not received any of that money. That program was established to protect insurers entering the exchanges from big losses, but initially paid out only 12.6 percent of anticipated payments because congressional Republicans imposed restrictions.

- One key goal: The lawsuit seeks to invalidate claims by the Obama administration that the federal government should have "super priority" status in recovering funds it's owed by CoOportunity Health, which did business in Iowa and Nebraska. "The federal government has tried to jump to the head of the creditor line, but is not following Iowa or federal law in withholding over $20 million due to CoOportunity," Iowa's insurance commissioner Nick Gerhart said in a statement.

OREGON INSURERS PROPOSE RATE INCREASES - Nine of the 10 insurers that participate on the state's ACA insurance exchange are asking for average rate increases of at least 15 percent, and three are requesting average rate hikes of at least 29.6 percent. 

See the proposed rates: 1.usa.gov/1WHeXVj 

MEDICAL ERRORS MAY BE THIRD-LEADING CAUSE OF DEATH - That's according to a new BMJ study, which concludes that more than 250,000 Americans die per year because of surgical errors, inaccurate diagnoses and even communication breakdowns.

According to the researchers, led by Johns Hopkins surgeon Marty Makary, the exact toll of medical errors is difficult to quantify because of how they're reported and recorded. In an open letter, they call on CDC to update how it tracks medical errors on death certificates.

"Creating one additional field on the death certificate form to inquire if immediately preventable complications stemming from the patient's medical care was the primary contributor to the patient's death would advance the science of safety," they write

The CDC's Bob Anderson told ProPublica that the agency's approach to tracking mortality data is consistent with international guidelines. It would be difficult to change "unless we had a really compelling reason to do so," he said.

Read the study: http://go.politicoemail.com/?qs=d0bd487779fd49d7f3bd2c624ecf5605f50fb9882831f0759304f6d939ff0339

Top causes of death in 2014, per CDC
. Heart disease: 614,348 deaths
. Cancer: 591,699
. Chronic lower respiratory diseases: 147,101
. Accidents (unintentional injuries): 136,053

OBAMA'S IN FLINT TODAY - The president is spending the day in the Michigan city affected by a toxic water crisis. He'll tour local facilities, take part in a roundtable discussion, give a speech, meet with local leaders - and drink the water, if Gov. Rick Snyder gets his way.

"We are hopeful the president will drink the water in Flint, to help reinforce Gov. Snyder's actions and the EPA's message that filtered Flint water is safe to drink," Snyder's spokesperson said in a media statement. 

State of recovery. In the four months since Flint was declared a federal emergency, workers armed with blood tests and resources - including bottles of water - have poured into the city. But tens of millions of dollars in federal support are still being held up in the legislative process, and while Michigan will expand Medicaid coverage to an additional 15,000 Flint residents next week, the effort has been delayed for weeks.

HOW RICK SNYDER'S INNER CIRCLE FAILED ON FLINT - MLive.com is out with an in-depth investigation of how the Flint crisis unfolded and who knew what - and when. The article concludes that Gov. Snyder's once-praised corporate management style became his downfall. 

"A year ago ... Snyder was stoking rumors of a presidential bid as a metrics-driven Republican whose ability to run government like a business transformed a troubled state," the article begins. "Now, he is viewed as the person ultimately responsible for one of the nation's biggest public-health disasters in memory - the lead contamination of a water system serving 100,000 people, and a possible link between the water system and an outbreak of Legionnaire's disease that killed 12 people."

Read the story: http://go.politicoemail.com/?qs=d0bd487779fd49d7de5913ef267f38a0283414bcbe860ceb4509e22c328f2436

** A message from PhRMA: Developing innovative medicines is not possible without the people who volunteer to participate in clinical trials. During Clinical Trials Awareness Week, we celebrate clinical trial study volunteers who help inform the drug discovery process. Watch here how clinical trials are playing an important role in making new treatments a reality. **

HOW THE HOUSE GOP'S BUDGET SIDECAR WOULD CHANGE HEALTH CARE - House Republican leaders are trying to entice conservative hard-liners to back a $1.07 trillion budget by promising to move a separate deficit reduction package, Pro's Ben Weyl and Matthew Nussbaum report.

While the sidecar hasn't been formally unveiled, it's also not quite a secret. Several House committees have already approved bills that will make up the package, with Medicaid, Obamacare and Dodd-Frank some of the biggest targets.

Here's a roundup of the health care implications.

- The Energy and Commerce backed legislation to reduce federal contributions to the State Children's Health Insurance Program; eliminate the prevention and public health fund under Obamacare; tweak Medicaid provider taxes, provide less funds to states for providing Medicaid health care to prison inmates; and prohibit multimillion-dollar jackpot lottery winners of being eligible for Medicaid.

- The Ways and Means Committee approved bills to eliminate the Social Services block grant; and recover Obamacare subsidy overpayments.

- The Judiciary Committee approved a bill to limit damages from medical malpractice lawsuits.

BROOKINGS CAUTIOUS ON PART B DEMO - Kavita Patel and Caitlin Brandt write that Medicare's planned Part B pilot to change how the program pays for drugs is well-intentioned, but could cause unintended complications.

For instance, the Brookings Institution researchers warn that the Part B demo is competing with a new oncology care model that's also trying to improve payment, and there needs to be an exemption for organizations participating in the cancer pilot.

They also caution that CMS needs to anticipate the potential consequences related to geographic stratification. "It is possible to imagine organizations with multiple locations directing patients to optimal sites for their business," they argue, citing a Drug Channels blog post.

Read the Brookings post: http://go.politicoemail.com/?qs=d0bd487779fd49d760d23b0bb828bab76748ad9856b23b42752f43fa4a0e3810 

IMS, QUINTILES THE LATEST HEALTH CARE MEGA-MERGER - The two firms on Tuesday announced plans to merge in a nearly $9 billion deal.

IMS Health specializes in health care information and technology, while Quintiles works with pharmaceutical companies on clinical trial research. The combined organization would work "to transform the clinical development of innovative medicines, demonstrate the value of these medicines in the real world, and drive commercial success," Quintiles CEO Tom Pike said in a statement.

More: http://go.politicoemail.com/?qs=d0bd487779fd49d799981d0d0e9665f5dc9fb47a329c628e43342a6216770792 

URBAN INSTITUTE'S PRIMER ON PAYMENT MODELS - The Urban Institute and the Catalyst for Payment Reform are out with a detailed, five-part review of how different payment models and benefit design options work.

The series includes reports on:

1) How payment methods like bundled payment, capitation, and shared savings work. More.
2) How benefit designs like value-based design and high-deductible health plans work. More.
3) How payment models like patient-centered primary care. More.
4) A typology of payment models. More.
5) A typology of benefit designs. More.

THE TWO OPIOID EPIDEMICS - The Boston Globe notes that two very different public health crises are often getting conflated in news coverage and even in health care debates.

. Heroin crisis. This is largely concentrated in the Northeast and Midwest, and heroin victims tend to be men in their twenties or thirties. 
. Prescription opioid epidemic. This is affecting people across the nation, especially middle-aged Americans, and also including women.

More: http://go.politicoemail.com/?qs=d0bd487779fd49d735e8f1f8bbbef37285356791f6bf75d020a379e8d5989bc2 

PRINCE DIED A DAY BEFORE ADDICTION DOCTOR WAS TO TREAT HIM - That's according to an attorney working with the doctor's family, the Star Tribune reports.

Prince's representatives called Howard Kornfeld, a nationally known specialist in opioid addiction, on the night of April 20 with an urgent medical request. Kornfeld wasn't able to immediately make the trip from California, but sent his son - who arrived at Prince's estate on the morning of April 21, helped find Prince unconscious and reportedly was the one who called 911. http://go.politicoemail.com/?qs=d0bd487779fd49d79021164c32892dad66d21668b12a4ab3ddbe7434f0ee9870

CHANGES AT HHS - Secretary Burwell on Tuesday announced one new hire and two other significant changes.

. Drew Littman, who's been working at Venn Strategies, is joining HHS as Senior Counselor. Littman, who previously worked for Sens. Al Franken and Barbara Boxer, will focus on communication and external engagement issues and inherit some of Leslie Dach's portfolio.

. Sonya Bernstein will become a Deputy Chief of Staff with more responsibility for communications and long-term scheduling.

. Dawn O'Connell's role is being broadened to include implementing top priorities out of the Administration for Children and Families, including unaccompanied children and refugee issues. 

PLANNED PARENTHOOD BACKS STRICKLAND IN OHIO - Planned Parenthood today is endorsing former governor Ted Strickland in his Ohio Senate race against sitting Sen. Rob Portman. The organization's endorsement is one of its first of the cycle, and its announcement focused as much on bashing Portman as it did on backing Strickland. "Senator Rob Portman has voted to severely restrict access to these critical services at Planned Parenthood health centers and shamefully dismissed reproductive care as illegitimate," Planned Parenthood's Cecile Richards said in a statement.

WHAT WE'RE READING, by Rachana Pradhan

Democrats in the Arizona House on Tuesday failed to restore the state's CHIP program through a budget amendment, the Associated Press reports.http://bit.ly/1VJmsw7

Bloomberg's Zach Tracer profiles a blues singer who helped revolutionize America's drug pricing model. http://go.politicoemail.com/?qs=d0bd487779fd49d7a3d01031bbfdcad4189757c2bb4df05d11a654185d1a2e6b

The Washington Post reports on a JAMA study suggesting that health care price transparency tools aren't saving much money. http://go.politicoemail.com/?qs=d0bd487779fd49d737ada906ebc9be7b24b175450a0c9bbe4e3371b7a084952e 

The Wall Street Journal has the latest on lawsuits against Johnson & Johnson from women who blame their ovarian cancer on the company's baby powder. http://go.politicoemail.com/?qs=d0bd487779fd49d76fa42ce97a827b60aafe29772dcdf668c32d79bae2fb384d

Also from the WSJ: soda sales in Mexico are on the rise again two years after it imposed a tax on sugary drinks. http://go.politicoemail.com/?qs=d0bd487779fd49d7597f0aa1c27495b52cf1b5ed4c0a9c6f2ce11b246aceae33

** A message from PhRMA: A dynamic and collaborative health care ecosystem is crucial to conducting efficient and effective clinical trials, but 2/3 of trials fail to enroll enough participants. Misconceptions and a lack of awareness about this important research often keep people from participating. During Clinical Trials Awareness Week, get the facts about how America's biopharmaceutical companies are designing new ways to conduct clinical trials to increase efficiency and bring medicines to patients faster. Learn more here. **

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