Subject: POLITICO Pulse, presented by PhRMA: Most exchange shoppers happy with coverage — Oklahoma passes bill making performing abortions a felony — The hopes for delivery system reform
From: POLITICO Pulse <[email-masked]>
To: <[email-masked]>
Date: Fri, 20 May 2016 08:03:08 -0600

By Dan Diamond | 05/20/2016 10:00 AM EDT

EXCHANGE SHOPPERS ARE HAPPY WITH THEIR COVERAGE - As reports of double-digit rate increases for 2017 come pouring in, new data from the Kaiser Family Foundation shows that most marketplace customers are happy with their current coverage. About two-thirds rate their coverage as either "excellent" or "good." 

A slight majority of respondents said they're satisfied with the cost of their plan's premium, while half of respondents are satisfied with the cost of their deductible. But researchers note that respondents were slightly more dissatisfied with their premium and deductible costs in 2015 than they were in 2014. One potential explanation: There was a more than 30 percent surge in enrollment in high-deductible plans, which expose customers to higher care costs.

And despite broad focus on narrow networks, at least 74 percent of shoppers were satisfied with their choice of primary care doctors or hospitals in their networks. (They were a little more concerned about availability of specialists: Only 59 percent of respondents said they were happy with their specialist options.)

See the survey: http://go.politicoemail.com/?qs=4937a7fe6f886a4ba9ac6fe6676105ce01b5aa9ef94bc7c48ccfba6b2e6b4673 

OKLAHOMA PASSES BILL MAKING PERFORMING ABORTIONS A FELONY - Under the first-of-its-kind bill, physicians who perform an abortion would lose their medical licenses and could face three years in prison. There's only one exception: If the abortion was to save the mother's life. 

Republican Gov. Mary Fallin, who hasn't said whether she'll sign the bill, has four business days left to decide - or it automatically becomes law without her signature. The measure would put Oklahoma at odds with federal law if it takes effect, and it would certainly be challenged in court. Abortion-rights groups say the bill explicitly flouts Roe v. Wade and is unconstitutional.

More for Pros: http://go.politicoemail.com/?qs=d34b332cd6166928fb3abdabc7a10db35f76e069b2bef5f25e87a25064509d42 

THANK GOODNESS IT'S FRIDAY PULSE - And I'm thankful that I can use my fingers to count to five. Soccer goalkeeper Nick Rimando, on the other hand... Tips to [email-masked] or @ddiamond on Twitter.

WHAT YOU MISSED AT THE 'TIPPING POINT' - Thursday's event on health care delivery reform, moderated by POLITICO and presented by the Commonwealth Fund, tackled questions on how fast those reforms are taking effect, who's driving the pace of change and what comes next.

Here are a few excerpts from the spirited discussion:

HHS office of health reform director Meena Seshamani: "From the Medicare perspective, we have more than 470 ACOs and 9 million beneficiaries in them. There's been an incredible partnership between the public and private sector ... The train is moving."

Montefiore executive Andrew Racine: "The ACA is what government should be doing ... setting the table, putting the incentives there, and finding some way to partner both with the states and with the private sector to get it to happen."

Catholic Health Initiatives executive Clifford Deveny: "There's a lot of change fatigue ... MACRA, we see that as probably being more disruptive than the whole ACA. Because as you start to change how physicians are paid ... those will pull a lot different levers."

Yale professor Zack Cooper: "We've got to start testing our interventions in health care the way we test drugs - randomized trials ... We're starting to bring the science we see outside of health care delivery to see what's going on."

Watch video of the event: http://go.politicoemail.com/?qs=90276f640db0a470fb1571c4f3f63fc967a455b2cecd7a24149e65a659beb3a6 

U.S. Ebola czar says GOP is being 'irresponsible' on Zika. In an interview for POLITICO's new "Pulse Check" podcast, Ron Klain - who led the White House's successful response to the Ebola outbreak - says that Congress is fiddling around with Zika virus, and America's already getting burned. To listen to the full interview and ensure you don't miss upcoming "Pulse Check" episodes, subscribe to the podcast on iTunes. http://go.politicoemail.com/?qs=06430000b65d6eb41e0ad607e2dc20dce2cce2cde5d2b762fe9eed9ebc589107 

FREE SPEECH, FIREARMS AND FLORIDA - We're a month away from an appeals court hearing on Wollschlaeger v. Governor of Florida, which challenges a Florida law limiting what physicians can say to patients about gun ownership. The case is expected to have wide-ranging implications, researchers write in NEJM, who add that there are key reasons for doctors to talk about the public health effects of gun ownership.

"Every U.S. case - control study, for example, has shown that the presence of a gun in the home is a strong risk factor for suicide," they write, adding that the odds of suicide are more than three times as high in homes with guns as in those without guns.

More: http://go.politicoemail.com/?qs=b774b7ef4ef58521d3816983c3ed8856373b4e8c2f3d16e1383316de073a46ee

Meanwhile, a pair of eye-catching cover stories in major magazines explore two key health care trends: Pharma's profit chasing, and the rise of drug-resistant bacteria. 

Bloomberg: The real reason Big Pharma wants to help pay for your prescription. The article details how pharma firms from Turing to Valeant are using charity programs to cover for drug price hikes.

"This is not a feel-good story," Benjamin Elgin and Robert Langreth write. "It's a story about why expensive drugs keep getting more expensive, and how U.S. taxpayers support ... a very profitable form of investing for drug companies - one that may also be tax-deductible."

The Economist: When the drugs don't work. The package of stories, which tackle the rise of antibiotic resistance, concludes that political leadership is needed to curb over-reliance on drugs.

"The lack of an incentive to do the right thing is hard to correct," the lead article reads. "In some health-care systems, doctors are rewarded for writing prescriptions. Patients suffer no immediate harm when they neglect to complete drug courses after their symptoms have cleared up, leaving the most drug-resistant bugs alive."

** 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. **

WHEN TWO TESTIMONIES COME FROM ONE AUTHOR - Yesterday's PULSE featured the odd story of two witnesses using nearly identical written statements to criticize Medicare's Part B demo at a House subcommittee hearing. The common thread: Hart Health Strategies, the lobbying firm representing both of them and which goofed on its write-up.

- The lobbyist's response: Hart Health Strategies president Vicki Hart told our POLITICO Influence colleagues that in the future her firm will keep an eye out for identical passages when they help prepare witnesses. 

She also emphasized that the verbatim words were describing the background process, not the witness's experiences. "Who do people think writes testimony?" she said. "I don't think its so unusual for a health care lobbying firm to have health care clients use our assistance. What's the rub? That's our job."

GO OUTSIDE OF HEALTH CARE TO MAKE AMERICANS HEALTHIER? - That's according to the leaders of the Aetna Foundation and the American Public Health Association, who write in Health Affairs that health care leaders need to tackle non-traditional issues like community safety and pollution to improve patient outcomes. More: http://go.politicoemail.com/?qs=84753ccf92864f35bf3c44db03c7ccab4c37c6ab62b2e95f4ab7e2c8144f290f 

THE HEALTH RISKS FACING TRANSGENDER TEENS - Pennsylvania's physician general says the White House's recent guidance on transgender students, which reaffirm the rights under Title IX, is as much a civil rights issue for transgender students as it is a health issue

Rachel Levine - who is transgender herself - treated a number of LGBTQ students as a doctor at the Penn State Hershey Children's Hospital-Milton S. Hershey Medical Center and saw first-hand the risks they face, including higher rates of depression, anxiety, substance use and suicide. 

"There's nothing inherent in the LGBTQ population that gives them that risk," she told our POLITICO Education colleagues. "It's the victimization and bullying that puts them at risk." 

SEEKING LESSONS FROM 1115 DEMOs - George Washington University professor Sara Rosenbaum and colleagues this week evaluated the six states that expanded Medicaid through 1115 waivers, which generally require beneficiaries to bear more costs. 

Those states: Arkansas, Indiana, Iowa, Michigan, Montana and New Hampshire. Other states, including Arizona and Ohio, are pursuing 1115 demos too. 

"Early reports from demonstration states are raising questions and issues for future research and program evaluations," the authors write. "In reality, few people may be paying premiums because some states are not actually enforcing their requirements. Conversely, for people who are required to pay, disenrollment may be widespread."

More: http://go.politicoemail.com/?qs=84753ccf92864f35df4928450361ef1eea045a4ea5c86074cca667edf3ba47e8 

QUITTING SMOKING IMPROVES NATIONAL HEALTH CARE - A new study in PLOS Medicine finds that if 10 percent of American smokers decided to stop, and the rest cut back by 10 percent, the country's national medical spending would fall by $63 billion per year. More from Reuters: http://go.politicoemail.com/?qs=472ada02024e5435728486bfcd5518f5144a26178ee3ab8fb9898a2aa909a925 

WHAT WE'RE READING

Horribly sad: Florida man says he killed his wife because he couldn't afford her meds. http://go.politicoemail.com/?qs=867b8f719726dc2bd4ef246ee2c6fd18022e685aa897040b01b64bf21cf24c92 

Julia Belluz on the link between our inability to understand risk and variable surgical outcomes. http://go.politicoemail.com/?qs=867b8f719726dc2bf85a7c8bb899155b7b2a161b7d5b2baa4b6b19a3c6011547 

In the face of everything, Theranos is planning a major expansion, Rebecca Robbins and Meghana Keshavan report. http://go.politicoemail.com/?qs=2af6f877b0ac1754dd6b6e56d1e7f854687990080638546529ee6a91e508682c 

Meet a doctor who's going state to state in the Midwest to provide abortions to patients who have no or few alternatives. http://go.politicoemail.com/?qs=c58f43887b3bdaeb46d0c5813821a6639c14991c7cbd71d68e0e85fd54b81c21

** 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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