Subject: POLITICO Pulse, presented by Stop CMS Cuts: Anti-abortion groups slowly move toward Trump — GOP hints at Obamacare alternatives — House to wrap opioid votes today
From: POLITICO Pulse <[email-masked]>
To: <[email-masked]>
Date: Thu, 12 May 2016 08:02:27 -0600

By Dan Diamond | 05/12/2016 10:00 AM EDT

Rick Scott is demanding federal funds to treat Zika virus in Florida, and Larry Ellison just gave $200 million for cancer research. But first: Anti-abortion groups are slowly making peace with Donald Trump.

ANTI-ABORTION GROUPS MOVING - RELUCTANTLY - TOWARD TRUMP. The unenthusiastic thawing of relations comes as the Trump camp has made moves that anti-abortion leaders view as potentially promising that he will champion their causes if he becomes president. 

On Tuesday evening, the presumptive GOP nominee pledged to appoint "pro-life" judges, his clearest and most prominent effort to date to tap into one of the highest priorities of anti-abortion voters. The groups also hailed Donald Trump for hiring John Mashburn, chief of staff for Sen. Thom Tillis and a prominent opponent of abortion.

The campaigns' shift toward the general election means that Trump benefits from comparison with the Democratic front-runner. "As unpredictable as Donald Trump is, Hillary Clinton is completely predictable," said Penny Nance, CEO and president of Concerned Women of America. "We have no question about where she is on these issues."

More from Jennifer Haberkorn for Pros: http://go.politicoemail.com/?qs=f4b8a993ed380f073d5a057ecc7425bf49b8de0ae703a4163381eca6d449c28e 

GOP HINTS AT OBAMACARE ALTERNATIVES, EYE EMPLOYER TAX BREAK - Several House Republicans outlined their health care priorities during an Energy and Commerce health subcommittee hearing on alternatives to the health care law on Wednesday, providing clues to the GOP task force report in the works. 

Committee Chairman Fred Upton said that he wants to ensure that no patient loses coverage because he or she is sick and promoted the role of high-risk pools and guaranteed issue. Subcommittee chairman Joe Pitts praised pooling options and portability.

- Stepping back from the employer-sponsored model? Pitts said health insurance is too closely tied to employment, suggesting that the GOP will cap or eliminate the tax benefits for employers who provide health coverage, Pro's Jennifer Haberkorn reports.

"Employer sponsored insurance is a critical part of our health care system and must be protected," Pitts said, "but for many, their health insurance is too closely tied to employment. People who are laid off, fired or have to quit working can find themselves uninsured at a time when they can least afford it. We need better options."

- Members are getting briefed today. Task force leaders will share early details of their report, per the Hill, although they're positioning the party's Obamacare alternative as a white paper, not legislation. 

THIS IS THURSDAY PULSE - Where unlike some members of the health care industry, we keep our promises: You'll get a new "Pulse Check" podcast every week. Tips to [email-masked] or @ddiamond on Twitter.

With help from Jen Haberkorn (@jenhab), Sarah Karlin-Smith (@SarahKarlin) and Brett Norman (@BrettNorman).

CHIP KAHN ON HEALTH REFORM, THE 2016 CAMPAIGN AND MORE - The head of the Federation of American Hospitals sat down with our "Pulse Check" podcast to discuss his role behind the infamous "Harry and Louise" ad campaign, how he sees the presidential election playing out for health care and what it takes to strike health policy deals on the Hill.

While Kahn thinks the industry's moving in the right direction, he criticized many recent reforms as just warmed-over ideas. "I'm frequently supportive, but just skeptical," Kahn told POLITICO. "Policy makers ... think what they're talking about is brand new, but frankly there's nothing new under the sun" in health care.

- Medicare's Part B demo is 'overreach.' Kahn said he understands why CMS is under political pressure to lower drug costs, but he doesn't think the agency's controversial Part B payment proposal is the way to do it.

"This is not a demonstration," Kahn said, pointing to the scope of CMS's proposal. "I have concern for the precedent of moving national."

Listen to the podcast: http://go.politicoemail.com/?qs=f4b8a993ed380f07ca177063c09fa8410164d52f8c9b694bbf66394fe9a85f94
Subscribe on iTunes: http://go.politicoemail.com/?qs=f4b8a993ed380f075da3cddb3c6f3997fb3e524b00ee6635fda3e65dd2d21135

Tidbit we learned from the podcast
. Kahn thinks the best bills are finely aged. "I think legislation's a lot like wine," he said. "It takes time and you can't just slap it together."

HOUSE TO WRAP UP OPIOID VOTES TODAY - The House overwhelmingly passed a bill Wednesday to establish a new federal task force to update best practices for pain management, along with several other measures targeting the opioid epidemic. Today lawmakers will vote on the Judiciary Committee's Comprehensive Opioid Abuse Reduction Act before packaging it all up to conference with the Senate.

AMA TAKES STRONGER STANCE ON OPIOIDS - For the first time, the nation's leading physician group is calling on doctors to avoid opioids, and preferably use non drug or non-opioid pain treatments.

In a letter to doctors, AMA President Steven Stack said physicians should avoid initiating opioids for new patients with chronic non-cancer pain and should limit the amount of opioids prescribed in post-operative and acute settings by prescribing the lowest effective dose for the shortest period of time if opioids are necessary. 

Read Stack's letter: http://go.politicoemail.com/?qs=f4b8a993ed380f07c162dc852ece5de702a077c5c49a58a1252e191279b0ee4e

- What's not in the letter: The AMA doesn't suggest mandatory education for physicians that prescribe opioids or call for a mandate that doctors use state Prescription Drug Monitoring Programs - although the association does say doctors should register and use the tools, which helps track any other providers that may also be giving patients opioids. And unlike recently released CDC guidelines, AMA doesn't suggest exactly how many days doctors should prescribe the drugs for. 

SLAVITT SAYS CMS NOW SUPPORTS UDIs - The agency would like to see the incorporation of unique device identifiers in electronic records and medical billing claims, acting Administrator Andy Slavitt said Wednesday in an unexpected change of his agency's position. Slavitt was testifying at a House Ways & Means Committee hearing, where he faced questions over CMS's new physician payment rule and other regulations that affect doctors. More for Pros.

** A message from Stop CMS Cuts: Medicare has proposed a payment "model" that will take clinical decision making out of the hands of physicians by allowing the government to influence decisions for seniors. A patient's care should be determined by physicians in collaboration with patients, not government regulators. Stop Medicare's experiment on seniors. Visit StopCMSCuts.com. **

FIRST IN PULSE: HEALTH SPENDING GROWTH STAYS BELOW 5 PERCENT - That's according to Altarum Institute's latest economic indicators, which found that national health spending in March grew only 4.7 percent year-over-year. It's the fifth consecutive month of spending growth below 5 percent, and the latest reminder that health care's period of slow growth - or "slowth" - isn't over yet.

- But hospitals' rapid job growth continues. The hospital sector added 22,900 jobs in April, according to the Bureau of Labor Statistics' latest estimates. If that number holds up, it would be the largest single month addition of hospital jobs in Altarum's 25 years of data and suggests that the hospital industry has grown at a record 4 percent pace since last year.

See the indicators: www.altarum.org/HealthIndicators

RICK SCOTT: FEDERAL ZIKA FUNDING NOW - The Florida governor brought his request for Zika funding straight to lawmakers on Capitol Hill yesterday. He didn't specifically endorse the White House's $1.9 billion request, but says that Congress needs to act soon. Asked if he'd consider state funding in the meantime, Scott said that fighting the virus was a "national issue." He's meeting with HHS Secretary Sylvia Mathews Burwell today.

TODAY: PLANNED PARENTHOOD ENDORSES HASSAN - The organization is backing New Hampshire Gov. Maggie Hassan in her hard-fought Senate race against sitting Sen. Kelly Ayotte. 

ACCUSED PLANNED PARENTHOOD GUNMAN DEEMED UNFIT FOR TRIAL - A Colorado judge on Wednesday said that Robert Dear isn't mentally competent, sending him to a mental health institute instead of sending him to trial. Dear is accused of killing three people and wounding nine others at a Planned Parenthood clinic last year. http://go.politicoemail.com/?qs=f4b8a993ed380f07ebaa18f036a0b4773c9a543ac27a3f31257694f8f90eadb3 

ADOLESCENTS' ACCESS TO HEALTH CARE IS GETTING BETTER - That's according to a National Center for Health Statistics report out this week, which finds that just 2.3 percent of adolescents between the ages of 10 and 17 lacked a place for preventive care in 2014, down from 4.5 percent in 2008. http://go.politicoemail.com/?qs=f4b8a993ed380f07a61c5f1deb974a32c4b06421be4480e16dbfae40a6711d53 

LARRY ELLISON GIVES $200 MILLION FOR CANCER RESEARCH - The Oracle founder's donation will allow USC to create a new multidisciplinary center led by professor David Agus, a prominent cancer specialist who's treated many Silicon Valley executives. 

According to Agus, his new role was partly inspired by a comment from one famous former patient. "I remember sitting with Steve [Jobs] and he said to me 'why can't you debug me?'" Agus said on Wednesday. Read more: http://go.politicoemail.com/?qs=f4b8a993ed380f076c8cd2af6ccfbf26206ba1adfbe993b8bd5f637e253ade83

It's the latest in a series of major donations to cancer research; Facebook billionaire Sean Parker last month announced he was donating $250 million to launch a new immunology institute, and Michael Bloomberg in March gave $50 million to Johns Hopkins.

REPORT: CHARITY CARE FALLS IN 340B HOSPITALS - Most hospitals in the 340B drug discount program provided less charity care in 2014 than they did three years before, according to a new report by the AIR340B Coalition - a pharma-backed group critical of the program's rapid expansion in recent years. That's true of all hospitals as well, in part due to the coverage expansion under Obamacare, but most 340B hospitals - 64 percent - are providing less charity care than the national average for all hospitals, the report found.

... The 340B program discounts outpatient drugs for hospitals that care for underserved populations - often Medicare disproportionate share (DSH) hospitals. "We wonder whether the DSH metric is the correct one at all anymore," AIR340B spokeswoman Stephanie Silverman told reporters.

... About a quarter of 340B hospitals provided 80 percent of all the charity care delivered in 340B hospitals. 

See the report: http://go.politicoemail.com/?qs=f4b8a993ed380f079a20e1697f76b4c9ecf0cf5c3891c3f61dd469adba1620ed

... Advocates for 340B pushed back, saying hospitals in the program treat almost twice as many low-income patients as non-340B hospitals and provide nearly 60 percent of uncompensated care. "Once again the drug industry's Astroturf group gets it conveniently wrong on 340B," 340BHealth's Randy Barrett wrote in an email. "Eligibility in the program is not based on charity care but on the number of Medicaid patients and low-income or disabled seniors served by safety-net hospitals."

EXCHANGE PLANS OFFER BETTER PROTECTION THAN EMPLOYER PLANS FROM OUT-OF-POCKET COSTS - That's according to a new Commonwealth Fund report that compares cost-sharing in marketplace plans versus employer-sponsored plans. For instance, researchers found that employer-based plans are more likely to require that beneficiaries meet a deductible for primary care visits. About 28 percent of silver plans in the exchanges required patients to meet a deductible before getting covered for primary care versus 35 percent for employer-based plans. 

See the report: http://go.politicoemail.com/?qs=f4b8a993ed380f073dfe285e917ef243e8e71fd60f2fe514e9dd399a1c0cd1ce 

TRUMP'S ECONOMIC PLANS CONFUSE EXPERTS, AGAIN - A top economic adviser to Republican presidential candidate Donald Trump said his policies would generate a surplus of as much as $7 trillion in a decade, a wildly optimistic estimate that's unlikely to pan out, POLITICO's budget writers report.

Sam Clovis spoke at a conference sponsored by the Peter G. Peterson Foundation, and experts said the speech is likely to raise more questions about the economic advice that the presumptive Republican nominee is getting.

"I understand less about Trump's budget plan after listening to Mr.Clovis than I did before," David Wessel, director of the Hutchins Center on Fiscal and Monetary Policy at the Brookings Institution, tweeted.

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? Thursday, May 19 - Doors at 8:00 a.m.; W Hotel - 515 15th St NW. RSVP: http://go.politicoemail.com/?qs=f4b8a993ed380f07d0301cf143a25379bccf4b9144055363a1be1f4ad047711e 

WHAT WE'RE READING by Paul Demko

Aetna, Anthem, Cigna and Humana have spent $400 million on lawyers, investment bankers and other advisers in seeking approval for a pair of blockbuster insurance mergers, reports Modern Healthcare's Bob Herman. http://go.politicoemail.com/?qs=f4b8a993ed380f079e5271f2145787157fff92e80bb8dca5d7622e6fffb9fe6e

The 2016 summer Olympics in Brazil must be postponed or moved because of the Zika crisis, argues University of Ottawa law professor Amir Attaran in the Harvard Public Health Review. http://go.politicoemail.com/?qs=f4b8a993ed380f0745d5f619f0a4996b44b9f4551e0450e1191a005bc51cdd94

California's Obamacare exchange expects premiums to increase by an average of 8 percent for 2017, reports Kaiser Health News. http://go.politicoemail.com/?qs=f4b8a993ed380f071ab4cabea4b196cf09a53e71c3c6954f5a2e45ec8441f5f5

A series of mouse experiments is providing clues about how the Zika virus results in severe brain malformation, reports NPR. http://go.politicoemail.com/?qs=f4b8a993ed380f07fc85c6170f7d7643f6d143b2435e83537749c69415380b1c

A West Virginia medical clinic hired an anesthesiologist to treat patients with chronic pain, removing tough decisions about prescribing addictive painkillers from primary care docs, explains Abby Goodnough in the New York Times. http://go.politicoemail.com/?qs=f4b8a993ed380f07dbe7c5aa42c55912c83e1c19adf14fb2b5bcfe001200b8e8

Former Sens. Bill Frist and Tom Coburn urge the Senate to act on companion legislation to the House's 21st Century Cures Act. http://go.politicoemail.com/?qs=f4b8a993ed380f072c677f13fa25d042bd1cad755e731fb283bea24cfe7b8511

Chip Kahn - the head of FAH and this week's PULSE CHECK guest - on the questions to ask when evaluating quality measurement programs: http://go.politicoemail.com/?qs=f4b8a993ed380f07b77a7cef1a3faa7364e5d00fa6ad9e56c90baaee40d26db4

** A message from Stop CMS Cuts: Medicare has proposed a new payment "model" for Part B drugs that is really an experiment that will take clinical decision making out of the hands of physicians by allowing government bureaucrats to influence decisions for seniors. In a cookie-cutter approach, Medicare wants to sway treatment options based solely on cost and not on the patient's individual clinical needs. Rather than testing payment changes in a limited, controlled model, this is a mandatory, national experiment without patient safeguards and disclosures. Decisions about a patient's care should be made by physicians in collaboration with patients, not government regulators. 

Bipartisan lawmakers, patient advocates and providers agree: We must stop Medicare's experiment on seniors. Visit StopCMSCuts.com to learn more. **

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