California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

In This Edition:

Latest From California Healthline:

California Healthline Original Stories

Some Immigrants, Fearful Of Political Climate, Shy Away From Medi-Cal

Some foreign-born California residents fear they could be penalized for using Medi-Cal and other social benefits. Others, in families of mixed-immigration status, worry about jeopardizing their loved ones’ chances of becoming green-card holders or citizens. (Emily Bazar, 2/16)

5 Reasons Why An $89,000 Drug Has Congress Fuming

A drug from Marathon Pharmaceuticals has ignited a firestorm on Capitol Hill and beyond. What makes it different than the $750,000 drug that came before it? (Sarah Jane Tribble and Sydney Lupkin, 2/16)

Summaries Of The News:

Sacramento Watch

With ACA Repeal Looming, Calif. Lawmakers To Propose Single-Payer System For State

No state has a single-payer system, and critics say it would require hefty tax increases. However, advocates contend that taxes would replace insurance premiums, and savings would come from eliminating the huge administrative costs of insurance companies.

The Mercury News: California Lawmakers To Introduce Single-Payer Health Care Plan Today
In a surprise move that further complicates President Donald Trump’s push to repeal and replace the Affordable Care Act, two California lawmakers today plan to introduce legislation that would create a single-payer health care system covering all 38 million Californians — including its undocumented residents. The universal health care plan, called the Healthy California Act and being proposed by Sens. Ricardo Lara, D-Bell Gardens, and Toni Atkins, D-San Diego, doesn’t offer much in the way of detail right now. (Seipel, 2/17)

Covered California & The Health Law

'Everybody Is Holding Their Breath': San Diego Has A Lot To Lose If ACA Is Repealed

One in nine of the county's residents could lose insurance, and officials worry the cost is going to fall onto their already-strained budget. Meanwhile, angry constituents are calling on Rep. Jeff Denham, R-Turlock, to hold a meeting on health care.

inewsource: Without Obamacare Or A Replacement, 370,000 In San Diego County Could Lose Insurance
Scripps Institution of Oceanography scientist Linda Rasmussen is “extremely nervous” about President Donald Trump’s plan to repeal Obamacare. It’s kept her healthy since 2014, when she enrolled in a subsidized plan through Covered California, the health insurance marketplace the law enabled. If Republicans repeal it without an equivalent replacement, and without federal subsidies she now receives, she’ll be out of luck. Because of a pre-existing condition decades ago, she said, “I would not be able to get health insurance period, not at any cost. I’d be completely uninsured,” just like before the health reform law took effect. (Clark, 2/16)

Modesto Bee: People At Town Hall In Modesto Challenge Denham To ‘Show Your Face’ And Speak With Constituents About ACA Repeal
About 300 people gathered in a Modesto church for a town hall Wednesday evening, urging Republicans in Congress not to repeal the Affordable Care Act. Union groups and health advocates kept up pressure on Rep. Jeff Denham, R-Turlock, to not support dismantling the federal health program unless there’s a new plan that protects consumers and covers more people. (Carlson, 2/16)

And in other news —

Fresno Bee: California Medi-Cal Leader In Wait-And-See Mode On Affordable Care Act Repeal 
Diana Dooley doesn’t like to speculate about a repeal, replacement or repair of the Affordable Care Act, but the secretary of California’s Health and Human Services Agency knows changes are coming. She’s just not sure when Obamacare, as the Affordable Care Act is widely known, will be cut or modified. “My message now is that we have a law and we’re operating under that law,” she said Thursday shortly after speaking to students at the Pay It Forward Luncheon Series at Fresno State. (Anderson, 2/16)

Molina Blames Participation In Health Law For 'Clearly Unacceptable' Earnings

The company hinted it might withdraw from the marketplaces, saying there are “simply too many unknowns” to commit to participation beyond 2017.

Los Angeles Times: Molina Healthcare Stock Dives On 'Clearly Unacceptable' Earnings 
Molina Healthcare Inc. shares plunged Thursday, the day after the Long Beach insurer said losses related to its participation in the Affordable Care Act marketplace led to “clearly unacceptable” earnings for 2016. The insurer reported after the close of regular trading Wednesday that its adjusted earnings per diluted share fell to 50 cents last year, down from $2.57 the year before. (Masunaga, 2/16)

State of Health: CEO Of California-Based Health Insurer Says Obamacare Just Needs A Tune-Up 
[CEO J. Mario] Molina says there’s been a serious downside to his company’s success: a provision of the Affordable Care Act known as “risk transfer.” The program was designed to help insurance companies cover losses, if they ended up with a lot of really sick, expensive patients. The way it works: companies with fewer sick patients pay some of their revenues to the companies that have more. It was a fine idea, Molina said, but the formula lawmakers came up with to calculate risk was all wrong. (Dembosky, 2/17)


Exclusive CRISPR Licenses 'Bottleneck' Innovation, Legal Experts Argue

Licensing deals cut by UC Berkeley and Massachusetts’ Broad Institute may be limiting the potentially lie-saving applications of this gene-editing technology, according to assertions made by intellectual property experts in Friday’s issue of the journal Science.

Stat: Exclusive CRISPR Licenses Slow Development Of Therapies, Legal Experts Argue
The exclusive licenses granted to three for-profit companies on key discoveries about the revolutionary genome-editing technology CRISPR-Cas9 threaten to “bottleneck” its use “to discover and develop useful human therapeutics,” patent experts argued in a paper published on Thursday. What the exclusive licenses have done “is give an entire industry to … companies that will never be able to fully exploit it,” Jorge Contreras of the University of Utah, a co-author of the paper in Science, said in an interview. “And that may hold back the development of therapies.” (Begley, 2/16)

The Mercury News: How UC Berkeley's CRISPR License Could Limit Innovation
A smart biotech company could have a great idea for how to use gene editing to develop a new lifesaving therapy — but because of the way licensing deals have been cut by UC-Berkeley and Massachusetts’ Broad Institute, it would never get a chance to try it. That’s the assertion of intellectual property experts in Friday’s issue of the journal Science, who criticize the licensing landscape around the taxpayer-funded and powerful new tool called CRISPR-Cas9, warning it could limit its promise. “The way universities license biotechnology — through for-profit surrogate companies — may ultimately hinder innovation,” according to intellectual property attorneys Jacob Sherkow of New York Law School in New York, who co-wrote the new paper with Jorge Contreras of the University of Utah. (Krieger, 2/16)

Veterans Health Care

After Notable Drop Last Year, San Diego VA Gets Star Back In National Rankings

Jack Harkins, a member of the United Veterans Council in San Diego County, said news of the VA’s three-star rating last year made his phone ring and ring. After implementing a variety of improvements the clinic is back to four stars.

San Diego Union-Times: San Diego VA Health System Regains Four-Star Rating 
San Diego VA officials announced Thursday that their health system has regained its four-star rating — after dropping to three stars several months ago — based on performance from October 2015 through September of last year. This interim rating, out of a possible five stars, is being circulated internally in the U.S. Department of Veterans Affairs. It’s expected to be formally released to the public in the fall. But local VA leaders didn’t want to wait until then to share their progress. Media coverage in December revealed that the VA had a previously private star rating program for its regional health networks, and the San Diego VA Healthcare System was one of a handful in nationwide that had suffered a notable drop in performance year over year. (Sisson, 2/16)

Public Health and Education

Physicians Embracing Role In Combating Human Trafficking

Victims of trafficking often have to visit clinics or the ER, where doctors can look for signs of abuse.

Sacramento Bee: Sex-Trafficking Victims Find Specialized Care At Mercy Clinic 
[Ronald] Chambers, like a growing number of health care providers across the country, has waded into the disturbing world of human trafficking to learn how to better recognize and treat its victims. Although the illicit trade has become a media buzzword in recent years and a cause célèbre for public health campaigns, medical professionals have, until recently, remained largely in the dark about their role in helping fight the crime. (Caiola, 2/17)

National Roundup

GOP Leadership Presents 'Smorgasbord' Of Repeal Options, But Few Concrete Details

House Speaker Paul Ryan met with rank-and-file Republicans to review a plan to dismantle and replace the health law on Thursday. Ryan told reporters leadership will introduce the legislation after the House's upcoming recess.

The Associated Press: GOP Leaders Unveil New Health Law Outline, Divisions Remain
At a closed-door meeting in the Capitol basement, House Speaker Paul Ryan, R-Wis., and other party leaders described a broad vision for voiding much of President Barack Obama's 2010 statute and replacing it with conservative policies. It features a revamped Medicaid program for the poor, tax breaks to help people pay doctors' bills and federally subsidized state pools to assist those with costly medical conditions in buying insurance. Lawmakers called the ideas options, and many were controversial. One being pushed by Ryan and other leaders would replace the tax increases in Obama's law with new levies on the value of some employer-provided health plans — a political no-fly zone for Republicans averse to tax boosts. (Fram, 2/16)

NPR: GOP Health Care Would Cut Coverage For Low-Income Families
The outline plan is likely to take away some of the financial help low-income families get through Obamacare subsidies, and also result in fewer people being covered under the Medicaid health care program for the poor. "In general this is going to result in fewer people covered nationwide," says Caroline Pearson, a senior vice president at Avalere, a health care consulting group. (Kodjak, 2/16)

The Washington Post: House GOP Discusses Obamacare Replacement Ideas — But Doesn’t Call Them A Plan
According to numerous lawmakers and aides in the room, as well as a policy memo distributed afterward, the House leaders laid out elements of a repeal-and-replace plan — including long-standing Republican concepts like health savings accounts, tax credits and state high-risk pools for the chronically sick. But they did not detail how those elements would fit together or get passed into law. “It’s sort of a smorgasbord right now,” said Rep. Daniel Webster (R-Fla.). (DeBonis and Snell, 2/16)

The Wall Street Journal: GOP May Trim Tax Break For Employer-Backed Insurance
House Republicans, looking for ways to pay for their plan to repeal and replace the Affordable Care Act, are considering changing the special tax treatment for employer-provided health benefits. Capping how much of employees’ health benefits can be shielded from income and payroll taxes is one of the ways GOP lawmakers might offset the cost of their emerging health plan. (Peterson and Rubin, 2/17)

In other national health care news —

The New York Times: Trump Health Pick Says Medicaid Needs A Major Overhaul
President Donald Trump's pick to run the government's major health insurance programs said Thursday that Medicaid needs a full overhaul but she doesn't support turning Medicare into a "voucher" plan. Indiana health care consultant Seema Verma testified before the Senate Finance Committee on her nomination to lead the Centers for Medicare and Medicaid Services, or CMS. The $1 trillion agency oversees programs that cover about 1 out of 3 Americans. (2/16)

The Washington Post: Medicaid Exposes Rifts Within The GOP Over The Program’s Future After The ACA
As congressional Republicans move from talking points to details of how to abolish the Affordable Care Act, behind-the-scenes jockeying over the future of Medicaid demonstrates the delicate trade-offs the GOP faces in trying to steer health policy in a more conservative direction. For years, many Republicans have railed against the ACA’s expansion of Medicaid, which has extended coverage to about 11 million people. But now that they have the political power to reverse those gains, internal disagreements have emerged. Some lawmakers want to preserve the federal money their states are getting under the expansion. Others argue that part of that money should be shifted to states that did not broaden their programs — or used for other purposes. (Eilperin, Goldstein and Snell, 2/16)

The Wall Street Journal: U.S. Authorities Pressed China For Action On Deadly Opioid
China’s crackdown on an extremely potent synthetic narcotic came amid pressure from U.S. authorities and evidence linking it to hundreds of U.S. overdose deaths since it first emerged in Ohio in July. The drug, carfentanil, has been connected to at least 700 fatalities in states including Ohio, Michigan and Florida, according to data compiled by The Wall Street Journal from county medical examiners and NMS Labs, a private laboratory outside Philadelphia that performs toxicology testing for counties around the U.S. (Kamp and Campo-Flores, 2/17)

Editorials and Opinions

Viewpoints: Drug Prices Are Meaningless -- And That's The Problem

A selection of opinions on health care developments from around the state.

Los Angeles Times: Trump Tries To Save Obamacare Exchanges While Undermining Them 
With the drive to “repeal and replace” Obamacare losing steam, the Trump administration quietly moved to shore up a key feature of the healthcare law this week: the state exchanges where people shop for non-group coverage. And to its credit, Trump’s Department of Health and Human Services zeroed in on some of the factors that have led a handful of major insurers to leave the exchanges. But before you praise (or condemn) Trump for coming to Obamacare’s rescue, consider this: Another arm of the new administration has taken a step that could undo much of the work the department is trying to do, and leave the exchanges no better off — and possibly in worse shape — than they are today. (Jon Healey, 2/16)

Los Angeles Times: Trump's IRS Stages A Stealth Attack On Obamacare
e Internal Revenue Service has become the first agency to follow President Trump’s directive to start undermining the Affordable Care Act. In a quiet rule change, but an important one, the IRS has told tax preparers and software firms that it won’t automatically reject tax returns that fail to state whether the tax filer had health insurance during the year. That effectively loosens enforcement of the ACA’s individual mandate. It appears to be a direct response to Trump’s Jan. 20 executive order requiring federal agencies “minimize...the economic and regulatory burdens of the Act.” (Michael Hiltzik, 2/15)

Sacramento Bee: California Provides Model To Replace The Affordable Care Act
The new administration and Congress are under intense pressure to craft a market-based alternative to the Affordable Care Act. It won’t be easy. To achieve the financial stability required to make the market work, reformers should heed some important lessons from California. Health plans and risk-taking medical groups essentially made a “deal” with Congress to participate in the ACA. They agreed to cover applicants with pre-existing conditions without charging higher premiums in return for: an expanded individual market driven by a federal mandate that everyone buy insurance; premium and cost-sharing subsidies financed by insurers and the government; and three federal risk-mitigation programs to help stabilize the new marketplaces. (Leonard D. Schaeffer and Dana Goldman, 2/14)

Sacramento Bee: Republicans Are Running Away From Their Constituents
As recent town-hall meetings of GOP Reps. Tom McClintock of Elk Grove, Jason Chaffetz of Utah, Gus Bilirakis of Florida, Diane Black of Tennessee and others turn into well-publicized tongue-lashings, their colleagues are ducking and running. ... In Roseville, McClintock left his town-hall meeting with a police escort. “It’s the first time I’ve ever had a police department have to extract me from a town hall, and I’ve done well over 100 of them,” he told the Los Angeles Times. The scene is reminiscent of the tea party summer of 2009, but the energy is on the other side this time. Now, as then, the victims say the perpetrators are outsiders – Chaffetz said those who protested him included “paid” people from out of state, an echo of Nancy Pelosi’s claim of “astroturfing” – but now, as then, the anger is real. (Dana Milbank, 2/15)

Orange County Register: California Job Losses From Obamacare Repeal? Fear Not!
Obamacare was a cash cow for providers, which now argue it was a program for jobs and economic growth. They now say that repealing Obamacare will kill California jobs. That grabs any politician’s attention, but it is not true. According to a study by the UC Berkeley Labor Center, which is promoted by the California Hospital Association, “The majority (135,000) of these lost jobs would be in the health care industry, including at hospitals, doctor offices, labs, outpatient and ambulatory care centers, nursing homes, dentist offices, other health care settings and insurers. (John R. Graham, 2/16)

Los Angeles Times: With Billions At Stake, A Federal Judge Just Nullified The GOP's Most Cynical Attack On Obamacare 
Moda Health, a small Oregon health insurer, just won a $214-million judgment against the federal government. Normally that wouldn’t be worth reporting, except that in awarding Moda the money, the federal judge in the case dismantled the most cynical attack on the Affordable Care Act that congressional Republicans had devised... OP politicians such as House Speaker Paul Ryan (R-Wis.) talk continually about a lack of competition on the Affordable Care Act exchanges as though that’s a structural flaw in Obamacare. They don’t admit that much of that lack of competition is their own handiwork. (Michael Hiltzik, 2/13)

Los Angeles Times: Direct-To-Consumer Drug Ads: A Bad Idea That's About To Get Worse 
Direct-to-consumer, or DTC, drug ads on TV became a thing in 1997, when the Food and Drug Administration greenlighted such marketing. Prior to that time, the thinking among policymakers was that consumers lacked the medical expertise to make informed decisions about prescription meds, and that such matters were best to left to doctors. (David Lazarus, 2/15)

Los Angeles Times: How Aetna Frittered Away $1.8 Billion On A Merger Destined To Fail 
Let’s calculate the financial carnage of Aetna’s breakup with Humana, a $34-billion merger deal that was shut down by a federal judge three weeks ago and ended by the two big insurance companies on Tuesday... This is the usual unspecific pap employed to justify any big merger, especially in healthcare. If we’ve learned anything from experience, it’s that such mergers end up raising prices and reducing efficiencies and innovation. In other words, the opposite of what [Mark] Bertolini claimed. That’s because lower prices and greater efficiencies and innovation stem from competition, which is exactly what mergers like the Aetna-Humana deal destroy. (Michael Hiltzik, 2/15)

Santa Rosa Press Democrat: Keeping Sonoma Valley Hospital Healthy: Yes On B
Last year, Sonoma residents celebrated the 70th anniversary of one of the community’s most cherished assets — Sonoma Valley Hospital. Since its founding in 1946, the hospital has played a central role in ensuring both the physical and economic health of the valley. With some 476 employees and a payroll of roughly $30 million, the hospital is reported to have an overall economic impact on the region of about $100 million. But as anyone associated with health care today knows, there are no long-term guarantees, especially for rural hospitals. (2/14)

Los Angeles Times: Dr. Oz Takes On Those Bogus For-Profit Stem Cell Clinics--And Cuts Them To Shreds
The undercover investigation you’re about to see today is going to make you really angry, because we’re exposing the worst kind of scam — one that takes advantage of those most vulnerable, stealing not just their money, but their hope, their dignity.” That’s how Dr. Mehmet Oz introduces a series of segments scheduled to run on his daytime television program Tuesday. His quarry: those for-profit clinics offering supposed stem cell treatments for an implausible host of diseases — unproven, unlikely and very expensive cures. (Michael Hiltzik, 2/13)