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Covered California & The Health Law

California Republican Lawmakers Could Help Tip Scale Against GOP Plan

If enough vulnerable Republicans defect, the House leaders may not be able to push their plan through their chamber. Meanwhile, Los Angeles Times readers weigh in on the American Health Care Act.

Los Angeles Times: Vulnerable California Republicans Find Themselves At Center Of Healthcare Bill Persuasion Efforts
Seven California Republicans are among the 23 Republicans nationwide who represent House districts that chose Hillary Clinton for president. Now they find themselves at the center of the debate over the proposed House GOP healthcare bill. While Republicans hold a large majority in the House, more than two dozen GOP defectors would be enough to keep the bill from passing. (Wire, 3/15)

Los Angeles Times: Our Readers Are Split On GOP Healthcare Plan 
For the past several weeks, we've been asking people to grade President Trump on his performance and share their stories of how his presidency has affected them personally. The answers have varied greatly. Then last week, House Republicans released their plan to replace the Affordable Care Act, and we received an overwhelming number of responses on the issue. Here's what some of you had to say. (Leu, 3/15)

And in other news —

Orange County Register: More Than 2.5 Million Southern Californians May Lose Health Insurance Under GOP Plan
Many of the 2.5 million Southern California residents insured by Obamacare could lose coverage under the Republican replacement plan, local health experts say. The uninsured rate in California has reached a record low of 7 percent since the passage of the Affordable Care Act, or Obamacare. In Los Angeles, Orange, Riverside and San Bernardino counties, about 674,025 people receive subsidized plans through Covered California, the state exchange, and 1.8 million through expanded Medi-Cal, known nationally as Medicaid. (Perkes, 3/15)

Fresno Bee: Covered California Says AHCA Would Increase Premiums For Some 
A House Republican plan to replace health insurance subsidies available through the Affordable Care Act with tax credits based solely on age could make coverage unaffordable to older and lower- to middle-income Californians, according to Covered California, the state’s health insurance exchange. An analysis by Covered California said the proposed American Health Care Act would cut support to buy health insurance by 40 percent in 2020. “Providing 40 percent less funding means there will be less coverage,” said Peter V. Lee, executive director of Covered California. “It means fewer Americans will be able to afford to purchase health insurance.” (Anderson, 3/15)

Enrollment Numbers Dip Slightly And Fall Short Of Obama's Goals

More than 12 million signed up for coverage under the Affordable Care Act as premiums increased, but advocates blame the small decrease on the Trump administration's failure to make a spirited enrollment push.

Los Angeles Times: Obamacare Enrollment Drops, To 12.2 Million, As Congress Debates Repeal
Driven by a drop-off in enrollment after President Trump took office, total sign-ups for Obamacare health plans fell this year for the first time, a new report released by the Trump administration Wednesday indicates. A total of 12.2 million Americans enrolled in a plan through one of the healthcare law’s marketplaces during the 2017 open enrollment period, according to the report, which provides a final tally of this year’s signups. The 2017 final figure, which updates a preliminary report released last month, was down from 12.7 million in 2016. (Levey, 3/15)

Sacramento Watch

Gubernatorial Candidate See S.F. Health System As Model To Emulate

Healthy San Francisco covers everyone regardless of immigration status or ability to pay. Lt. Gov. Gavin Newsom signed the program into law when he was the city's mayor.

Sacramento Bee: Gavin Newsom Wants San Francisco Health Care Model For California 
Through focusing on regular checkups and preventative care, [Alice] Chen says overall health care costs have ticked down over the past decade, due in large part to the system’s ability to divert patients away from costly emergency room visits and catch health complications before they escalate to severe illness and disease. That concept is fundamental to Healthy San Francisco, the city’s universal health care program adopted a decade ago that covers everyone regardless of immigration status or ability to pay. (Hart, 3/16)


State Senator Introduces Bill To Curtail Pharma's 'Arms Race Of Profit Generation'

The proposal would require manufacturers to give 90 days' notice to purchasers before significantly increasing a drug's price.

Los Angeles Times: Claiming Momentum Is On Their Side, California Lawmakers Try Again To Require More Transparency On Drug Prices
California Democrats, labor unions, health insurers and consumer advocacy groups — along with newly joined backer Tom Steyer, the billionaire activist — are restarting their effort to shed more light on prescription drug prices after a similar measure sputtered last year. State Sen. Ed Hernandez (D-West Covina) unveiled his new bill at a Capitol news conference Wednesday. (Mason, 3/15)

Capital Public Radio/KXJZ: Sen. Hernandez Takes Another Shot At Drug Price Transparency Bill 
Under SB 19, drugmakers would have to notify consumers 90 days in advance of a substantial price hike. Sen. Hernandez says his bill would also require health plans to report the proportion of the premiums spent on prescription drugs. "Looking at what's happening with our health care system right now, at the end of the day, consumers always going to want and demand lower health care prices and it's our responsibility in government to make sure they have it," he says. (Johnson, 3/16)

KPCC: State Senator Introduces New Drug Price Transparency Bill 
[Drug makers] would also have to describe any changes or improvements to the effectiveness of the drug that explain the increase, or state if there were none. The regulations would apply to drugs with a wholesale cost above $600 a month whose price increased by more than 25 percent in the previous three years, and to drugs with a wholesale cost less than that amount whose price increased by more than 10 percent over the same time period. (Plevin, 3/15)

Public Health and Education

Kennedy Warns Mental Health Conference That Difficult Times Are Ahead

Former Rep. Patrick Kennedy, an advocate for mental health services, spoke at a two-day mental health care conference aimed at highlighting local programs that bridge the gap between mental health services and minority groups.

Santa Rosa Press Democrat: Santa Rosa Summit: Reduce Stigma Of Mental Health Treatment 
At a statewide mental health conference Wednesday in Santa Rosa, former U.S. Congressman Patrick Kennedy spoke openly about his own struggles with mental illness and addiction and the continued fight to make mental health services a priority. Kennedy, the nephew of President John F. Kennedy and son of the late Sen. Edward Kennedy, cautioned a group of almost 300 mental health workers and advocates from all over the state that difficult times are ahead, as lawmakers in Washington move to repeal Obamacare and cut the federal Medicaid program. One such proposal, proposed by GOP member of Congress, would send Medicaid payments as block grants to states. Critics say that would most likely lead to deep cuts in the Medicaid program. (Espinoza, 3/15)

In other public health news —

National Roundup

GOP Health Plan Will Undergo 'Necessary Improvements,' Ryan Promises Wary Lawmakers

House Speaker Paul Ryan tries to salvage support for his plan, as both the right wing and the moderates in his party revolt. What to do with Medicaid is a major issue being worked through.

The Associated Press: GOP Leaders Acknowledge Health Bill Changes, May Delay Vote
Their health care overhaul imperiled from all sides, the White House and top House Republicans acknowledged Wednesday they would make changes to the legislation in hopes of nailing down votes and pushing the party's showpiece legislation through the chamber soon. House Speaker Paul Ryan, R-Wis., declined to commit to bringing the measure to the House floor next week, a fresh indication of uncertainty. (Fram and Alonso-Zaldivar, 3/15)

The Washington Post: Ryan: Health Care Plan Must Change To Pass The House
Speaking after a private meeting of GOP lawmakers, Ryan said that leaders would “incorporate feedback” from the rank-and-file in response to the CBO findings. He did not repeat his previous comments calling support for the bill a “binary choice” for Republican lawmakers. “Now that we have our score we can make some necessary improvements and refinements to the bill,” he said, referring to the CBO’s estimate of the effect on the number of those covered by health insurance and what the GOP proposal would cost. (DeBonis, 3/15)

The Wall Street Journal: Republicans Explore Changes To Health-Care Plan
In conversations with House leaders and administration officials, lawmakers focused on proposed changes to Medicaid, with conservative House Republicans pressing for work requirements and an earlier phaseout of the expansion started under the Affordable Care Act, known as Obamacare. Some Senate Republicans also sought to boost the value of tax credits to give more aid to low-income and older people who buy insurance. Others wanted to strike a provision that calls for insurers to charge higher premiums to consumers who let their coverage lapse, a measure intended to encourage people to buy insurance. (Armour, Peterson and Radnofsky, 3/16)

Politico: Ryan, Pence Race To Salvage Obamacare Repeal Amid GOP Dissent
Meanwhile, members of the hard-right House Freedom Caucus declared that they believed they had enough commitments from their own allies to kill any attempt by Republican leaders to ram through the current bill without significant changes. They said that they intend to present to leadership an amendment on Friday that they say could unite conservatives and moderates. “It’s up for us, moderates and conservatives, to come together,” said Freedom Caucus Chairman Mark Meadows coming out of a Wednesday evening meeting. (Bade, Cheney and Haberkorn, 3/16)

The New York Times: Trump Urges Supporters To Unite Behind G.O.P. Health Plan
President Trump made a plea on Wednesday for his supporters to unite behind the Republican plan to overhaul Americans’ health care as the only way to squelch Democratic attempts to scuttle the plan. At the same time, facing resistance to the bill from within his own party, House Speaker Paul D. Ryan said it would be refined and improved. (Davis, 3/15)

The New York Times: One Certainty Of G.O.P. Health Plan: Tax Cuts For The Wealthy
The House Republicans’ plan to replace the Affordable Care Act is messy and confusing. No one is sure exactly how Americans will be affected and how much more health insurance will cost them. But there are two certainties. Their health care plan provides a tax cut for the wealthiest Americans. And it will make it easier for Republicans to pass more tax cuts this year. It could also be viewed by some people as a break from some of the populist campaign promises President Trump made to lift up the country’s “forgotten men and women.” (Rappeport, 3/15)

Wall Street Journal: Q&A: What Are The ‘Three Prongs’ In GOP’s Obamacare Repeal-And-Replace Effort?
Republican leaders have been talking about a three-part approach to reworking the U.S. health-care system in recent days. What does that mean and why are they doing it? On Tuesday afternoon alone, White House press secretary Sean Spicer repeatedly described “three prongs” and Vice President Mike Pence talked about a “multi-step process” within minutes of each other. (Radnofsky, 3/15)

Los Angeles Times: Here's Why The GOP Is Struggling To Come Up With A New Healthcare Plan: That Wasn't The Goal
The tribulations now facing Republicans are not hard to understand: The party never set out to revamp the nation’s healthcare system. That was always a Democratic pursuit. Republicans simply wanted to repeal Obamacare, which they saw as a costly government intrusion. Only after they took the White House and it became apparent that millions of Americans would lose their health coverage under a straightforward repeal did Republicans begin to take seriously the “replace” part of their campaign promise. (Mascaro, 3/15)

The Washington Post: The Long (And Surprisingly Happy) Life Of Nancy Pelosi’s ‘Pass The Bill’ Gaffe
On Tuesday afternoon, Sean Spicer made up a quote from Nancy Pelosi, and nobody complained. In 2010, famously, then-House Speaker Pelosi (D-Calif.) told the National Association of Counties that the Affordable Care Act would become appreciated when it finally became law. “We have to pass the bill so that you can find out what is in it, away from the fog of the controversy,” she said. Spicer remembered it differently. “Anyone in the country and anyone in the world, could read it,” he said of the GOP's American Health Care Act. “That's a vastly different approach than after it's being done, told, after we pass it you can read it, which is what Speaker Pelosi said.” Nobody corrected him, but why would they? (Weigel, 3/15)

Trump Slashes Health Spending In Federal Budget Plan

The administration's budget blueprint proposes reducing the Department of Health and Human Service's funding by 18 percent -- with more than a third of the $15.1 billion in cuts coming from the National Institutes of Health, the government’s main engine of biomedical research.

The Washington Post: Trump’s Budget Calls For Seismic Disruption In Medical And Science Research
President Trump’s budget calls for a seismic disruption in government-funded medical and scientific research. The cuts are deep and broad. They also go beyond what many political observers expected. Trump had made clear that he would target the Environmental Protection Agency, but the budget blueprint calls for a startling downsizing of agencies that historically have received steady bipartisan support. The National Institutes of Health, for example, would be cut by nearly $6 billion, about a fifth of the NIH budget. (Achenbach, 3/16)