DFA Round Up – June 9, 2017

  • As the Senate attempts to fast-track repeal, step up and sign our petition urging the Senate not to take away coverage from millions of Americans.
  • Join us June 22nd for a White Coat Fly-in. Given the Senate’s announcement that they will be fast-tracking a bill to repeal the ACA by the end of the month, we are hosting an emergency White Coat Fly-in this month instead of July. We will hold a press conference and lobby day along with Congressman Raul Ruiz (CA-36) and other provider partners, to send a strong message that Congress should not support any proposal that strips coverage from 23M Americans, and does not provide affordable, quality health care for all. The Senate is closer than ever to repeal. We need you in DC. RSVP to join us.


Senate Republicans are reportedly nearing a bill to repeal the Affordable Care Act, coalescing around a replacement plan that diverges from the House bill, in an effort to garner support from more moderate Republicans. Key GOP centrists have expressed their willingness to end federal funding for Medicaid expansion, creating an opening for more convergence within the party on this critical issue. Republican proposals would gradually phase out funding over a slower timeframe, and cap federal payments to states. The Senate bill is also poised to allow states waivers for Obamacare rules on essential health benefit requirements, but not the more popular consumer protections for pre-existing conditions. These changes have received strong pushback from conservatives, creating a similar dynamic among centrists and conservatives which had caused problems for House leadership to pass a bill. Furthermore, Republicans have included language in the bill that prohibits abortion coverage, which may be non-compliant with Senate procedural rules that only allow for budgetary changes. This has drawn fire from conservative, anti-abortion groups who have vowed opposition to any bill that does not include abortion restrictions.  President Trump has affirmed his interest in an aggressive timeline for repealing the law, with some reporting that Senate Republicans may try to vote on a bill by the end of June.

With little guidance from the administration, insurers remain uncertainabout their continuation in federal marketplaces. Anthem exited the Obamacare market in Ohio earlier this week, leaving at least 18 counties and 13,000 people without any coverage option under the program next year. An Anthem exit would in other markets would raise the number of uninsured to 300,000 across seven states. In New York, health insurers are seeking an average 16.6% premium rate increase, a substantial increase in cost for New Yorkers who do not receive help from Obamacare subsidies. Without clarity on whether cost-sharing reduction payments will continue, or whether the individual mandate requirement will be enforced, companies have requested anywhere from a 4.4% to 48.8% rate increase for Affordable Care Act plans. In the wake of the growing insurer exodus from the exchanges, Senate Republicans are concluding that cost-sharing subsidies will have to continue in order to stabilize the market, and are likely to include this in their repeal bill. Though Price has confirmed that the Department of Health and Human Services budget for the next fiscal year includes funding for the payments, it is still unclear for how long these will remain.


Tell us about what you are up to! Email your updates and photos to [email protected].


Dr. Ram Krishnamoorthi was invited by Oren Jacobsen to give a talk in Northbrook to a group that meets monthly to hear about various issues and ways to take action. He spoke about health care reform and urged attendees to speak out at this critical moment for the health of millions of patients.


Dr. Bruce Rector, leader of DFA’s Drug Pricing, Value, and Affordability Campaign, spoke at the Public Health Association of NYC Legislative Breakfast on drug affordability and public health.


Dr. Lisa Plymate shares that the state Health Care is a Human Right coalition created a video featuring coalition members titled, “What’s Your Plan?” You can watch it here.


The DFA Food Team, led by Rita Nguyen, Isabel Chen and Rebecca Parad, held a Food As Health webtalk recently. The conversation focused on the many patients who struggle with food insecurity, though often don’t share this struggle with their health care provider. Guest experts discussed the importance of understanding patients’ food access situations and supporting them with connections to nutritious food as an important part of any treatment plan to prevent or manage illness. A campaign to address food insecurity will be launching this summer. View a recording of the webtalk here.


Dr. Bruce Rector, a leader of the DFA Drug Pricing Team, which includes Dennis Deruelle, Justin Lowenthal, and Mark Rood, have had an impressive three wins already this year on drug affordability that DFA contributed to getting passed. An overview is below:

Maryland: At the end of the legislative session, the Legislature passed a drug pricing law intended to curb price gouging. It gives Maryland’s Attorney General the power to demand explanations from drug companies for unconscionable price increases for generic or off-patent drugs, and to administer fines. We previously wrote about how this bill should serve as a model for legislators in other states.

New York: A new law sets an annual cap on Medicaid prescription drug spending. It aims to limit total payments to the sum of medical inflation plus 5%. If this is exceeded, it allows regulators to conduct a review that uses scientific studies and other information to determine if specific medications are overpriced in relation to their medical benefits.

Nevada just passed a bill, S.B. 539, that mandates transparency from both pharmaceutical companies and the middlemen in the drug pricing process known as pharmacy benefit managers (PBMs). PBMs are responsible for negotiating between pharmacies and insurance companies. The bill also requires that health care nonprofits disclose any contributions they receive from the pharmaceutical industry, PBMs and insurers. It was approved by the State Senate 19-2 and has been sent to the Governor’s desk; he stated he will be proud to sign it.


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