First Edition: November 20, 2014

Kaiser Health News: Costly Hepatitis C Treatments Help Drive 12 Percent Drug Spending Jump
After several years of modest increases, American spending on medications is projected to shoot up by 12 percent this year, pushing the nation’s drug bill to between $375 billion and $385 billion, according to a report by the IMS Institute for Healthcare Informatics. Several factors are driving the spending spike, including the introduction of expensive new hepatitis C drugs and fewer drug patent expirations than in previous years, the report found. Such expirations typically lead to savings as cheaper generics replace brand-name drugs. (Rabin, 11/20)

Kaiser Health News: Study: American Seniors Face Health Care Gaps, Despite Medicare
Americans older than 65 are more likely to have chronic illnesses and to say they struggle to afford health care – despite qualifying for the federal Medicare program – than are seniors in other industrialized countries, according to a study by the Commonwealth Fund published Wednesday in the journal Health Affairs. The findings, which are based on phone surveys conducted in 11 industrialized countries, highlight gaps in Medicare coverage that should be addressed, said Donald Moulds, one of the study’s authors and executive vice president for programs at the fund. (Luthra, 11/19)

The New York Times: Obama’s Immigration Plan Could Shield Four Million
But farm workers will not receive specific protection from deportation, nor will the Dreamers’ parents. And none of the five million immigrants over all who will be given new legal protections will get government subsidies for health care under the Affordable Care Act. These new details about the broad reach of Mr. Obama’s planned executive action on immigration emerged as he prepared to speak to the nation in a prime-time address on Thursday night. (Shear and Pear, 11/19)

The Washington Post's Wonkblog: Obama’s Order Won’t Extend Obamacare To Undocumented Immigrants
That means the millions who will be protected from deportation won't be eligible to purchase subsidized coverage from the public health insurance marketplaces established under the Affordable Care Act. The decision will disappoint advocacy groups, but it doesn't come as a total surprise. The Obama administration passed on a similar opportunity two years ago to extend health-care eligibility to so-called "dreamers," illegal immigrants who entered the United States as children. In September, the Obama administration said it cut off ACA marketplace coverage to about 115,000 immigrants who failed to provide proof of their citizenship or immigration status. (Millman and Eilperin, 11/19)

The New York Times' Bits: Chasing Entrepreneurial Opportunity In The Affordable Care Act
Some foes of the Obama administration’s Affordable Care Act portray the law as nothing less than socialist-style government control of American health care. Noah Lang, a health care entrepreneur, is not one of those people. Mr. Lang, chief executive of Stride Health, explains that the Affordable Care Act is one of two major developments in the last few years that have made it possible for a company like his San Francisco start-up to exist. The other big force, he says, is the explosion in available health data, led by government initiatives, notably HealthData.gov. (Lohr, 11/19)

The Washington Post: Paul Ryan: Obama Already Hurting Chances For 2015 Cooperation
Rep. Paul Ryan, the incoming chairman of the powerful House Ways and Means Committee, laid out an expansive agenda Wednesday for 2015, including a GOP alternative to the Affordable Care Act and a fix for the looming shortfall in the federal disability insurance program. An overhaul of the nation’s tax laws will also rank high on the agenda when Ryan (R-Wis.) takes the helm of the tax-writing panel in January. However, Ryan acknowledged significant hurdles to passing tax reform during President Obama’s final years in office, and said far-reaching legislation may have to wait until a new president is seated in 2017. (Montgomery, 11/19)

The Wall Street Journal: Republican Governors Set Sights on 2016 Presidential Race
Five of the six governors who are considering a presidential bid appeared on a discussion panel and teased out their differences concerning immigration, Medicaid and other issues. ... The governors exploring presidential campaigns span the party’s spectrum of ideology and style. During the discussion, which included the governors of Louisiana, Indiana, Wisconsin, Texas and Ohio, some of those differences emerged. Indiana Gov. Mike Pence called for repealing the 2010 health care law “lock stock and barrel.” Ohio’s John Kasich defended his state’s decision to expand Medicaid, which has come under fire from the right. (Hook and Haddon, 11/19)

The Wall Street Journal: Christie’s Strategy on National Issues: Address Some, Not Others
Mr. Christie said the Supreme Court shouldn’t rule on gay marriage, instead leaving it to states to make decisions. He has supported the Keystone XL pipeline—a popular position among the Republican business base. And he has bashed the Affordable Care Act, even as New Jersey accepted a Medicaid expansion that been controversial among conservatives. (Dawsey, 11/19)

The Wall Street Journal's Pharmalot: Sticker Shock: Some Medicare Part D Beneficiaries Will Pay More Next Year
As the new year approaches, many Americans with prescription drug coverage provided by Medicare Part D may encounter sticker shock. The reason is that more Part D beneficiaries will be expected to pay co-insurance, which means they will be asked to pay a higher percentage of the total cost of their medicines. As many as 66% of Part D plans will apply co-insurance, an increase of 83% from last year, for their top formulary tiers, according to an analysis by Avalere Health, a consulting firm. These tiers include expensive specialty medicines and so-called non-preferred brand-name drugs, which are reimbursed at lower rates. (Silverman, 11/19)

NPR: Gilead Buys Shortcut For FDA Drug Review For $125 Million
How much is a fast track for the Food and Drug Administration review of a new drug worth? Try $125 million. In an auction, Gilead Sciences, a maker of HIV and hepatitis medicines, just bought a coupon good for the accelerated review of a drug of the company's choice from Knight Therapeutics, a Canadian company. The priority review voucher entitles Gilead to move a drug of its choice through the FDA four months faster than the normal track. (Hensley, 11/19)

The Wall Street Journal: Fallout From Gruber’s Remarks Spreads
The fallout over comments made by a Massachusetts Institute of Technology economist about the Affordable Care Act has spread to the states, where both Republicans and Democrats are pulling back from a man who sold his expertise about health systems. Vermont said it won’t continue to pay Jonathan Gruber for his work on its health-insurance plan, which aims to create universal coverage financed with public funds. Michigan lawmakers said they plan to investigate work he did for that state. (Armour, 11/19)

The Washington Post's Fact Checker: Explainer: What Gruber Meant When He Said ‘If CBO Scored The Mandate As Taxes, The Bill Dies’
What did Gruber mean when he uttered this words in a now-infamous video that has inflamed hostility to the Affordable Care Act? This is a bit of a wonky subject, but we think it is worth explaining, because commentators on both the right and the left have jumped to the wrong conclusion. They assumed Gruber was discussing the fact that the administration had not described penalties for failing to get insurance as “taxes,” even though the Supreme Court later said Obamacare was constitutional because the individual mandate was indeed a tax. But that’s not correct. (Kessler, 11/19)

The Wall Street Journal: NIH Proposes Greater Disclosure Of Clinical Studies
Federal health officials on Wednesday took steps to compel scientists to make clinical study results public even when the findings cut against the interest of pharmaceutical companies. The National Institutes of Health released a proposed rule that would give federal officials more power to enforce a 2007 law that generally called for results of many medical studies to be published. The proposed rule would, for example, typically require researchers to publish later-stage studies even when the FDA doesn’t approve the drug or device being evaluated. (Burton, 11/19)

Los Angeles Times: Judge Won't Stop L.A. County From Sending 91,000 Medi-Cal Cancellations
More than 91,000 Medi-Cal recipients in Los Angeles County will be sent letters this week telling them that their state-supported health care coverage will end on Nov. 30. A judge this week refused to block the notices, even though health advocates argued that the letters lack important details that would help recipients renew their plans. (Brown, 11/19)

Los Angeles Times: Southland Employers Expect 4.8% Hike In Health-Benefit Costs
Southern California employers expect their health-benefit costs to rise 4.8% next year as the economy recovers and mandates under the federal health law kick in, a new survey shows. Nationwide, more people are expected to sign up for health benefits at work during the current open enrollment season as new federal rules begin taking effect in 2015 and penalties increase for being uninsured. (Terhune, 11/19)

Los Angeles Times: California Health And Child-Welfare Agency May Seek Increase In Tobacco Tax
Under preliminary consideration are proposals to push state lawmakers to tax "e-cigarettes" or increase existing taxes on tobacco products — and even to snag a share of any tax revenue from legalized marijuana sales if California decides to go that route. The agency considering those options, First 5 California, is among a group of agencies and health organizations supported by California's web of tobacco taxes, which brought in an estimated $835 million in the 2013-14 fiscal year, a decline from $1.2 billion in 1999-2000, a year after cigarette taxes last rose. (Willon and Mason, 11/19)