Viewpoints: Tread Carefully When Revamping FDA; GOP Still Missing Subsidy Strategy

Bloomberg View: How To Fix The FDA: Carefully
The process for approving new drugs in the U.S. takes a long time and costs a lot of money. But in trying to speed things up too much, Congress runs the risk of allowing drugs to reach the market that aren't necessarily safe. Some lawmakers -- led by Energy and Commerce Committee Chairman Fred Upton, a Republican from Michigan, and Diana DeGette, a Colorado Democrat -- assert that drugs are slow in coming because the Food and Drug Administration has been failing to innovate quickly enough. But last year the agency approved more new drugs than in any other year in almost two decades. (5/22)

The Wall Street Journal: A Legal Cure For The FDA’s Free Speech Malady
We are free to tell you that a clinical trial shows the drug Vascepa to be an effective treatment for persistently high triglyceride levels. But should the drug’s manufacturer, Amarin, tell you or your doctor the same thing, the company would face criminal prosecution and civil liability. Therein lies a First Amendment anomaly, one that may finally be resolved by a lawsuit that Amarin filed earlier this month against the Food and Drug Administration. (David B. Rivkin Jr. and Andrew Grossman, 5/21)

The Wall Street Journal: In Search Of An ObamaCare Breakout
We often ask Congressional Republicans how they prefer the Supreme Court to rule in the ObamaCare subsidies case—as a matter of politics, putting aside the law. The smarter ones usually demur, because they know the risks are real, the damage is potentially large, and many of their colleagues are complacent even at this late hour. With a ruling in King v. Burwell approaching in June, there are troubling signs that Republicans in Congress are headed for another friendly-fire massacre that ends in a victory for President Obama. To borrow the novel idea of Wisconsin Senator Ron Johnson, this time Republicans would be smarter to try to win the inevitable debate with a unified and politically defensible strategy. (5/21)

The Washington Post's Plum LIne: Sorry, Republicans: Obamacare Is Getting More And More Entrenched
Republicans have always had a problem where rhetoric meets reality on the Affordable Care Act. In the abstract, the law has never been overwhelmingly popular, but many of the things the law actually does — like preventing insurance companies from denying coverage because of pre-existing conditions — are extremely popular. And so, if Republicans actually succeed in reversing the law’s progress in a meaningful way — as they might with the King v. Burwell lawsuit that could take coverage from millions of people — they may realize, like the dog that caught the car, that this wasn’t such a hot idea after all, and they might not know what to do about it. (Paul Waldman, 5/21)

The Wall Street Journal: Quality Now Trumps Quantity In Stats On Uninsured
Sometimes, fixing one statistical problem creates a new one. For years, the Current Population Survey conducted by the U.S. Census Bureau overestimated the number of people without health insurance. Last year, the Census Bureau revised the survey to correct the error, which was likely caused by the way the government asked Americans about their coverage. The fix, which had been in the works since 1999, should produce more-accurate estimates. But responses obtained with the new methodology aren’t compatible with responses collected using the previous approach, making it harder to examine uninsured rates over the years at a crucial moment—as Americans try to gauge the success of the Affordable Care Act. (Jo Craven McGinty, 5/22)

Palm Beach Post: Gov. Rick Scott Gets His LIP Split As Feds Blink On Medicaid Expansion
It’s been a battle for the ages over Medicaid expansion between the Obama administration on one side and Gov. Rick Scott and the Florida House of Representatives on the other this year. Just days ahead of the budget special session, the U.S. Department of Health and Human Services has blinked first. In a letter sent to the Florida Agency for Health Care Administration today, the U.S. Department of Health and Human services has tentatively agreed that $1 billion is how much hospitals and safety-net providers can expect to be made available for uncompensated care next year, through a program known as LIP, or the Low Income Pool. ... That pretty much of a win for Scott, at least for this year. That $1 billion is close to what the LIP has been for many years, with the exception of last year, and it’s a lot better than zero, which was the concern raised in the closing days of the regular legislative session. So does that mean Scott and House Speaker Steve Crisafulli can declare victory and ignore Medicaid expansion? Not quite. (5/21)

Tampa Bay Times: Case For Medicaid Expansion Gets Stronger
Now the urgency is even greater for Florida to accept billions in federal Medicaid expansion money and provide private health coverage to more than 800,000 Floridians. The Obama administration signaled Thursday it is prepared to cut by more than half the federal money it sends to an account that helps hospitals cover the cost of treating the uninsured. That reaffirms that the most fiscally and morally responsible action for the Legislature to take in its June special session is to adopt the Senate's bipartisan plan, accept the Medicaid expansion money and transform how poor people get medical care. (5/21)

Orlando Sentinel: Senate Plan Offers Fla. Solution To Health Needs
If we simply reject the Washington model and never pass a Florida solution, the federal government will certainly have no reason to consider alternatives to the Medicaid expansion contemplated by Obamacare. However, if the Senate, House and Gov. Scott work together to present Florida's best offer for coverage expansion, we can put our state in the best posture to negotiate free-market guardrails that emphasize personal responsibility and control the future cost and growth of the Medicaid program for Florida's taxpayers. (Florida Senate President Andy Gardiner, 5/22)

The Miami Herald: Florida House Should Allow Vote On Medicaid Expansion
How will the Florida Legislature divvy up $80 billion? Each year the Legislature meets for 60 days to sort through all types of issues, but the only bill they are required to pass is an annual spending plan referred to as the appropriations bill — more commonly called the state budget. This year the Republican-led House and Senate failed to pass that one bill before session ended. The two chambers could not reach a consensus on whether or not to accept federal funds to expand Medicaid coverage to an additional 840,000 of Florida’s working poor. The full Senate wanted to, the House leadership did not. (Paula Dockery, 4/21)

The Wall Street Journal: At Last, Scrutiny For Public-Union Deals
If you’ve ever spent hundreds on a smartphone or thousands on a new car, you know what it’s like to hunt for the best deal. Yet when paying for state and local government services worth billions, Americans often hand politicians a blank check without ever knowing if they could get more for their money. Year after year, elected officials behind closed doors negotiate labor contracts for 19 million state and local government workers. The result? Skyrocketing salaries, health-care costs and pension benefits are making services like public schools and policing unaffordable for taxpayers. According to the Bureau of Economic Analysis, compensation for government workers nationwide has grown 21% since 2000, compared with only 9% in the private economy. (Matthew J. Brouillette, 5/21)

Reuters: CVS-Omnicare Portends Lower Doses Of Pharmacy M&A
CVS Health’s $10 billion deal for Omnicare portends lower doses of pharmacy M&A. The drugstore’s purchase gives it entrance to nursing homes and expands specialty medicine distribution. But the increasingly concentrated industry is bumping up against antitrust concerns and may have to live with fewer transactions. (Robert Cyran, 5/21)

The New England Journal of Medicine: Symbol Of Health System Transformation? Assessing The CMS Innovation Center
The Center for Medicare and Medicaid Innovation (CMMI), created by the Affordable Care Act (ACA), is catalyzing profound changes in U.S. health care. Congress gave CMMI $10 billion for fiscal years 2011 through 2019 to test “innovative payment and service delivery models to reduce program expenditures . . . while preserving or enhancing the quality of care”; it has the power to expand any model that reduces costs without reducing quality or improves quality without increasing costs and to make it an ongoing part of Medicare. Since CMMI began operations, it has created numerous programs .... But it faces four key challenges. (Lawrence P. Casalino and Tara F. Bishop, 5/21)

The New England Journal of Medicine: The CMS Innovation Center — A Five-Year Self-Assessment
We believe the Innovation Center's work to date has demonstrated that government can learn, work with the private sector, and implement evidence-based policy with creativity, efficiency, and effectiveness — and in doing so, catalyze improvement in health care delivery across the United States. Of course, the Center has also faced challenges — beginning with the difficulty of measuring quality in health care. Although CMS has driven health care improvement through quality measurement, the science of quality measurement continues to evolve. (Rahul Rajkumar, Matthew J. Press and Patrick H. Conway, 5/21)