• Senate Health Panel Aims for Deal on Stabilizing Markets Early Next Week The Hill by Rachel Roubein — The Senate's health panel intends to craft a bipartisan bill to stabilize the insurance markets by early next week, enabling the full Senate to pass it by the end of the month, according to Chairman Lamar Alexander (R-Tenn.). Alexander laid out the goal Thursday during the Health Committee's fourth hearing on stabilizing the markets ahead of a Sept. 27 deadline for insurers to sign contracts to sell plans on HealthCare.gov, with open enrollment beginning Nov. 1. Last week, Alexander said he'd hoped for a deal by the end of this week.
  
  
• Bipartisan Effort to Stabilize Insurance Market Hits Snag Over State Flexibility Modern Healthcare by Harris Meyer — Disagreement over how much flexibility to give states to redesign the ACA's coverage requirements under state innovation waivers could doom prospects for passage of a stabilization package before the Sept. 27 deadline for insurers to decide whether to offer individual-market plans in 2018 and what their premiums will be. Without certainty about cost-sharing reduction payments, insurers are expected to raise rates in some areas by more than 20 percent, or stop offering coverage on the exchanges entirely.

• Uninsured Rate Falls to a Record Low of 8.8 Percent Kaiser Health News by Phil Galewitz — Three years after the Affordable Care Act's coverage expansion took effect, the number of Americans without health insurance fell to 28.1 million in 2016, down from 29 million in 2015, according to a federal report released Tuesday. The latest numbers from the U.S. Census Bureau showed the nation's uninsured rate dropped to 8.8 percent. It had been 9.1 percent in 2015. Both the overall number of uninsured and the percentage are record lows. The latest figures from the Census Bureau effectively close the book on President Barack Obama's record on lowering the number of uninsured. He made that a linchpin of his 2008 campaign, and his administration's effort to overhaul the nation's health system through the ACA focused on expanding coverage. When Obama took office in 2009, during the worst economic recession since the Great Depression, more than 50 million Americans were uninsured, or nearly 17 percent of the population.

• Bernie Sanders Announces Single-Payer Bill with Major Support in Senate Huffington Post by Daniel Marans and Jonathan Cohn — Sen. Bernie Sanders (I-Vt.) unveiled Wednesday a new version of his plan to give everybody government-run health insurance, potentially opening a new chapter in the ongoing debate over how to make health care in the U.S. more affordable and available….Of course, Republican political strategists say they are equally eager to engage in a fight over single payer, because they are convinced that Americans will oppose it, particularly as they learn more about it. Where advocates like Sanders see a chance to achieve what countries including Canada, Sweden and Taiwan have (universal coverage, generally strong health outcomes and far less spending), critics in the GOP and elsewhere see the specter of taxes choking the economy and government rationing vital care.
  
  
• Medicare for all or State Control: Health Care Plans Go to Extremes The New York Times by Robert Pear — In one Senate office building, some of the leading lights of the Democratic Party gathered Wednesday to embrace what was once a proposal only of the far left: a huge expansion of Medicare, large enough to open the popular, government-run health program to all Americans. In another Senate office building, a smaller but equally adamant group of Republican senators stood together to take one last stab at dismantling the Affordable Care Act. They proposed instead to send each state a lump sum of federal money, along with sweeping new discretion over how to use it. Important elements in both parties are trying to move beyond President Barack Obama's health care law, which has always been a complicated, politically difficult mix of government and private health insurance. But they are moving in radically different directions. The proposals appeared to have only one thing in common: Neither is likely to be enacted any time soon.
  
  
• Senator Asks for CBO Score of Sanders's Single-Payer Bill The Hill by Rachel Roubein — Sen. John Barrasso (R-Wyo.) is asking congressional scorekeepers to analyze the cost of Sen. Bernie Sanders's (I-Vt.) "Medicare for all" bill, which could fuel Republican attacks that a single-payer health-care system would bankrupt the country. In a letter to the head of the nonpartisan Congressional Budget Office, Barrasso — the Senate Republican Policy Committee chairman — wrote he was "deeply concerned that Senator Sanders' Medicare-for-All legislation is not only a government takeover of health care, but would also put financial burdens on the American people that they cannot sustain." He cited a 2016 cost estimate from the left-leaning Urban Institute that a previous plan from Sanders would cost $32 trillion over 10 years.

• Senate GOP Tries One Last Time to Repeal Obamacare Politico by Burgess Everett and Josh Dawsey — Obamacare repeal is on the brink of coming back from the dead. Senate Majority Leader Mitch McConnell (R-Ky.) and his leadership team are seriously considering voting on a bill that would scale back the federal government’s role in the health care system and instead provide block grants to states, congressional and Trump administration sources said. It would be a last-ditch attempt to repeal Obamacare before the GOP’s power to pass health care legislation through a party-line vote in the Senate expires on Sept. 30. No final decision has been made, but the GOP leader has told his caucus that if the bill written by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) has the support of at least 50 of the 52 GOP senators, he will bring it to the floor, Graham and Cassidy say. That would give Republicans one more crack at repealing the Affordable Care Act, a longtime party pledge…McCain has been cautiously open to the approach, but some more conservative senators could scuttle it since the bill keeps many of Obamacare’s taxes. Some senators are expected to wait until the CBO score arrives until making a final decision.

• Analysts See Trump Threats to Insurers Boosting Premiums The Associated Press by Alan Fram — Average premiums for individually purchased health insurance will grow around 15 percent next year, largely because of marketplace nervousness over whether President Donald Trump will block federal subsidies to insurers, Congress's nonpartisan fiscal analyst projected Thursday. The Congressional Budget Office estimate comes as Trump has repeatedly threatened to halt the payments in his drive to dismember President Barack Obama's health care law. The agency said 2018 premiums will grow "largely because of short-term market uncertainty — in particular, insurers' uncertainty about whether federal funding for certain subsidies that are currently available will continue to be provided." It also attributed the projected increase to growing numbers of people living in regions where only one insurer sells policies, therefore facing less competition.
  
  
• HHS Slashes Funding to Groups Helping ACA Consumers Enroll by Up to 92 Percent The Washington Post by Juliet Eilperin and Amy Goldstein — Health and Human Services (HHS) officials have informed grass-roots groups that assist with enrollment under the Affordable Care Act that their funding will be reduced by as much as 92 percent, a move that could upend outreach efforts across the country. The groups, which fund organizations known as "navigators," had been braced for the cuts since the Trump administration announced two weeks ago that it would shrink overall program funding by 41 percent and slash the department's ACA advertising budget from $100 million to $10 million. At the time of the announcement, HHS officials said the outreach wasted taxpayers' money. "This is nothing short of sabotage," Sen. Tammy Baldwin (D-Wis.), a member of the Health, Education, Labor, and Pensions Committee said in a statement Thursday that the cuts reflected the president's broader effort to undermine the ACA. 

• New Gene-Therapy Treatments Will Carry Whopping Price Tags The New York Times by Gina Kolata — The first gene therapy treatment in the United States was approved recently by the Food and Drug Administration, heralding a new era in medicine that is coming faster than most realize — and that perhaps few can afford. The treatment, Kymriah, made by Novartis, is spectacularly effective against a rare form of leukemia, bringing remissions when all conventional options have failed. It will cost $475,000. With gene therapy, scientists seek to treat or prevent disease by modifying cellular DNA. Many such treatments are in the wings: There are 34 in the final stages of testing necessary for F.D.A. approval, and another 470 in initial clinical trials, according to the Alliance for Regenerative Medicine, an advocacy group.
  
  
• Bill to Shed More Light on Prescription Drug Prices Heads to Gov. Jerry Brown's Desk Los Angeles Times by Melanie Mason — Powered by increasing scrutiny of costly prescription drugs, a measure that would require sweeping new disclosure on how medicines are priced cleared its final legislative hurdle Wednesday. The state Senate approved the bill with no debate, belying the fierce behind-the-scenes jockeying that pit pharmaceutical companies against health insurers, labor unions and liberal activists. The measure, SB 17 by state Sen. Ed Hernandez (D-Azusa), would require health plans to report to the state the 25 drugs that are most frequently prescribed, those that are most costly and those that have had the highest year-to-year increase in spending. It also would require drug makers to provide advance notice of planned price increases if the hikes exceed certain thresholds.

• CMS' Proposed Home Health Payment Model Alarms Providers. Would It Boost Access for Medically Complex Patients? Modern Healthcare by Harris Meyer —The CMS has proposed the largest overhaul of Medicare home health payment in many years, out of concern that the current reimbursement system discourages providers from serving patients with clinically complex or chronic conditions. Critics say Medicare's system now gives home health providers incentives to select patients who need higher-paying therapy services, such as joint replacement, rather than those needing help with traumatic wounds or poorly controlled chronic conditions or who are dually eligible for Medicaid and Medicare. Under the proposed home health groupings model, Medicare payment would be based on patient characteristics rather than number of visits for various forms of therapy. The new system would boost payment for skilled-nursing and home health aide visits for medically complex patients.
  
  
• Providers Find Success in CMS's Multipayer Model Modern Healthcare by Virgil Dickson — In 2012, Clark and her practice began their journey to transform how practitioners delivered care. When the practice was accepted into the CMS's Comprehensive Primary Care Initiative, it moved from the standard care pattern to one that put more emphasis on preventive screenings and follow-ups. Not only did she notice an overall improvement in quality of care, her practice also achieved notable savings under the model. Clark's practice reduced average monthly patient costs by about 40 percent, from more than $1,200 a month to $725 by the time the initiative ended in 2016. The practice also had marked reductions in emergency department utilization and hospitalizations for chronic illnesses. The program helped them decrease costs associated with congestive heart failure by almost 50 percent. 

Editor: Peter Van Vranken