If you thought the "ease along" ethos of Washington would quickly tame Donald Trump, this week proved you wrong. While most of American media is still trying to figure out how to cover Trump, a process that is making everyone look bad, Jim VanderHei at Axios nails it as he points out some pretty major events that occurred in the shadow of "he said, she said." Health care was no different. You wouldn't know it for all the obsessing over who lied and who didn't so here is our run-down of the week:
The future of the much maligned individual mandate is very much in doubt. But does it matter? We are becoming less sure and so are others:
- Kellyanne Conway appeared on the Sunday morning shows and put the individual mandate in play as part of last week's ACA-related executive order.
- Three economists appeared before the Ways and Means subcommittee on Oversight to discuss the effectiveness of individual mandate. Their take? meh.
- The insurance industry went into apoplexy in response to the EO, suggesting market chaos - not that things are exactly orderly right now.
- Our take? Their full-throated endorsement of the ACA in 2009 has not been forgotten by those that oppossed the law, then and now. The prospect of market chaos is the only argument - and it is a shaky one - the insurance industry has to remain relevant and exert some influence over repeal and replace.
Trump appears headed toward a block grant for Medicaid:
- Kellyanne Conway's appearance on the ABC's "This Week" also included the prospect of block grants for state Medicaid programs.
- President Trump's one time opponent, Gov. John Kasich is not entirely down with the plan but like most governors is most concerned about keeping the federal grant money spigot open.
ACA Replace: All the cool kids are doing it
- Senators Susan Collins and Bill Cassady introduced their Patient Freedom Act of 2017 as a potential replacement to the ACA which allows states to "keep their Obamacare, if they like it." Most critically, the bill would not repeal the ACA taxes which is never going to fly with House Republicans. Text of bill can be found here.
- Senator Rand Paul, while deriding the idea that "you could keep your ObamaCare" introduced his own plan.
The Republicans went on a retreat in Philadelphia - site of the 2016 Democratic Convention, no symbolism there - but still cannot seem to get on the same page for repeal and replace of the ACA.
- At least we have a schedule. Plan is to have repeal and replace through reconciliation by early March.
- The cautiousness of Congress - especially the Senate - may become a liability for Members as Trump urges action on the ACA with 'nuff talk."
A Federal judge said "no can do" to the AET/HUM merger
- The problem? The companies were unable to convince the judge that Medicare Advantage and traditional Medicare were the same market.
- We suppose, based on how AET stock price responded to the news, that there were some analysts out there that thought the merger would be approved. We were not among them.
- The companies are considering appeal.
Tim Price, President Trump's pick for HHS Secretary was grilled by Democrats on the Senate Finance Committee for four hours last week.
- So many questions focused on stock trades in Price's portfolio designed to cast an ethical cloud over the nominee.
- We are with the conventional wisdom on this one - Price gets confirmed.
Loads of health related hearings on the docket next week.
- Oversight and Investigations Subcommittee of Energy and Commerce Committee holds hearing on: Medicaid Oversight: Existing Problems and Ways to Stengthen the Program, Jan 31 at 10am
- Health Care, Benefits and Administrative Rules subcomittee of House Oversight and Government Reform Committee holds hearing on Fraud, Waste and Abuse under the Affordable Care Act, Jan. 31 at 2pm
- House Education and Workforce Committee holds hearing on "Rescuing Americans from the Failed Health Care Law and Advancing Patient-centered Solutions" Feb. 1 at 10 am
- Health Subcommittee of House Energy and Commerce Committee holds hearing on "Strengthening Medicaid and Prioritizing the Most Vulnerable." Feb 1 at 10 am
- Senate Health, Education, Labor and Pension Committee holds hearing on "Obamacare Emergency: Stabilizing the Individual Market." Feb 1 at 10 am
Under-reported in Philly was Trump's walk on music at the Republican retreat was "A Little Less Talk (and a Lot More Action):" Ok, not really you have to admit it could have happened. #fakenews
The Hedgeye View:
HCA | "IN HCA WORLD..." | FIELD NOTES AND 4Q16 PREVIEW, Jan. 27
FIELD NOTES | EXAS | COVERAGE IS COLOGUARD'S BACKBONE, Jan. 27
CONGRESSIONAL LEADERS MAY BE ON TO FISHY MEDICAID ENROLLMENT, Jan 26
(Hit Sales@Hedgeye so they can hook you up)
Follow us on twitter @HedgeyeEEvans for this and more.
Call with questions. We have plenty of time to talk since we blocked all the cable news channels here.
Emily Evans
Managing Director
Health Policy
@HedgeyeEEvans
