| | | | |  | | By Megan R. Wilson and Daniel Payne | | | With Alice Miranda Ollstein
| | |  An appeals panel on Monday maintained Obamacare’s rules for free preventive care while legal challenges move forward. | Jonathan Bachman/AP Photo | PATIENT GROUPS CHEER ACA STAY — Affordable Care Act rules requiring free preventive care services can remain in effect while a legal battle over them plays out, Alice reports. A federal appeals panel Monday paused a lower-court decision that tossed out requirements in the law that insurance companies cover the HIV prevention drug PrEP and a range of preventive services nationwide like annual physicals, cancer screenings and Pap tests with no cost-sharing for patients. Many major insurers have pledged to maintain preventive care at no cost for now — regardless of action in the courts — but experts fear that patients could eventually be hit with out-of-pocket charges. Public health groups warn of serious consequences if the lower-court ruling is upheld — citing research showing that even small costs deter many people from seeking preventive care, leading to sicker patients and more costly treatments. A slew of groups — including the American Cancer Society Cancer Action Network, the American Kidney Fund, the Leukemia and Lymphoma Society and the AIDS Institute — cheered the administrative stay issued by a panel at the 5th U.S. Circuit Court of Appeals as legal challenges against the rules move forward, Megan reports. “The stay prevents restoration of cost barriers for critical services that prevent and protect against chronic illness and death — a decision that will alleviate concern for the patients and families we serve and ensure that such critical coverage will continue,” more than a dozen patient groups wrote in a joint statement. More than 151 million people in the U.S. are covered by private insurance. Studies have shown that offering free preventive services lead to an increase in the use of those services — including more blood pressure and cholesterol tests, colorectal cancer screenings, flu vaccinations and contraceptive use. What’s next? The groups will continue to advocate for the conservative-leaning 5th Circuit to overturn the ruling in a battle that could be headed to the Supreme Court. WELCOME TO TUESDAY PULSE. It’s Megan Wilson, the POLITICO health team’s lobbying reporter. Just wondering: Are you a company thinking about leaving your trade association? Hit me up at mwilson@politico.com. And don’t forget to tip Daniel Payne, your regular Pulse host with the most, at dpayne@politico.com. TODAY ON OUR PULSE CHECK PODCAST, host Ruth Reader talks with AI entrepreneur and NYU professor emeritus Gary Marcus, who will testify before the Senate Judiciary Subcommittee on Privacy, Technology and the Law today as lawmakers consider regulating artificial intelligence in health care.
| | | | | | | A message from PhRMA: Middlemen say they want lower prices, yet they often deny or limit coverage of lower-cost generics and biosimilars while giving preferential coverage to medicines with higher prices. This might be good for PBM’s bottom line, but it can lead to higher costs for patients. What else are they hiding? | | | | | | | 
A House subcommittee is set to mark up a group of health care–related bills this week. | Getty Images | HEALTH PANEL SET FOR MARATHON MARKUP — The House Energy and Commerce Health Subcommittee will mark up 17 bills Wednesday morning on a set of wide-ranging proposals, many of which aim to increase transparency and address consolidation in the health care industry. Some others would extend programs to support workforce development and reauthorize animal drug user fees. However, there's a notable omission from the markup announcement: measures the committee had been considering that would tweak site-neutral payment policy to ensure Medicare and patients pay the same amount for a service regardless of where it’s performed. As soon as they were floated, the proposals prompted intense backlash from hospital groups, which immediately launched an advertising offensive attempting to sway public opinion against the idea. But hospital lobbyists shouldn’t be celebrating just yet: A committee aide tells Megan that policymakers are still working through the details of the site-neutral proposals while moving forward with the bundle of bills they say will “make a real impact on lowering costs for patients.”
| | | | GET READY FOR GLOBAL TECH DAY: Join POLITICO Live as we launch our first Global Tech Day alongside London Tech Week on Thursday, June 15. Register now for continuing updates and to be a part of this momentous and program-packed day! From the blockchain, to AI, and autonomous vehicles, technology is changing how power is exercised around the world, so who will write the rules? REGISTER HERE. | | | | | MORE TRANSPARENCY PUSHES — The House Ways and Means Committee also is probing transparency in the health care system and will hear from executives, consultants and experts this morning. Chair Jason Smith ","url":"https://directory.politicopro.com/member/192689","personId":"192689","linkText":"Jason Smith","link":{"target":"NEW","attributes":[{"name":"data-person-id","value":"192689","_id":"00000188-24dc-dc13-a5fc-25dc84660000","_type":"f601356c-0e4b-3847-a646-21bd958d59ca"}],"url":"https://directory.politicopro.com/member/192689","_id":"00000188-24dc-dc13-a5fc-25dc84660001","_type":"33ac701a-72c1-316a-a3a5-13918cf384df"},"_id":"00000188-228e-d79a-af9d-72af923c0000","_type":"353fe80b-e1b5-3663-85ca-add066ecafc0"}">Jason Smith(R-Mo.) will investigate “how a lack of transparency in America’s health care system increases costs and prevents patients from being effective health care shoppers.” Among the witnesses is a representative for the Clark Grave Vault Company, which makes burial vaults that protect caskets from damage. Also testifying will be William Short, executive chairman of an employee benefits provider, and Dr. Ron Piniecki, the co-founder of an ambulatory surgery center that offers up-front pricing. Although it’s unclear what angle the panel is taking with regard to the death industry, federal regulators have noted the sector lacks price transparency and the Federal Trade Commission is mulling updating rules requiring disclosure. COMMUNITY HEALTH TO THE HILL — Leaders from community health centers nationwide are flying into Washington this week to ask for more funding and reforms to the 340B discount drug program that gives safety net hospitals access to cheaper medicines, Daniel reports. It comes as community health centers, which often serve low-income patients, grapple with reduced pandemic funding, the prospect of less reimbursement amid Medicaid redetermination and increasing labor costs across the health sector. Advocates for Community Health, an industry group, tells Pulse that meetings will be with lawmakers and their staffs across the aisle and with leadership — including Senate Majority Leader Chuck Schumer and Minority Leader Mitch McConnell, in addition to Sens. Patty Murray (D-Wash.) and Kyrsten Sinema (I-Ariz.). In those meetings, community health center advocates will focus on increasing funding through the reauthorization of the Community Health Center Trust Fund and fiscal year 2024 appropriations.
| | | | A message from PhRMA:   | | | | | | Shallot Communications, a consulting firm run by two Obama administration HHS alums, hired Jamie Hill to expand its offerings to include public affairs. Hill most recently served as head of communications at mental health startup Real, and her resume includes Google and HHS public affairs team during the Obama administration. Thomas Tsai has left the White House, where he was senior policy adviser for the Covid-19 response and testing and treatments coordinator. He is returning to Brigham and Women’s Hospital of Harvard Medical School where he is assistant professor of surgery and the Harvard Chan School of Public Health, where he is assistant professor of health policy and management.
| | | | DON’T MISS POLITICO’S HEALTH CARE SUMMIT: The Covid-19 pandemic helped spur innovation in health care, from the wide adoption of telemedicine, health apps and online pharmacies to mRNA vaccines. But what will the next health care innovations look like? Join POLITICO on Wednesday June 7 for our Health Care Summit to explore how tech and innovation are transforming care and the challenges ahead for access and delivery in the United States. REGISTER NOW. | | | | | | | | | Endpoints News reports that the Supreme Court’s refusal to take up a case involving “skinny labels” for generic drugs could have impacts throughout the industry. KFF Health News writes about how experts worry about an increase in hospitals creating their own police forces to protect health workers. STAT reports that Envision Healthcare, a physician staffing firm, has filed for bankruptcy and plans to sell a subsidiary that runs outpatient surgery centers.
| | | | A message from PhRMA: PBMs control your health care. Pharmacy benefit managers (PBMs) decide if medicines get covered and what you pay, regardless of what your doctor prescribes. They say they want lower prices, yet they often deny or limit coverage of lower-cost generics and biosimilars, instead covering medicines with higher prices so they make more money. This business model allows PBM profits to soar and can lead to higher costs for everyone. What else are they hiding? | | | | | | | Follow us on Twitter | | | | Follow us | | | | |
