Pence says it's official: Trump to prioritize Obamacare repeal Presented by

TRUMP TO PRIORITIZE OBAMACARE REPEAL, PENCE SAYS — President-elect Donald Trump will prioritize repealing President Barack Obama's landmark health care law right "out of the gate" once he takes office, Vice President-elect Mike Pence said on "Fox News Sunday."

"Decisions have been made by the president-elect that he wants to focus out of the gate on repealing Obamacare and beginning the process of replacing Obamacare with the kind of free-market solutions that he campaigned on," Pence said.


… Quick action to eliminate the Affordable Care Act would set up an immediate showdown with congressional Democrats. The incoming Senate minority leader, Chuck Schumer, said on Sunday: "We're not going to repeal or help [Trump] repeal Obamacare."

Trump's a wild card, though. There's a gap between what Trump's said recently about "amending" Obamacare versus the health reforms that congressional leaders are pushing, conservative analysts told POLITICO's "Pulse Check" podcast. "I think he was a third-party candidate who ran with the Republican party," said Douglas Holtz-Eakin of the American Action Forum. "He's an independent." More.

INSURER MEGA-MERGER TRIAL GETS UNDERWAY — The first of two blockbuster cases is scheduled to begin in federal court this morning, with major ramifications for the health care industry.

Up first: DOJ v. Anthem-Cigna. One key moment to watch: When Anthem CEO Joseph Swedish takes the stand to testify on Monday.

How it could play out. The first two weeks will focus solely on national accounts. The trial will then pause for a week, which could allow U.S. District Judge Amy Berman Jackson, an Obama appointee, to determine that she's got enough evidence to rule on the case based on that sector alone — and dispatch with other pending issues such as the individual exchange market or local businesses.

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Would a Trump administration take a different approach? While it's possible that a Republican White House would seek less punitive measures, antitrust enforcement has generally garnered bipartisan support, Reed Abelson reports for the New York Times. More.

BIPARTISAN SUPPORT FOR MEDICARE'S INNOVATION CENTER — IN SOME FORM. Pharma groups are frustrated with it, worried that the center will introduce new payment reforms. Speaker Paul Ryan's "Better Way" explicitly calls for CMMI to be repealed.

But there's a growing consensus that the center will stick around, writes Pro's Arthur Allen, who explores two potential avenues for CMMI to be preserved under a Trump administration.

— Keep a trimmed-down version. A new coalition backed by pharma and other industry groups sees a slimmed-down CMMI as crucial to establishing new medical approaches like MACRA, Medicare's new physician payment law. “We think it could use some improvement,” said Mary Grealy, president of the Healthcare Leadership Council, which formed the coalition.

— Keep it to use for GOP-led reforms. CMMI in the Trump era could serve as a vehicle for a radical conservative overhaul of government health care — ways of introducing or testing some of the GOP agenda without legislation. “It might be renamed” but largely preserved, said one pharmaceutical policy expert tracking the still-fluid Republican discussions.

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WELCOME TO MONDAY PULSE — Where we're especially thankful this year for family, friends, fascinating health policy debates and Westworld. (In some order. After last night's brain-twisters, Westworld may be leapfrogging up the list.) Send tips and your own holiday gratitude to [email protected] or @ddiamond on Twitter.

PROGRAMMING NOTE — Due to the Thanksgiving holiday, PULSE won't publish on Thursday, Nov. 24 and Friday, Nov. 25, but we'll resume our normal publishing schedule on Monday Nov. 28.

TRUMP TRANSITION

Tom Price clear front-runner to be Trump's HHS Secretary. Price, a physician and an ardent opponent of Obamacare, would lead the dismantling of the ACA and potentially help Congress enact a new health plan. His selection would be a strong embrace of the House's effort to repeal and replace Obamacare, Pro's Jen Haberkorn writes. More for Pros.

Trump dined on Saturday with health tech executive Patrick Soon-Shiong. It's not clear what they discussed beyond “innovation in the area of medicine and national medical priorities,” according to a news release from the transition team. Soon-Shiong, a billionaire health tech executive, also owns shares in the Los Angeles Lakers and Tronc, which owns the Los Angeles Times, Chicago Tribune and other media companies. He was sued by MD Anderson Cancer Center last month over his use of the word “moonshot” for an immunotherapy clinical trial program he designed. More for Pros.

Jeff Sessions could change DOJ drug policy. Trump's choice for attorney general has been a forceful opponent of marijuana legalization, including saying that “good people don’t smoke marijuana." That's a departure from the Obama administration, which has mostly taken a hands-off approach to marijuana, and Trump's own rhetoric — he's said that marijuana should be left up to the states. More from POLITICO.

ON THE HILL

How ambitious plan for early 2017 could play out for Congress. House members and staffers can say goodbye to their three-day weekends and lengthy recesses — at least for a while.

Majority Leader Kevin McCarthy, who’s currently devising the 2017 House schedule, is likely to keep lawmakers in D.C. on Mondays and Fridays, a stark departure from the three-day weeks that have become routine in the chamber, as Republicans move aggressively to strike down Obamacare and pursue other top priorities. More.

DRUG PRICES

More than 60 percent of industry CEOs say drug prices should be a 'top priority' for administration, Congress. That's according to Modern Healthcare's latest industry power poll, although many respondents were worried that the next administration would ignore the problem.

“Drug costs are a huge monkey on the back of health systems and consumers,” said Jim Hinton, the current CEO of New Mexico's Presbyterian Healthcare Services and the incoming CEO of Baylor Scott & White Health in Texas. "It's hard not to be outraged by some of these drug costs. As a country we have to come to some agreement on this."

Chuck Schumer, Nancy Pelosi ask White House to end Part B demo. The incoming Senate minority leader and House minority leader asked the Obama administration to not release the final regulations to set up the controversial Part B drug demonstration, Pro's Jen Haberkorn and Sarah Karlin-Smith report.

With Donald Trump’s victory, the demonstration project is all but certainly dead. If the White House releases the final regulation, it could be undone with a quick vote by Congress in January or by the Trump administration.

… The only remaining question is whether the Obama administration makes a last-ditch attempt to set up the program. Releasing the final regulation would amount to a symbolic measure by the Obama administration to tackle drug prices. There's also an outside chance that the Trump administration would be too consumed with Obamacare repeal in its first few weeks to undo the drug demo. More for Pros.

ZIKA VIRUS

WHO says it's no longer an international public health emergency. That's according to a committee's report from Friday, which also concluded that the mosquito-spread disease remains a "significant enduring public health challenge requiring intense action."

The announcement didn't sit well with many public health advocates. "Unwise … [given] no vaccine or treatment and kids still being affected," tweeted Ashish Jha, the director of Harvard Global Health Institute. "I get why WHO made the decision, but worry it will enable further complacency for a disease that has seen way too much complacency," he added.

Zika vaccine may arrive as soon as 2018. While vaccines usually take a decade or more to develop, researchers are deploying innovative and ambitious technologies, like splicing DNA, in the race to find a vaccine. Key factors in the chase: Researchers and companies' efforts to save lives, win prestige and corner huge potential profits, the New York Times writes. More.

AROUND THE NATION

STATE WEEK: Republicans try to calm fears about ACA repeal impact on low-income constituents. “Of course we’re going to take care of people who cannot afford health care,” Arizona Sen. John McCain told Pro's Rachana Pradhan. “We’re not going to leave anybody behind. We want to replace Obamacare, not just repeal it.” More.

Scott Walker: Block-granting Medicaid would allow innovations. The Wisconsin governor, and newly elected head of the Republican Governors Association, told the Milwaukee Journal Sentinel that block-granting the program would allow Wisconsin to drug-test Medicaid beneficiaries, which is currently blocked by federal Medicaid rules. He also contended that block grants wouldn't explicitly lead to coverage cuts.

Walker also maintained that block grants would be popular among Democratic leaders, too. "If push comes to shove, there'd be a lot of Democratic governors who'd take it," he argued. More.

WHAT WE'RE READING

Medicaid beneficiaries in Kentucky are worried about the possibility of cuts under Gov. Matt Bevin and the incoming Trump administration, KHN's Phil Galewitz reports. More.

Researcher Peter Pronovost argues that surgical volumes should be public, so patients can pick providers that have fluency with certain procedures. More.

Massachusetts providers say they've seen a spike in patients suffering from anxiety and stress since the election, WBUR's Carey Goldberg reports. More.

AHRQ — the Agency for Healthcare Research and Quality — has been a target of cost-cutting Republicans before, and it may end up on the chopping block again under a Trump administration, Elizabeth Whitman writes at Modern Healthcare. More.

In New York Magazine, liberal policy writer Jon Chait lists out five reasons why he thinks "Obamacare might survive after all." More.

At National Review, conservative policy analyst Ramesh Ponnuru says it's important to protect Americans with pre-existing conditions. More.

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