Is it time for public option? Senate Dems lead new push today

Hillary Clinton releases a second letter from her doctor, while Donald Trump takes the stage with Dr. Oz. But first: the public option rises again.

IS IT TIME FOR PUBLIC OPTION? SENATE DEMOCRATS LEAD NEW PUSH TODAY — Top legislators and prominent progressives are throwing their weight behind the public option this morning, a joint effort intended to strengthen Hillary Clinton’s call for a public option ahead of the upcoming debates and tee up the proposal as a legislative priority for 2017.

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In the Senate: A new resolution filed by Sen. Jeff Merkley calls for every American to have the choice of a public health insurance option. The resolution has the backing of three members of leadership — Sens. Dick Durbin, Chuck Schumer and Patty Murray — as well as other notable progressive figures, like Sen. Bernie Sanders.

“At a time when 29 million people are still uninsured, and 31 million are underinsured, we must continue to make needed health care reforms,” Sanders said in a statement. “Insurance companies have shown they are more concerned with serving their shareholders than their customers.”

In the grassroots: At least a half-dozen organizations like the AFL-CIO will blast the announcement to millions of their members today, trying to build momentum on the ground. They’ve found a convenient villain: Activists are arguing that Aetna’s decision to quit many ACA exchanges forced their hand.

“We see this as the most significant health care push by Democrats since the passage of Obamacare,” said Stephanie Taylor, the co-founder of the Progressive Change Campaign Committee, which is partnering with Senate Democrats on the effort. “Aetna’s failed extortion attempt and decision to exit 11 states has created new urgency for making a public option available to every American.”

See more.

By the numbers: The coalition pointed to a 2013 CBO analysis that projected a national public option would lower federal health spending by $158 billion over a decade. Advocates also argued that it would help guarantee near-universal health coverage for Americans.

However, analysts say that Clinton’s proposal could take the form of a state-by-state public option, and not all states would opt in, which would reduce its effects on the deficit and the uninsured rate.

Will it work? Between Republican resistance and Democrats’ wariness after the last public option fight, the proposal would face long odds in Congress, and experts have raised questions over its viability. However, insurers’ departures from the exchanges have created new momentum to improve competition — especially in the nearly 1,000 counties that may have just a single Obamacare insurer next year.

“It’s hard to imagine anything but a public option of some kind as a backstop if no insurers are willing to participate in an area,” Kaiser Family Foundation’s Larry Levitt told PULSE. But it wouldn’t be a panacea for all of Obamacare’s other problems, like its less-than-ideal risk pool. “While a public option could fill in where there’s inadequate competition, it wouldn’t do anything to get more healthy people to enroll,” Levitt added.


1) Donald Trump’s much-touted appearance with Dr. Oz airs today.

2) Sens. Tammy Baldwin and John McCain and Rep. Jan Schakowsky are introducing a bipartisan drug pricing bill that requires drug makers to alert HHS at least a month before hiking a drug’s price by 10 percent or more.

3) The Senate Homeland Security & Governmental Affairs Committee will hold a 10 a.m. hearing on Obamacare premium hikes, with Ohio’s lieutenant governor and the insurance commissioners of Iowa, Washington state and Wisconsin slated to testify.

THIS IS THURSDAY PULSE — Where we still can’t decide on which food to bring to today’s Dr. Oz viewing party: GMOs, or KFC? Send party-planning tips to or @ddiamond on Twitter.

With help from Brianna Ehley (@BriannaEhley), Sarah Karlin-Smith (@SarahKarlin), and Rachana Pradhan (@RachanaDixit).


The scrutiny over the candidates’ personal health reached fever pitch on Wednesday, as both campaigns took steps to address concerns — in very different and evocative ways.

Trump takes the stage with Dr. Oz. The interview, recorded Wednesday, is scheduled to air starting at 1 p.m. ET in most markets today. As a result of the on-air check-up, Oz reportedly determined that Trump is overweight and has an elevated body-mass index.

“If elected at age 70, you’d be the oldest person to ever enter the Oval Office,” Oz says to Trump, in a clip released ahead of the episode. “Why do you think you have the stamina for the job?”

“I feel as good today as I did when I was 30,” Trump countered. Watch the clip.

Clinton campaign releases more medical info. Seeking to tamp down concerns raised after Clinton’s near-collapse on Sunday, the campaign shared more context on this weekend’s pneumonia diagnosis, including a second letter from her personal physician.

There are no major revelations, although Clinton apparently received a non-contrast chest CT scan on Friday that confirmed a small right middle-lobe pneumonia.

What wasn’t included in Wednesday’s release: Data on Clinton’s height and weight, which would’ve allowed reporters to calculate her body-mass index.

In one tweet. The difference between what Clinton’s released versus what Trump’s released. See the tweet.

How Dr. Oz became ‘Dr. Oz.’ Here’s the New Yorker’s epic 2013 Oz-expose. Read the piece.

Tim Kaine released doctor’s letter, too. A physician said Clinton’s VP pick exercises three times per week and is in “overall excellent health” — although he should take more Vitamin D. See the letter.

** A message from PhRMA: Today, there are more than 300 medicines in development for autoimmune diseases like arthritis, psoriasis, lupus, type 1 diabetes and MS. This is exciting news for the more than 23.5 million Americans living with autoimmune diseases. Learn more about the progress and promise of medicines in development here. **


Bipartisan bill would require drug makers to justify big hikes. The Fair Accountability and Innovative Research (FAIR) Drug Pricing Act, which is being introduced today, would impose new restrictions on companies that plan to make a 10 percent price hike.

Companies would be required to alert HHS at least a month before the planned hike and justify the request by sharing details on profit, R&D costs, advertising and more. Sens. Tammy Baldwin and John McCain are co-sponsoring the bill in the Senate, while Rep. Jan Schakowsky will sponsor the legislation in the House.

Health Affairs launches new series: ‘Drugs and Medical Innovation.’ The journal’s blog later today will kick off an ongoing series that tackles the challenges of balancing innovation, patient benefit, affordability and more.


California lawmakers want approval of ACA waivers for undocumented. Nearly all Democrats in California’s congressional delegation — including Nancy Pelosi — say the Obama administration should approve an upcoming state request to expand Obamacare coverage to undocumented immigrants, the first of its type in the country, Pro’s Rachana Pradhan reports. They’d have to pay the full cost themselves, no federal subsidies.

Pros: Read more.

… State Sen. Ricardo Lara told a press conference at the U.S. Capitol that state lawmakers are looking at ways to cover “the rest of the undocumented community in California” who cannot afford to purchase coverage on their own. Any such program would not use federal funds.


How a Hillary victory would change the Clinton Health Access Initiative. There’d be a leadership shake-up: Former President Bill Clinton, his daughter Chelsea Clinton and three other members would step down from the organization’s board. It’s the first time the initiative has detailed plans for what would happen if the former secretary of state wins the White House this fall, other than a previous announcement from Bill Clinton that he would step down from its board.


Top reviewer of hotly watched drug departs agency. Ronald Farkas, the clinical team leader in the FDA division overseeing the agency’s review of Sarepta’s Duchenne muscular dystrophy drug, has left the agency. Farkas had been viewed as being critical of the drug’s application, which has generated a wave of political attention — and his departure raises questions about what’s next for the drug’s prospects.

… More than 100 members of Congress have pushed FDA to approve the drug. The agency was supposed to issue a decision on the drug in May, but said at the time it would take more time to make a decision. An FDA advisory committee in April recommended against the drug’s approval, finding there wasn’t enough evidence to approve effectiveness.


Prostate cancer study suggests rethinking treatment for early-stage patients. According to a new NEJM study that tracked patients for 10 years, there was no difference in death rates between men who were picked at random to have surgery or radiation, or to have “active monitoring” of the cancer before receiving treatment later as necessary.

Read the New York Times write-up: More.
See the study: More.

Mercatus: Obamacare has ‘worsened’ Medicaid’s problems. Brian Blase argues that the ACA expansion is adding to “Medicaid’s unsustainable spending trajectory,” as enrollment has surpassed expectations and individual enrollees have been more expensive than projected. Overall, the CBO now expects federal Medicaid spending over the next decade to be $232 billion above 2014 estimates. See the study: More.


FIRST IN PULSE: Aledade adds Danny Krifcher as first Chief Commercial Officer. Krifcher had been an executive vice president at Avalere Health, with previous stops as the CEO of Wellbridge Health and an executive at AOL.

Thorn Run Partners relaunches TRP Health Policy division. Billy Wynne will serve as managing partner of the group, which has added four staffers in the past three months.

Solving for the rising cost of complex drugs. Pro’s Sarah Karlin-Smith is one of the moderators for Real Clear Health’s 8 a.m. event at the Hyatt Regency on Capitol Hill. Keynote speakers include Reps. Xavier Becerra and Bill Johnson and panelists include BIO’s Dan Durham, Brookings’ Paul Ginsburg, and PCMA’s Mark Merritt. See the livestream.

Peter Orszag hosts Clinton fundraiser. Tonight’s event will take place at the home of the former Obama budget official and is billed as a conversation on economic policy, with Clinton adviser Jacob Leibenluft and economists Alan Krueger and Austen Goolsbee slated to speak. Health wonks will recognize some of the co-hosts — including Zeke Emanuel, Keith Fontenot and Ken Baer — but be prepared to pony up to attend: At press time, tickets are $500 and up.

EVENT ALERT- OUTSIDE, IN: Join POLITICO and featured guests: AARP Public Policy Institute’s Jean Accius, ChenMed’s Jessica Chen, NaviMed’s Bijan Salehizadah, U.S. Department of Veterans Affairs’ Kenneth Shay, and U.S. Department of Health and Human Services’ Edwin Walker for a discussion on whether tech can transform aging in America. September 21 — 8 a.m.; Carnegie Library — 801 K St. NW. RSVP:


If Trump becomes president, it would be a terrible idea for Republicans to repeal Obamacare without any replacement plan in place, argues James Capretta in National Review.

Could grantmakers have done a better job helping Obamacare succeed? Health Affairs convenes a panel of experts to discuss how their advocacy efforts could have been more successful.

Last year Nigeria was declared to be polio free, but that assertion has proven premature. At least three new cases have been discovered in areas of the country previously controlled by terrorist group Boko Haram, reports NPR.

Could plants hold the key to solving one of the greatest threats to public health — antibiotic resistant bacteria? Ferris Jabr looks at research inspired by ancient herbal remedies in The New York Times Magazine.

CHI Health’s hospitals in Iowa and Nebraska face very different financial prospects. The biggest difference, according to Bloomberg: the Iowa facility has been boosted by Medicaid expansion.

Iowa’s move to Medicaid managed care has been a mess, argues the Des Moines Register editorial board. But Iowa Gov. Terry Branstad and the Obama administration don’t seem to care.

** A message from PhRMA: For the more than 23.5 million American patients with autoimmune diseases, hope comes in the form of treatments and cures. And today, the need for innovative medicines has never been greater. Thankfully, there are 311 medicines currently in development for autoimmune diseases, and the science continues to evolve as the biopharmaceutical industry uncovers the causes of these diseases. Today, patients and families have hope for brighter futures, thanks to the tireless work of researchers and scientists at America’s biopharmaceutical companies – with every day bringing us closer to new treatments and cures. Learn more here. **