Trump administration opens door to importing medicine from Canada

A pharmacist counts pills in a pharmacy in Toronto in this January 31, 2008 file photo. REUTERS/Mark Blinch/Files

By Michael Erman

(Reuters) – The Trump administration took a first step on Wednesday toward allowing the importation of medicines from Canada, an action the president has advocated as a way to bring cheaper prescription drugs to Americans.

The U.S. Department of Health and Human Services said it and the Food and Drug Administration will propose a rule that will allow it to authorize states and other groups to pursue pilot projects related to importing drugs from Canada.

The agency also said that it would allow drugmakers to bring drugs that they sell more cheaply in foreign countries into the United States for sale here, potentially enabling them to sell below their contracted prices in the U.S.

Drug industry shares were lower slightly, with the NYSE Arca Pharmaceutical Index <.DRG> off 0.25 percent versus a broader flat market. Wall Street analysts said importation was far from being put into place and was limited to certain drugs from Canada.

Health and Human Services Secretary Alex Azar said he has had prior discussion with Canada about importation and that it would be up to the states, pharmacies and distributors to address any hurdles.

“There are hurdles of course, but the hurdles now are known. They are being laid out and they are surmountable,” he said during a call with reporters.

Canadian officials were not immediately available for comment. Reuters has previously reported that Canada opposes any U.S. plans to buy Canadian prescription drugs that might threaten the country’s drug supply or raise costs for its own citizens.

Many drug purchase agreements in Canada forbid the re-export of drugs to other countries, according to a Canadian government memo obtained by Reuters.

“Given the size of the U.S. market and of large states such as Florida, which alone is two-thirds of the population of Canada, reliance on imports from Canada would have limited viability as a long term solution to the high cost of drugs in the U.S.,” Health Canada said in a statement on July 17.

Evercore ISI analysts Ross Muken and Michael Newshel said in a research note that any implementation is still far away given the technical steps of rulemaking and that the proposals will face challenges. For instance, he said, most Republicans in Congress oppose importation.

The first part of the proposal would allow states, wholesalers or pharmacists to submit plans for pilot projects for Canadian drugs if their raw materials are manufactured in the same plant as the U.S. version and are in line with the FDA’s approval. It would exclude biologics, infused drugs, injected drugs, inhaled drugs for surgery and certain parenteral drugs.

The Trump Administration has experienced several recent failures in its efforts to bring down drug prices. Its plans to make drugmakers disclose prices in TV ads had to be thrown out after it lost a legal battle with drugmakers, and it abandoned efforts to force pharmacy benefit managers to pass discounts onto Medicare recipients.

Drug pricing is an important election issue for Trump and also for Democrats, many of whom have said they would support importing medicines to lower U.S. drug prices. Pharmaceutical companies have opposed importing medicine.

(Reporting by Manas Mishra in Bengaluru; Michael Erman and Caroline Humer in New York and Allison Martell in Toronto; Editing by Steve Orlofsky)

Chinese hacking against U.S. on the rise: U.S. intelligence official

A staff member sets up Chinese and U.S. flags for a meeting in Beijing, China April 27, 2018. REUTERS/Jason Lee

By Jim Finkle and Christopher Bing

NEW YORK (Reuters) – A senior U.S. intelligence official warned on Tuesday that Chinese cyber activity in the United States had risen in recent months, and the targeting of critical infrastructure in such operations suggested an attempt to lay the groundwork for future disruptive attacks.

”You worry they are prepositioning against critical infrastructure and trying to be able to do the types of disruptive operations that would be the most concern,” National Security Agency official Rob Joyce said in response to a question about Chinese hacking at a Wall Street Journal conference.

Joyce, a former White House cyber advisor for President Donald Trump, did not elaborate or provide an explanation of what he meant by critical infrastructure, a term the U.S. government uses to describe industries from energy and chemicals to financial services and manufacturing.

In the past, the U.S. government has openly blamed hackers from Iran, Russia or North Korea for disruptive cyberattacks against U.S. companies, but not China. Historically, Chinese hacking operations have been more covert and focused on espionage and intellectual property theft, according to charges filed by the Justice Department in recent years.

A spokesperson for Joyce said he was specifically referring to digital attacks against the U.S. energy, financial, transportation, and healthcare sectors in his speech on Tuesday.

The comments follow the arrest by Canadian authorities of Meng Wanzhou, chief financial officer of Chinese telecommunications giant Huawei Technologies, at the request of the United States on Dec. 1. Wanzhou was extradited and faces charges in the U.S. related to sanctions violations.

(Reporting by Jim Finkle and Christopher Bing; Editing by Bernadette Baum)

Cyber-attack on Singapore health database steals details of 1.5 million, including PM

Singapore Prime Minister Lee Hsien Loong in Manila, Philippines November 14, 2017. REUTERS/Aaron Favila/Pool

By Jack Kim

SINGAPORE (Reuters) – A major cyber attack on Singapore’s government health database stole the personal information of about 1.5 million people, including Prime Minister Lee Hsien Loong, the government said on Friday.

The attack, which the government called “the most serious breach of personal data” that the country has experienced, comes as the highly wired and digitalized state has made cybersecurity a top priority for the ASEAN bloc and for itself.

Singapore is this year’s chair of the 10-member Association of Southeast Asian Nations (ASEAN) group.

“Investigations by the Cyber Security Agency of Singapore (CSA) and the Integrated Health Information System (IHiS)confirmed that this was a deliberate, targeted and well-planned cyberattack,” a government statement said.

“It was not the work of casual hackers or criminal gangs,” the joint statement by the Health Ministry and the Ministry of Communications and Information said.

About 1.5 million patients who visited clinics between May 2015 and July 4 this year have had their non-medical personal particulars illegally accessed and copied, the statement said.

“The attackers specifically and repeatedly targeted Prime Minister Lee Hsien Loong’s personal particulars and information on his outpatient dispensed medicines,” it said.

A Committee of Inquiry will be established and immediate action will be taken to strengthen government systems against cyber attacks, the Ministry of Communications said in a separate statement.

It did not provide details about what entity or individuals may have been behind the attack.

Lee, in a Facebook post following the announcement, said the breach of his personal medical data was not incidental and he did not know what information the attackers were hoping to find.

“My medication data is not something I would ordinarily tell people about, but there is nothing alarming in it,” he said.

(Reporting by Jack Kim; Editing by Clarence Fernandez and Michael Perry)

Slowing gasoline price rises keep U.S. inflation in check

A woman shops in the Health & Beauty section of a Whole Foods in Upper St. Clair, Pennsylvania, U.S., February 15, 2018. Picture taken February 15, 2018. REUTERS/Maranie Staab

By Lucia Mutikani

WASHINGTON (Reuters) – U.S. consumer prices rose marginally in May amid a slowdown in increases in the cost of gasoline and the underlying trend continued to suggest moderate inflation in the economy.

The Labor Department’s inflation report was published ahead of the start of the Federal Reserve’s two-day policy meeting on Tuesday. Steadily rising inflation and a tightening labor market are expected to encourage the U.S. central bank to raise interest rates for a second time this year on Wednesday.

The Consumer Price Index increased 0.2 percent last month, also as food prices were unchanged. That followed a similar gain in the CPI in April. In the 12 months through May, the CPI increased 2.8 percent, the biggest advance since February 2012, after rising 2.5 percent in April.

Excluding the volatile food and energy components, the CPI rose 0.2 percent, supported by a rebound in new motor vehicle prices and a pickup in the cost of healthcare, after edging up 0.1 percent in April. That lifted the year-on-year increase in the so-called core CPI to 2.2 percent, the largest rise since February 2017, from 2.1 percent in April.

Annual inflation measures are rising as last year’s weak readings fall from the calculation. Last month’s increase in both the CPI and core CPI was in line with economists’ expectations.

The Fed tracks a different inflation measure, which is just below its 2 percent target. Economists are divided on whether policymakers will signal one or two more rate hikes in their statement accompanying the rate decision on Wednesday.

The dollar held gains versus a basket of currencies immediately after the data before falling to trade slightly lower. U.S. Treasury yields were trading lower while U.S. stock index futures were slightly higher.

FOOD PRICES

The Fed’s preferred inflation measure, the personal consumption expenditures price index excluding food and energy, rose 1.8 percent on a year-on-year basis in April, matching March’s increase.

Economists expect the core PCE price index will breach its 2 percent target this year. Fed officials have indicated they would not be too concerned with inflation overshooting the target.

Last month, gasoline prices increased 1.7 percent after surging 3.0 percent in April. Food prices were unchanged in May after rising 0.3 percent in the prior month. Food consumed at home fell 0.2 percent amid declines in the cost of meat, eggs, fruits and vegetables.

Owners’ equivalent rent of primary residence, which is what a homeowner would pay to rent or receive from renting a home, rose 0.3 percent in May after a similar gain in April.

Healthcare costs gained 0.2 percent last month after nudging up 0.1 percent in April. Prices for new motor vehicles rose 0.3 percent after sliding 0.5 percent in April.

Prices for used cars and trucks fell 0.9 percent after tumbling 1.6 percent in April. Airline fares declined 1.9 percent in May after dropping 2.7 percent in the prior month. Prices for apparel and recreation were unchanged in May.

(Reporting by Lucia Mutikani; Editing by Paul Simao)

Suspected cholera cases in Yemen hit 1 million: Red Cross

A health worker reviews a list of patients admitted to a cholera treatment center in Sanaa, Yemen

DUBAI (Reuters) – The number of suspected cholera cases in Yemen has hit 1 million, the International Committee of the Red Cross said on Thursday, as war has left more than 80 percent of the population short of food, fuel, clean water and access to healthcare.

Yemen, one of the Arab world’s poorest countries, is in a proxy war between the Houthi armed movement, allied with Iran, and a U.S.-backed military coalition headed by Saudi Arabia.

The United Nations says it is suffering the world’s worst humanitarian crisis. The World Health Organization has recorded 2,219 deaths since the cholera epidemic began in April, with children accounting for nearly a third of infections.

Cholera, spread by food or water contaminated with human faeces, causes acute diarrhea and dehydration and can kill within hours if untreated. Yemen’s health system has virtually collapsed, with most health workers unpaid for months.

On Dec 3, the WHO said another wave of cholera could strike within months after the Saudi-led coalition closed air, land and sea access, cutting off fuel for hospitals and water pumps and aid supplies for starving children.

The ports were closed in retaliation for a missile fired from Yemen by the Houthis. On Wednesday, despite a fresh missile attack on Riyadh, Saudi Arabia said it would allow the Houthi-controled port of Hodeidah, vital for aid, to stay open for a month.

(Reporting by Sylvia Westall; Editing by Kevin Liffey)

Nearly 1.5 million people signed up for Obamacare plans so far: officials

Nearly 1.5 million people signed up for Obamacare plans so far: officials

WASHINGTON (Reuters) – More than 800,000 people signed up for Obamacare individual health insurance plans in the second week of open enrollment, U.S. government health officials said on Wednesday, bringing the total number of sign-ups to nearly 1.5 million so far.

There is particular scrutiny of how Affordable Care Act programs are faring after a year in which President Donald Trump has sought to undermine Obamacare, especially after his fellow Republicans in Congress failed to pass legislation to repeal and replace the law.

More people have signed up for Obamacare plans in the first two weeks of 2018 open enrollment than in the same time period last year, and the sign-ups include about 345,000 new consumers, according to the latest figures from the U.S. Centers for Medicare and Medicaid Services.

But the Trump administration halved the 2018 open enrollment period to six weeks, slashed the Obamacare advertising budget by 90 percent and cut funding for groups that help people enroll in Obamacare insurance, so it is still unclear whether there will be the same level of participation as in years past.

The Congressional Budget Office has forecast that 11 million people will buy plans in 2018, 1 million more than were enrolled in 2017.

Republicans, who control the White House, Senate and U.S. House of Representatives, failed this summer to push through legislation to overturn the 2010 law, former Democratic President Barack Obama’s top domestic policy achievement.

Repealing Obamacare has long been a goal of Republicans and it was one of Trump’s main election campaign promises. Frustrated by inaction in Congress, the president has taken steps through executive and regulatory actions to undercut the law, and has promised to let the healthcare program “implode.”

Republicans including House Speaker Paul Ryan have said they will try again next year to repeal the law, which has extended health insurance coverage to 20 million more Americans but which has long been seen by Republicans as costly government overreach.

The Senate this week added a repeal of Obamacare’s individual mandate, the requirement that most Americans purchase health insurance or else pay a penalty, to its version of an overhaul of the U.S. tax code that is working its way through Congress.

(Reporting by Yasmeen Abutaleb; Editing by Frances Kerry)

Senate Finance chairman revises tax plan to end Obamacare mandate

Senate Finance chairman revises tax plan to end Obamacare mandate

WASHINGTON (Reuters) – The head of the U.S. Senate Finance Committee proposed major changes to a Republican tax reform plan, adding a repeal of Obamacare’s health insurance mandate and making corporate tax cuts permanent while ending individual cuts in 2025.

In a statement late on Tuesday, committee chairman Orrin Hatch said the proposed changes would also slightly lower some individual tax rates and includes a repeal of the alternative minimum tax but only through 2025, when it would be reinstated.

The 226-page amendment comes as the Senate continues to craft its version of tax reform alongside the U.S. House of Representatives, which is finalizing its own bill. The two plans must be reconciled and merged into a final plan that can pass both chambers before it goes to President Donald Trump to sign into law.

Republicans, who control Congress and the White House but have yet to pass any major legislation, are eager for a legislative victory ahead of the 2018 midterm elections and are pushing hard to pass tax cuts by the end of the year.

It was not immediately clear how many of Hatch’s colleagues will support the plan in the Senate, where Republicans hold a slimmer 52-48 majority than in the House.

Democrats have dismissed the Republican plans as giveaways to corporations and the wealthy that would swell the nation’s deficit. If Democrats remain united in opposition, Republicans cannot lose more than two senators from their ranks and still have enough votes to pass tax legislation.

The inclusion of the healthcare provision, however, could add to the uncertainty, given that Republicans earlier this year failed to make good on their pledge to repeal and replace former President Barack Obama’s 2010 healthcare overhaul.

Hatch’s changes would end one of the more unpopular provisions in Obama’s Affordable Care Act that require Americans to obtain health insurance or pay a penalty. The nonpartisan Congressional Budget Office estimated that the change would increase the number of uninsured by 13 million people by 2027.

“By scrapping this unpopular tax from an unworkable law, we not only ease the financial burdens already associated with the mandate, but also generate additional revenue to provide more tax relief to these individuals,” Hatch said in a statement.

But several key moderate Republicans, including Senators Susan Collins and John McCain, expressed uncertainty on Tuesday over tying the tax bill to the healthcare provision details.

Hatch’s plan would also expand access to deductions for so-called “pass-through” businesses and increase the child tax credit to $2,000 from the earlier proposed $1,650, Hatch said. The current tax credit for children is $1,000.

(Reporting by David Alexander; Editing by Jeffrey Benkoe)

Maine governor will not expand Medicaid, ignoring voters

Maine governor will not expand Medicaid, ignoring voters

By Gina Cherelus

(Reuters) – Maine Republican Governor Paul LePage said on Wednesday he will not expand the state’s Medicaid program under Obamacare, ignoring a ballot initiative widely backed by voters, calling it “ruinous” for the state’s budget.

Maine looked set to become the first state in the nation to expand Medicaid by popular vote.

About 60 percent of voters in Maine approved the ballot proposal in Tuesday’s election, according to the Bangor Daily News newspaper.

Republicans in Washington have failed several times to pass legislation that would dismantle former President Barack Obama’s signature healthcare law.

LePage said he will not implement the expansion until it is fully funded by the Maine legislature.

“Credit agencies are predicting that this fiscally irresponsible Medicaid expansion will be ruinous to Maine’s budget,” LePage said in a statement. “I will not support increasing taxes on Maine families, raiding the rainy day fund or reducing services to our elderly or disabled.”

LePage said a previous Medicaid expansion in Maine in 2002 had created $750 million in debt to hospitals and took resources away from vulnerable people.

Maine has been prominent in the nation’s healthcare debate. U.S. Senator Susan Collins, a moderate Republican from Maine, helped block her party’s efforts to repeal Obamacare. Collins did not immediately respond to a request for comment on LePage’s decision.

Maine voters were asked to approve or reject a plan to provide healthcare coverage under Medicaid for adults under age 65 with incomes at or below 138 percent of the federal poverty level, which in 2017 is about $16,000 for a single person and about $22,000 for a family of two.

If implemented, about 70,000 additional state residents would be eligible for the Medicaid program, local media reported, in addition to the roughly 268,000 people who are currently eligible.

(Reporting by Gina Cherelus in New York; Editing by Daniel Wallis and Jeffrey Benkoe)

Voters in Maine approve expansion of Medicaid under Obamacare

Voters in Maine approve expansion of Medicaid under Obamacare

By Brendan O’Brien

(Reuters) – Voters in Maine on Tuesday approved a ballot initiative to expand the state’s Medicaid program under Obamacare, sending a clear signal of support for the federal healthcare law to lawmakers in the state and Washington D.C.

The approval of the ballot question in Maine comes after Republicans in Washington failed several times over the last few months to pass legislation that would dismantle the Affordable Care Act, former President Barack Obama’s signature healthcare law.

Maine has recently figured prominently in the nation’s debate on how to reform healthcare. U.S. Senator Susan Collins, a moderate Republican from Maine, helped block her party’s efforts to repeal Obamacare this year, which angered President Donald Trump.

Maine, which becomes the first U.S. state to approve Medicaid expansion by ballot initiative, is one of 19 states that has not expanded Medicaid under the Affordable Care Act.

About 60 percent of voters in Maine approved the ballot initiative, according to the Bangor Daily News newspaper.

Tuesday’s ballot asked Maine voters to approve or reject a plan to provide healthcare coverage under Medicaid for adults under the age of 65 with incomes at or below 138 percent of the federal poverty level, which in 2017 is about $16,000 for a single person and about $22,000 for a family of two.

The state’s Republican governor, Paul LePage, staunchly opposes expansion of federal health care insurance, vetoing legislation to do so on several occasions.

“I’ve said it before, “free” is very expensive to somebody,” LePage said in a radio address last week.

About 70,000 residents in Maine would be eligible for the state’s Medicaid program when and if state officials certify the results of the election. Lawmakers could vote to repeal or alter the referendum, much like they have recently for several citizen-initiated referendums, the Bangor Daily News reported.

“It is now the responsibility and the duty of the governor and the legislature to fully and faithfully implement this law,” the state’s Speaker of the House, Sara Gideon, said in a statement.

The Legislature’s Office of Fiscal and Program Review in Maine estimated that expansion of Medicaid would cost the state about $55 million and bring in about $525 million of federal money to the state each year, according to the Bangor Daily News.

(Reporting by Brendan O’Brien in Milwaukee; Editing by Nick Macfie)

Obamacare 2018 enrollment clouded by uncertainty

A man looks over the Affordable Care Act (commonly known as Obamacare) signup page on the HealthCare.gov website in New York in this October 2, 2013 photo illustration.

By Yasmeen Abutaleb

WASHINGTON (Reuters) – As Americans begin signing up for Obamacare health insurance plans on Wednesday, experts expect reduced participation as a bitter political debate clouds the program’s future.

Republicans in Congress have repeatedly failed to repeal and replace former President Barack Obama’s healthcare law, which they have said drives up costs for consumers and interferes with personal medical decisions. Democrats have warned that repeal would leave millions of Americans without health coverage.

President Donald Trump promised to kill the law in his 2016 election campaign, and he has taken executive and administrative actions to undermine it.

“The market’s going to be extremely confusing. There’s going to be entire complexity of choice,” said David Anderson, a health policy researcher at Duke University.

The Center for American Progress, a liberal think tank, estimated this week that 2018 enrollment would have held steady from 2017, with 12.2 million people either signing up for or being automatically re-enrolled in individual health coverage under the Affordable Care Act had there not been administration efforts to undercut it.

The Trump administration has cut the 2018 enrollment period in half to six weeks from Nov. 1 to Dec. 15 for states using the federal Healthcare.gov website. Enrollment previously ran until Jan. 31, and many consumers often signed up in the last two weeks, according to state officials and organizations that help people choose insurance.

Senate Republicans and Democrats are working on legislation to stabilize Obamacare markets in the short term. The nonpartisan Congressional Budget Office estimates that four million fewer people will sign up for Obamacare private insurance than previously forecast due to Trump administration policies.

Still, CBO expects total enrollment to reach 11 million in 2018, up from the around 10 million who obtained and paid for coverage in 2017.

The administration has cut off billions of dollars in subsidies that insurers use to discount out-of-pocket medical costs for low-income Americans, slashed Obamacare advertising and cut funding to groups that help people enroll in health insurance. Several insurers have exited Obamacare markets due to concerns over subsidies and other Trump actions.

The Department of Health and Human Services said on Monday that premiums for the most popular Obamacare plans would rise 37 percent in 2018. Americans eligible for Obamacare tax credits to buy insurance may pay less for coverage, but costs would increase for middle-class consumers who do not get subsidies.

“It’s been such a flood of information. A lot of the population thinks the Affordable Care Act has already been put under,” said Daniel Polsky, a professor at the University of Pennsylvania and executive director of the Leonard Davis Institute of Health Economics. “The strange premium increases are going to be very confusing for consumers.”

The Trump administration is now planning changes for 2019. Last week, it proposed a rule giving states more flexibility over the benefits that must be covered by insurance. Under Obamacare, all insurers have to cover a set of 10 benefits, such as maternity and newborn care and prescription drugs.

(This version of the story corrects reference to CBO estimate on enrollment in paragraphs 7-8, clarifies estimate from think tank in paragraph 5)

 

(Reporting By Yasmeen Abutaleb; Editing by Michele Gershberg)