Overnight Health Care: Trump's VA pick on the ropes | White House signals it will fight for nominee | Senate panel approves opioid bill | FDA cracking down on e-cig sales to kids

Overnight Health Care: Trump's VA pick on the ropes | White House signals it will fight for nominee | Senate panel approves opioid bill | FDA cracking down on e-cig sales to kids
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Welcome to Tuesday's Overnight Health Care, where we just got a 1,883 page Medicare regulation, everyone's idea of a fun way to spend a Tuesday afternoon.

But first, a lot of new developments on the Veterans Affairs Secretary front. The nomination of Ronny Jackson is looking increasingly in peril.


VA pick on the ropes

President TrumpDonald John TrumpArizona GOP Senate candidate defends bus tour with far-right activist Alyssa Milano protests Kavanaugh in 'Handmaid's Tale' costume Bomb in deadly Yemen school bus attack was manufactured by US firm: report MORE's pick to lead the Department of Veterans Affairs was in the spotlight Tuesday as allegations of workplace misconduct swirled, and the president opened the door to his nominee's withdrawal.

Staffers on the Senate Veterans' Affairs Committee are looking into charges Adm. Ronny Jackson created a hostile work environment, excessively drank on the job and improperly dispensed medications.

The allegations have roiled Jackson's nomination, which was already facing skepticism from lawmakers on both sides of the aisle. They have also raised questions about the Trump administration's vetting of Jackson.

Backstory: The Senate Veterans Affairs Committee postponed a Wednesday confirmation hearing, and is looking into the allegations. The committee hasn't been able to verify the claims yet, but Sen. Jon TesterJonathan (Jon) TesterSenate gets to work in August — but many don’t show up Pearl Jam criticized for poster featuring dead Trump, burning White House Montana GOP Senate hopeful touts Trump's support in new ad MORE (D-Mont.) said they've received complaints from more than 20 current and former military personnel who worked with or for Jackson. Tester detailed some of those claims earlier Tuesday.

And there's an IG report: A 2012 inspector general report found that Jackson acted unprofessionally amid a power struggle with another doctor.

The Associated Press reviewed the six-page document on Tuesday. It detailed a power struggle between Jackson and Dr. Jeffrey Kuhlman over the White House medical unit, leading to staff member concerns about Jackson's leadership.

Staffers described the work environment as "being caught between parents going through a bitter divorce," The AP reported.

Read more on the IG report here.


White House signals it will fight for pick

The White House on Tuesday evening was defending Jackson even as his nomination appeared in trouble.

"Dr. Jackson's record as a White House physician is impeccable," said a senior White House official. "He has improved unit morale, received glowing reviews and promotions under Republican and Democrat presidents, and has been given a clean vet from the FBI."

Those remarks came after a meeting with Trump and Jackson that a White House official called "positive."

Earlier in the day, though it appeared President Trump was giving Jackson cover to drop out.

Trump repeatedly said Tuesday the choice to withdraw was Jackson's, but he also questioned why he would want to go forward and take the "abuse" from politicians.

"It's totally his decision, he'll be making a decision," Trump said when asked about the nomination of Jackson, who is the White House physician to the president.


What's next?

The White House plans to stick by Jackson. On Tuesday officials downplayed the IG report and also highlighted performance reports on Jackson that were signed by both Trump and his predecessor, former President Obama.

But Jackson still faces a tough vote in the Senate and could face a tough hearing with the allegations against him being discussed publicly.


Jackson wasn't the only big story on Tuesday...


Just out: a new proposal from the Trump administration hopes to force hospitals into being more transparent about the costs of their services. 

Highlights from the proposed rule from the Centers for Medicare  & Medicaid Services (CMS):

  • Hospitals would be required to publish their prices online beginning in the 2019 program year.
  • It would require hospitals to provide health records to patients in electronic format, or face a penalty.
  • It requests information on how to reduce "surprise" out-of-network billing, a signal that the administration hopes to turn to this issue soon.


Why this matters: This is all part of HHS Secretary Alex Azar's effort to drive down health costs. The first step, Azar says, is making sure patients have access to their health records and costs of health services, which are all too often not available to them.


Senate health panel unanimously approves opioid bill

The Senate HELP Committee approved their opioid bill on Tuesday, a day before the House Energy and Commerce Committee holds its big markup.

The bill includes more than 40 proposals from 38 different senators.

Specifically, it includes measures attempting to make it easier to prescribe smaller packs of opioids for limited durations, spur the development of nonaddictive painkillers and bolster the detection of illegal drugs at the border.


What's next: Alexander said he expects other committees will also have ideas on how to combat the opioid epidemic, "but if we can present our framework to Senator [Mitch] McConnell, maybe this is something the Senate can move on this summer."

Read more here.


Next month, the panel hopes to turn to a bill addressing rising maternal mortality rates in the U.S., an issue that's been placed on the backburner as Congress deals with other pressing health issues.

Ranking member Patty MurrayPatricia (Patty) Lynn MurrayGOP leader criticizes Republican senators for not showing up to work Senate Dems press Sessions for records on racial discrimination complaints Dem senators introduce resolution calling on Trump to stop attacking the press MORE (D-Wash.) said she and Alexander have come to an agreement about marking up a bill from Sens. Heidi HeitkampMary (Heidi) Kathryn HeitkampDems to challenge Kavanaugh for White House records To solve the southern border crisis, look past the border The Hill's Morning Report: Dems have a majority in the Senate (this week) MORE (D-N.D.) and Shelley Moore CapitoShelley Wellons Moore CapitoSenate GOP battles for leverage with House on spending Lawmakers, media team up for charity tennis event The Hill's Morning Report — Trump picks new fight with law enforcement, intelligence community MORE (R-W.Va.)

"It is unacceptable that in the United States of America in the 21st Century, maternal mortality rates are increasing, and increasing at higher rates for women of color," Murray said during a HELP Committee hearing Tuesday.

Why it matters: The bill in question would support state efforts to track and investigate maternal deaths, something not widely done in the U.S. Getting a handle on where deaths are happening, and why, is the first step to driving down the rates, experts argue.

What to watch for: It's still not clear when the House Energy & Commerce Committee will vote on the bill's House counterpart.

Read more here.

And for a deeper dive, read last week's story about what the hold up is in Congress here.


FDA Commissioner Scott Gottlieb issued a warning Tuesday to stores and online retailers selling e-cigs to kids.

The FDA has sent 40 warning letters to retailers who have violated the law, Gottlieb said, and will continue a nationwide "blitz" through the end of the month.

"Let me be clear to retailers. This blitz, and resulting actions, should serve as notice that we will not tolerate the sale of any tobacco products to youth," Gottlieb said.

Read more here.


Happening tomorrow:

  • The House Energy and Commerce Health Subcommittee will vote on over 60 opioid bills. 1 p.m., Rayburn 2123


What we're reading

Inside the secret U.S. stockpile meant to save us all in a bioterror attack (The Washington Post)

Centene's ObamaCare profits surge as market stabilizes (Forbes)

Express Scripts targets Amgen, Lilly migraine drugs in pricing shift (Reuters)


State by state

Maine governor defies ballot initiative expanding Medicaid (Politico)

Rhode Island Medicaid enrollment surpasses expectations (Associated Press)