Overnight Health Care — Sponsored by PCMA — Trump official won't OK lifetime limits on Medicaid

Overnight Health Care — Sponsored by PCMA — Trump official won't OK lifetime limits on Medicaid
© Getty

Welcome to Overnight Health Care, sponsored by the Pharmaceutical Care Management Association.


It's Tuesday evening and our campaign team is gearing up for Pennsylvania's primaries. Here are the key races we're watching tonight. (Check out TheHill.com for the latest.)

And on the health care front, we're wondering how the National Institutes of Health will respond to a big question: Is society becoming addicted to technology? (Ahem, Please keep reading on your computers or mobile devices for more on this...)


But first, we hear from Seema Verma, the head of the Centers for Medicare and Medicaid Services (CMS).

Verma once again made it clear that the Trump administration isn't giving conservative states a blank check for changes to Medicaid. During an event hosted by The Washington Post, Verma said the administration will not approve any requests by states to impose lifetime limits.

"We've indicated we would not approve lifetime limits, and we've made that pretty clear to states," Verma said.

Why this matters: The Trump administration has made state flexibility on Medicaid a priority, but the refusal to consider lifetime limits shows that it is not willing to allow just any proposal. Earlier this month, the administration rejected Kansas's request to impose lifetime limits on beneficiaries. Maine, Arizona, Utah and Wisconsin had also requested the ability to cap how long people can receive benefits.

The reasoning: "We always want to make sure that the program serves as a safety net and there's a place for people to go when they need it," Verma said. If someone doesn't comply with work requirements, he or she will temporarily lose coverage, and that's fine with CMS, so long as there's a pathway back to coverage.

Read more here.



Sponsored content - Pharmaceutical Care Management Association

Drugmakers set and raise prices unrelated to the rebates they negotiate with pharmacy benefit managers (PBMs).  The most direct way for drugmakers to reduce costs and improve access is to simply cut their own prices.



Republicans are pressuring the Trump administration to put abortion restrictions on a federal family planning program, and Democrats are fighting back.

House and Senate Democrats urged Health and Human Services Secretary Alex Azar in two separate letters sent Tuesday not to issue regulations that both sides say are targeted at Planned Parenthood.

Republicans have been asking the administration to restore Reagan-era regulations that banned organizations participating in the Title X family planning grant program from promoting or referring patients for abortions. It would also require a physical and financial separation between Title X providers and abortion providers.

"Calls to reinstate these policies directly acknowledge this effort as an opportunity for President TrumpDonald John TrumpGillibrand urges opposition to Kavanaugh: Fight for abortion rights 'is now or never' Trump claims tariffs on foreign nations will rescue US steel industry: report Bannon announces pro-Trump movie, operation team ahead of midterms: report MORE to fulfill his pledge to 'defund Planned Parenthood,' whose health centers remain an essential part of the family planning safety net, serving 40 percent of Title X patients," wrote 45 Senate Democrats, led by Sens. Elizabeth WarrenElizabeth Ann WarrenOn The Money: Turkey slaps more tariffs on US goods | Businesses fear blowback from Russia sanctions bill | Senate turns to toughest 'minibus' yet Warren introduces Accountable Capitalism Act Lewandowski says Bloomberg would be 'very competitive' against Trump in 2020 MORE (Mass.), Patty MurrayPatricia (Patty) Lynn MurraySenate Dems press Sessions for records on racial discrimination complaints Dem senators introduce resolution calling on Trump to stop attacking the press Overnight Health Care: Drug price fight heats up | Skepticism over drug companies' pledges | Ads target HHS secretary over child separations | Senate confirms VA pick MORE (Wash.) and Maggie HassanMargaret (Maggie) HassanDem senators introduce resolution calling on Trump to stop attacking the press Senators blast Michigan State president's handling of sex abuse scandal New Hampshire governor signs controversial voting bill MORE (N.H.)  

Why it matters: The administration is expected to release the regulations soon, and it could make it more difficult for Planned Parenthood to participate in the program. Because the regs were already upheld by the Supreme Court, it would be a huge win for Republicans ahead of the midterms.


20 Democratic state attorneys general are also fighting changes to Title X that the administration issued earlier this year. Funding criteria released by the administration in February will make it harder for Planned Parenthood to participate, a coalition of attorneys general, led by California's Xavier BecerraXavier BecerraCalif. AG seeks info on family separation policy Trump boasts he went '5 for 5' in Tuesday's elections California tees up effort to counter Trump’s car emissions rollback MORE, wrote Tuesday.

Planned Parenthood last week announced it would sue over the changes, and the attorneys general filed an amicus brief in support of an injunction.

"These new requirements are illegal, lack transparency, and undermine the longstanding, bipartisan Title X family planning program that helps millions of Americans. While the President continues to take action to undermine access to healthcare, California will keep fighting to protect the health of all Americans," Becerra said.

Read the brief here.



Drug lobby back on Trump's drug pricing proposals

PhRMA made its first extended remarks on Trump's new drug pricing plan, and made clear that it's not happy with some of the ideas.

Lori Reilly, an executive vice president at PhRMA, said the group had "serious concerns" about some of the proposals.

She pointed in particular to the proposal to move drugs from Medicare Part B into Part D. Secretary of Health and Human Services Alex Azar has criticized Part B for lacking competition and said taxpayers could get a better deal with the negotiation by private players in Part D.

Reilly also raised concerns about the proposal to allow more negotiation in Medicare Part D's "protected classes," where insurers are required to cover all of the drugs in certain categories, like antidepressants.

Read more here.


Meanwhile, Ways and Means plans hearings on drug prices

Congress is not expected to take major action on drug prices this year, but Ways and Means Chairman Kevin BradyKevin Patrick BradyTreasury releases proposed rules on major part of Trump tax law Republicans happy to let Treasury pursue 0 billion tax cut Trump weighs big tax cut for rich: report MORE (R-Texas) is at least getting the discussion going with a hearing.

Brady said it is too early to tell if the committee will move legislation on the issue, but said he wanted to consider the ideas.

"I think there's some very good ideas in that proposal and some very thoughtful ones that we need to be airing out," Brady told reporters. "So yeah I do expect to conduct congressional hearings on some of those ideas."

Many of the proposals Trump unveiled on Friday the administration can do on its own, but some larger changes could require Congress to act. That could include some changes to how Medicare pays for drugs.

Brady said he particularly liked items in the proposal to bring drugs to market faster to increase competition, as well as ideas to make sure that savings from insurer negotiations with drug companies make their way to consumers.

Read more here.


Vote on House VA overhaul bill coming this week.

The House is planning a vote later this week on a bill that would overhaul access to private sector care outside the VA health system. The legislation, called the VA Mission Act, advanced through the House Veterans' Affairs Committee by a 20-2 vote last week.  

In the Senate, VA Committee Chairman Johnny Isackson (R-Ga.) said he intends to bring the bill up next week, so it can sent to President Trump to sign.

Trump has urged swift movement on the legislation to overhaul access to private sector care, and urged lawmakers to pass it by Memorial Day.


And finally... two senators want answers on whether people, in particular children, are developing a technology addiction.

"To address the open question of whether we are addicted to technological devices and platforms, Congress must understand the current scientific consensus, potential gaps in research, and the best way to build a body of evidence that can inform effective policymaking," Sens. Brian SchatzBrian Emanuel SchatzPentagon’s No. 2 official: Trump’s ‘Space Force’ could cost 'billions' Senate Dem rips 'Space Force:' No Republican is willing to tell Trump it's a 'dumb idea' EPA pushes back on asbestos criticisms MORE (D-Hawaii) and Michael BennetMichael Farrand BennetWhen it comes to drone tech, wildfire officials need the rights tools for the job NFL player wears 'Immigrants made America great' hat mocking Trump US farmers shouldn't be collateral damage in free-traders' crusade MORE (D-Colo.) wrote in a letter sent Tuesday to the National Institutes of Health (NIH).

Background: A study last year from Common Sense Media showed children under the age of 8 spend an average of 48 minutes per day viewing the screen of a mobile device, up from 15 minutes per day just five years ago.

What the senators want: A briefing from the NIH and written responses to questions, including "is there consensus in the scientific community on whether our society is becoming addicted to technology?" They also want the tech industry to engage on the issue.



Sponsored content - Pharmaceutical Care Management Association

Pharmacy benefit managers (PBMs) have outlined several policy solutions to ensure patients receive opioid prescriptions when safe and medically appropriate. One important solution would be requiring e-prescribing of controlled substances in Medicare (S. 2460 / H.R. 3528, the Every Prescription Conveyed Securely Act). A new study by the Opioid Safety Alliance finds this could also save taxpayers $13 billion over 10 years.



Tuesday round-up.

The "middlemen" in the drug pricing debate are fighting back.

President Trump visited the first lady in the hospital for the second straight day. Earlier in the day, he said she is "doing really well" and recovering from her kidney surgery.

The World Health Organization on Tuesday unveiled an ambitious goal: eliminating artificial trans fats from all foods by 2023.

And a study in the American Heart Association's journal Hypertension is tying air pollution to high blood pressure for children.


What we're reading

U.S. state attorneys general sue Purdue Pharma over opioid epidemic (Reuters)

In the midst of a massive opioid crisis, hospitals are experiencing an opioid shortage (Marketplace)

Lack of insurance exposes blind spots in vision care (Kaiser Health News)


State by state

Governor sees 'Maryland Model' as example for US health care (Carroll County Times)

Oregon insurers propose modest ObamaCare rate increases (Washington Examiner)

Virginia budget inches along as passions over Medicaid inspire 'die-in' (The Washington Post)