Overnight Health Care: Trump officials to allow work requirements for Medicaid

Overnight Health Care: Trump officials to allow work requirements for Medicaid
© Victoria Sarno Jordan

The Trump administration will encourage states to pursue work requirements for certain Medicaid beneficiaries, a top official said Tuesday.

The remarks by Centers for Medicare and Medicaid Services (CMS) administrator Seema Verma would signal a significant departure from the Obama administration's approach to such requests.

Several states have already proposed work requirements, and Verma's comments indicate a willingness to fast-track those approvals.


The Obama administration repeatedly said work requirements were inconsistent with Medicaid's mission of providing health care to low-income people.

According to Verma, allowing states to impose work requirements is an essential part of granting them more flexibility. Making Medicaid beneficiaries work will ensure they bring themselves out of poverty.

"Let me be clear to everyone in this room, we will approve proposals that promote community engagement activities," Verma said. She defined "community engagement activities" as working, receiving job training, going to school or volunteering.

The speech was Verma's most detailed explanation of the direction she wants to take the program. She also sharply criticized the Obama administration's opposition to work requirements.

"Believing that community engagement requirements do not support or promote the objectives of Medicaid is a tragic example of the soft bigotry of low expectations consistently espoused by the prior administration," Verma said, according to prepared remarks of a speech to the National Association of Medicaid Directors.

"Those days are over."

Read more here.


FDA chief: Keep defense medical approvals in our sphere 

Food and Drug Administration (FDA) Commissioner Scott Gottlieb said the agency should retain control over medical device and drug approvals after a provision in the defense policy bill would give this power to the Defense Department for soldiers.

Gottlieb pointed to an alternative proposal he supports that, he said, would accelerate drug and device approvals at the FDA for the battlefield.

"That's important because we think we provide a level of oversight that helps ensure the safety of products, helps follow-up to make sure that if there are adverse events we're monitoring them, we're collecting that information," Gottlieb said at The Hill event Tuesday on opioid prevention sponsored by the Pharmaceutical Care Management Association, a trade group for pharmacy benefit managers. "So we think keeping it within the FDA context is the right thing."

At issue is a provision of the Senate's National Defense Authorization Act now going through conference committee. The measure would allow the Pentagon to sign off on unapproved medical devices and drugs to be used on military personnel for emergency use, which Politico first reported Monday. Approving drugs and devices is currently the FDA's responsibility.

Gottlieb said alternative language has been shared with both chambers' Armed Service Committees and that he is willing to make modifications to this language.

Read more here.


GOP unlikely to repeal ObamaCare mandate in tax measure 

The House is unlikely to repeal the mandate to buy insurance under ObamaCare as part of its tax-reform bill, GOP sources say, though the issue could return down the road.

President Trump and conservative lawmakers are pushing for the individual mandate to be repealed in the bill, but House Ways and Means Committee Chairman Kevin BradyKevin Patrick BradyTrump announces tariffs on 0B in Chinese goods New GOP tax cuts would add .8 trillion to deficit, says report House panel advances key bill in new round of GOP tax cuts MORE (R-Texas) has expressed worry that the controversial measure would jeopardize the broader tax-reform bill, given the Senate's failure on health care earlier this year.

"It hasn't ever been in the [House] bill," said one Republican on the Ways and Means Committee who has been taking part in the negotiations. "I expect that it will be added somewhere down the sausage-making venture."

Read more here.



GOP senator says CBO moving the goalposts on ObamaCare mandate

Sen. Mike LeeMichael (Mike) Shumway LeeOvernight Health Care: Opioid legislation passes overwhelmingly | DOJ backs Cigna-Express Scripts merger | Senate passes ban on pharmacy gag clauses US military intervention in Venezuela would be a major mistake The Hill's 12:30 Report — Obama jumps into midterm fight with speech blasting Trump | Trump wants DOJ to probe anonymous writer | Day four of Kavanaugh hearing MORE (R-Utah) on Tuesday sharply criticized the Congressional Budget Office (CBO) for shifting its estimates of the effect of ObamaCare's individual mandate as GOP lawmakers consider new ways of repealing the rule.

Lee's comments come after Sen. Bill CassidyWilliam (Bill) Morgan CassidyOutdated global postal system hurts US manufacturers GOP eyes another shot at ObamaCare repeal after McCain’s death Overnight Defense: Push to rename Senate building for McCain sparks GOP backlash | Pentagon has no plans to suspend future Korea war games | Mattis rejects plan to privatize Afghan War MORE (R-La.) told The Hill earlier on Tuesday that he has been informed the CBO is now projecting that repealing the mandate will provide significantly less savings than it previously projected.

Some Republicans are pushing to repeal the mandate in their tax reform bill to help pay for cuts, so a projection of less savings would make mandate repeal less useful.

"Just a few months ago the CBO had us playing by one set of rules for debating health care policy and now we are being told those rules have been completely changed for tax policy," Lee said in a statement.

Lee has a bill that would require the CBO to publish information on how it comes up with its analyses.

Read more here.


Notre Dame reverses decision to end no-cost contraceptive coverage 

The University of Notre Dame has reversed its decision to end free contraceptive coverage for employees.

The insurance company used by employees at Notre Dame will keep a plan with contraceptive coverage with no co-pay, US News & World Report reported Tuesday.

"The University of Notre Dame, as a Catholic Institution, follows Catholic teaching about the use of contraceptives and engaged in the recent lawsuit to protect its freedom to act in accord with its principles," the university said in an email Tuesday.

Read more here.


Op-eds in The Hill 

Faulty assumptions linking mental illness to violence is the wrong approach

The ACA won't work without the individual mandate. We must keep it.


What we're reading

Pain relievers worked as well as opioids in ER patients (Associated Press)

Six ways Amazon could up-end the pharmacy business (Bloomberg)

With online medical marijuana, it's buyer beware (Reuters)


State by state 

Nevada gets low marks for inmate health spending (Las Vegas Review-Journal)

Wisconsin: Employer, health care groups clash over workers' compensation (lacrossetribune.com)

This election day, Ohio is a bellwether in the national fight over drug costs (statnews.com)