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Overnight Health Care — Sponsored by PCMA — Divided Trump officials delay decision on Medicaid lifetime limits

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


It’s Throwback Tuesday, where a former HHS secretary — who resigned after using taxpayer money to fly on private and military jets — is back in the news. Also, allegations of a “raid” on Trump’s medical records, a troubling statistic from a new poll and a warning from the CDC.


But first… Trump officials abruptly pull back from decision on Medicaid lifetime limits.

The Trump administration was going to make major news today rejecting Medciaid lifetime limits in Kansas, but the announcement was cancelled at the last minute, sources say. 

Here’s what happened: CMS Administrator Seema Verma was going to make the announcement at a media availability on Tuesday afternoon, but internal administration disagreements led to the announcement being abruptly canceled. The media availability went on anyway, but no news was announced. 

Why it matters: Rejecting lifetime limits in Medicaid would be a significant move by the Trump administration drawing a line against a new level of restrictions on the program. Democrats had pressured the administration to reject the proposals. 

Even still, Verma hinted Tuesday that she opposes the idea. “We’re trying to think about all of the nuances here,” Verma told reporters, speaking in general about lifetime limit proposals. “We understand that people’s circumstances change over time and that they may actually get into a job and then maybe something happens in a few years.” 

Read more here



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Democrats are seizing on Tom Price’s remark that the repeal of ObamaCare’s individual mandate would drive up costs.

Key quote: “That may help, but it still is nibbling at the side,” Price told the World Health Care Congress, according to multiple reports. “And there are many, and I’m one of them, who believes that that actually will harm the pool in the exchange market, because you’ll likely have individuals who are younger and healthier not participating in that market, and consequently, that drives up the cost for other folks within that market.”

The politics: Democrats are giddy at Price’s remarks, believing it bolsters their argument that Republicans will be to blame if premiums increase this year. (The GOP repealed the individual mandate in their tax bill.)

  • “We couldn’t have said it any better ourselves,” Matt House, spokesman for Senate Minority Leader Charles Schumer (D-N.Y.), said in email highlighting Price’s comments.

They are also pointing out the apparent hypocrisy of Price’s remarks, given that when he was HHS Secretary, he was advocating for the exact thing he now says is harmful. In a 2017 interview with ABC’s Martha Raddatz, Price said the mandate was driving up premiums and was harming patients.

  • “Well, the individual mandate is one of those things that actually is driving up the costs for the American people in terms of coverage,” Price said. “So what we’re trying to do is make it so that ObamaCare is no longer harming the patients of this land. No longer driving up costs, no longer making it so they’ve got coverage but no care. And the individual mandate is one of those things.”

Read more here.


Price’s remarks weren’t the only ammunition Democrats found on Tuesday.

A new survey conducted by the Commonwealth Fund found that about 4 million Americans have lost insurance in the last two years. Democrats were quick to attribute that decline to actions taken by the Trump administration.

Key findings from the poll:

  • The uninsured rate was up significantly compared with 2016 among adults with an individual income of about $30,000 and a family income of about $61,000.
  • People who identified as Republican also had significantly higher uninsured rates, rising from 7.9 percent in 2016 to 13.9 percent in the current period.
  • About 60 percent of all adults surveyed said they were aware that the GOP tax bill included a repeal of the individual mandate penalty, and 9 percent of people who get their insurance through the individual market said they were planning to drop coverage as a result.

The blame game: The report pointed to specific actions taken by the Trump administration, from repealing the individual mandate to allowing insurance companies to offer short-term health plans that don’t have to cover pre-existing conditions. The administration also slashed the advertising budget for enrolling people in ObamaCare by 90 percent, and cut funds for local groups that help people sign up for coverage.

Read more here.


Meanwhile, a coalition of anti-abortion groups is calling on the Trump administration to cut Planned Parenthood off from family planning grants.

More than 85 anti-abortion groups signed a letter Tuesday saying that the family planning money, known as Title X, should not go to Planned Parenthood and other groups that perform or refer women for abortions. This shift would reinstate a regulation put in place by President Reagan.

Key quote: “The result of this policy is simply to separate the Title X network of family planning providers from abortionists like Planned Parenthood – the nation’s largest abortion chain,” states the letter, which was signed by leading anti-abortion groups like Susan B. Anthony List and National Right to Life.

Read more here.


Federal regulators aren’t happy with some companies making and selling e-cigarette liquids, and are cracking down on packaging resembling kid-friendly items.

At issue: Some of the products resemble juice boxes, whipped cream containers and even cookies.  

Pictures are here, as well as copies of the warning letters the Food and Drug Administration and Federal Trade Commission sent to the companies.

Next steps: The FDA and Federal Trade Commission asked the companies to respond within 15 business days on specific actions to address the agency’s concerns. If they don’t comply, additional action may follow, such as a seizure or an injunction.

From the other side: Nick Warrender — CEO of Lifted Liquids, which received a warning letter — said the company already changed the packaging resembling Warheads candies in November 2017. The product was taken off shelves, he said, and the logo was changed to resemble a bearded man vaping. He said he was surprised to receive the letter since the changes were made six months ago.

Other companies could not be reached immediately for comment.

Read more here.


It’s almost summer, which means it’s bug season. The CDC is warning that the U.S. public health system is not prepared to fight back against an increasing number of illnesses borne from flea, tick and mosquito bites.

The numbers: New data from the Centers for Disease Control and Prevention show more than 640,000 cases of illness caused by mosquito, tick and flea bites between 2004 and 2016, with a three-fold increase over that span.  The numbers of confirmed new transmissions jumped from just 27,000 in 2004 to more than 96,000 in 2016, the CDC said.

The solution: The increasing number of transmissions is worrying to some scientists who say those pathogens represent a growing risk to the country. Local and state health departments are on the front lines, and CDC said they need to be better at tracking, diagnosing and reporting cases. There also needs to be greater support of those agencies from the federal level.

Read more here.


Trump’s former doctor on Tuesday claimed that his office was “raided” by Trump associates who made off with the president’s medical records.

President Trump’s longtime personal doctor in New York says a trio of Trump associates showed up at his office without notice in February 2017 and seized the president’s medical records.

“They must have been here for 25 minutes or 30 minutes. It created a lot of chaos,” Dr. Harold Bornstein told NBC News, adding that he felt “raped, frightened and sad.”

He said Trump bodyguard Keith Schiller, a lawyer and a third person took lab reports and medical charts.

White House responds: Press secretary Sarah Huckabee Sanders said the records were transferred to the White House medical unit, calling it “standard operating procedure” and denying the characterization of a “raid.”

Read more here.



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Latest on Trump’s former VA nominee. The White House confirmed Tuesday that Adm. Ronny Jackson is no longer serving as President Trump’s personal physician.

“He’s still an active-duty Navy doctor assigned to the White House but upon his nomination to the Department of Veterans Affairs as secretary, an acting doctor was put in his place, and Dr. Conley will remain there,” White House Press Secretary Sarah Huckabee Sanders said during Tuesday’s press briefing.

Trump nominated Jackson to serve as Veterans Affairs (VA) secretary. Jackson withdrew his nomination last week after allegations of improper behavior.

Sean Conley, a Navy veteran, is performing Jackson’s duties.

Read more here.


What we’re reading

The doctor will text you now: 98point6 taking virtual primary care nationwide (Seattle Times)

ObamaCare chief doubts that more advertising would increase enrollment (Washington Examiner)

Medicare chief says it’s time health care caught up to other industries to benefit consumers (CNBC)

She didn’t get treated at the ER. But she got a $5,751 bill anyway. (Vox)


State by state   

Major health initiative targets 3 Indianapolis neighborhoods with high diabetes rates (Indianapolis Business Journal)

Ohio submits Medicaid work requirements for federal approval (AP)

Kentucky leaders back McConnell’s effort to address effect of opioids on workforce (WFPL)


From The Hill’s opinion pages

Short-term health plans are the right path for Trump to improve the marketplace

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