Overnight Health Care — Sponsored by PCMA — VA reform bill heads to Trump's desk

Overnight Health Care — Sponsored by PCMA — VA reform bill heads to Trump's desk
© Greg Nash

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


It's Wednesday in Washington, where lawmakers are already eyeing the long Memorial Day weekend and we're hoping it's a good night for the Caps in Tampa.

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The Senate sent a major VA reform bill to President TrumpDonald John TrumpOver 100 lawmakers consistently voted against chemical safeguards: study CNN's Anderson Cooper unloads on Trump Jr. for spreading 'idiotic' conspiracy theories about him Cohn: Jamie Dimon would be 'phenomenal' president MORE's desk Wednesday, and the CBO predicted ObamaCare premiums would increase by 15 percent in 2019. But first...


VA reform bill heads to Trump.

The Senate easily passed a sweeping $52 billion bill that will overhaul medical care options for veterans, sending the bill to President Trump's desk. The VA Mission Act passed 92-5, meeting Trump's public deadline to act on the issue and arrive on his desk before Congress departs for a weeklong Memorial Day recess.


The legislation overhauls medical care options for veterans, including giving them more access to private doctors and hospitals. The legislation includes a one-year extension of the Veterans Choice program, which allows veterans to see private medical providers under certain conditions.

Not privatization? The bipartisan nature of the legislation, which also passed the House 347-70, is a sign most Democrats aren't worried about the bill pushing the VA more towards privatization. Those concerns prevented an original version of the House bill from being included in the omnibus funding bill in March.

We break down the bill here.



Sponsored content - Pharmaceutical Care Management Association

Drugmakers set and raise the price of prescription drugs 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.



Trump urges anti-abortion advocates to rally in November. Trump urged them to get to the polls so he in turn can get more of his priorities through Congress, including a ban on abortions after 20 weeks.

Speaking at a fundraising gala for the Susan B. Anthony List, a national anti-abortion group, Trump said "if we work hard between now and November," seats held by vulnerable Dems can be "flipped to a senator who shares our values and votes our agenda."

We've got the recap of his speech here.

Hours before, the Department of Health and Human Services released a proposal targeted at Planned Parenthood funding, which Trump touted during his speech.

Under the proposed regulations, family planning clinics that refer patients for abortions or share locations or finances with abortion providers will be ineligible for funding through Title X.

Why it matters: Planned Parenthood receives millions of dollars in funds each year from the $286 million Title X program. The organization indicated last week it would no longer seek funding under the program if the restrictions were put into place.

We explain here.


CBO's estimates are in... And ObamaCare's premiums are expected to rise an average of 15 percent next year.

Why the increase?

  • It's largely due to the GOP's repeal of the individual mandate, the requirement that Americans have health insurance or pay a fine. The Congressional Budget Office estimates that this will contribute to about a 10 percent rise in premiums for 2019.
  • Rising health care costs.
  • Insurers aren't receiving a key ObamaCare payment from the federal government, which compensated them for subsidizing the out-of-pocket costs of certain enrollees.

Surprise! The finger pointing has already begun. Both parties are scrambling to blame the other for the price hikes. Insurers have released proposed rates in a few states, but they won't be finalized until early fall -- about a month ahead of the midterms.

We break down the numbers here.


It's not just CBO. In the same vein, a top insurance official is also warning of premium hikes from the mandate's repeal.

Kris Haltmeyer, a vice president at the Blue Cross Blue Shield Association, warned reporters on Wednesday of "substantial" premium increases, which he estimated on average to be in the low teens.  

He said that the premium increases were in part due to the repeal of the individual mandate. He also cited lawmakers' failure to pass a bill aimed at shoring up the market, which fell apart earlier this year amid a partisan dispute over abortion restrictions.

Key quote: "With the repeal of the individual mandate and the failure of Congress to enact stabilization legislation, we are expecting premiums to go up substantially," Haltmeyer said.

We've got more here.



Senate health committee Chairman Lamar AlexanderAndrew (Lamar) Lamar AlexanderThe Hill's Morning Report — Sponsored by United Against Nuclear Iran — Kavanaugh confirmation in sudden turmoil Cruz gets help from Senate GOP in face of serious challenge from O’Rourke Restoring our national parks would be a bipartisan win for Congress MORE (R-Tenn.) said Tuesday the committee could markup a bill banning gag clauses next month.

What are we talking about? Specifically, a bill from Sen. Susan CollinsSusan Margaret CollinsMurkowski echoes calls for Kavanaugh, accuser to testify Kavanaugh, accuser to testify publicly on Monday White House says Kavanaugh ready to testify over 'false allegation' MORE (R-Maine) would ban clauses in contracts between pharmacies, insurers and middle men that keep pharmacies from proactively telling customers they could save money on a prescription if they paid out of pocket instead of through insurance.

Why it matters: If it passes Congress, it would be one of the few actions Congress has taken to lower drug prices this year.

We explain here.


A group of senators want to ensure the federal government has a way to measure its progress in curbing the opioid epidemic.

The bill, introduced Wednesday, is from a bipartisan group: Sens. Ed MarkeyEdward (Ed) John MarkeySome employees' personal data revealed in State Department email breach: report Overnight Energy: Warren bill would force companies to disclose climate impacts | Green group backs Gillum in Florida gov race | Feds to open refuge near former nuke site ICE: No immigration enforcement in areas of hurricane shelters or evacuations MORE (D-Mass.), Lisa MurkowskiLisa Ann MurkowskiMurkowski echoes calls for Kavanaugh, accuser to testify Kavanaugh, accuser to testify publicly on Monday Kavanaugh furor intensifies as calls for new testimony grow MORE (R-Alaska) and Maggie HassanMargaret (Maggie) HassanHouse panel advances DHS cyber vulnerabilities bills Chris Pappas wins Democratic House primary in New Hampshire Overnight Health Care: Manchin fires gun at anti-ObamaCare lawsuit in new ad | More Dems come out against Kavanaugh | Michigan seeks Medicaid work requirements MORE (D-N.H.).

Solving the opioid epidemic is a large-scale public health challenge, and the senators want to make sure there are metrics in place to determine what is working, and what isn't.

What the bill would do: Require federal agencies to craft ways to measure the effectiveness of efforts to tackle the opioid epidemic within 180 days, with the goal of "significantly reversing" opioid misuse and opioid-related deaths within five years.

Read more here.


Advocates call for reducing stigma around gout

Advocates and doctors called for increased awareness of gout to reduce the stigma surrounding the illness at a roundtable dinner hosted by The Hill on Tuesday night and sponsored by Horizon Pharma.

Gout, a form of arthritis that can cause episodes of serious pain, affects about 8 million people in the United States. It has been nicknamed the "king's disease" because it is often associated with overweight people, but doctors and advocates stressed that it can affect a broader range of people and should not have a stigma.

Dr. Regina Benjamin, a former surgeon general of the United States, said that an awareness campaign about the disease could help people manage it better.


House Dems want CBO to reject a proposal that would roll back ObamaCare's transgender discrimination protections. 

The group of 127 Democrats want OMB director Mick MulvaneyJohn (Mick) Michael MulvaneyFinancial policymakers must be suffering from amnesia On The Money: Broad coalition unites against Trump tariffs | Senate confirms new IRS chief | Median household income rose for third straight year in 2017 | Jamie Dimon's brief battle with Trump Eight weeks out: Dems see narrow path to Senate majority MORE to reject a proposed rule that is expected to roll back a controversial anti-discrimination provision buried within ObamaCare.  

The rule has been under review at OMB since April, and is expected to be released later this summer. Democrats said the rule would allow health-care providers to deny treatment to transgender patients and women who have had abortions, if the provider has a religious objection.

What's the objective? Mulvaney is not going to listen to House Democrats. But they're calling attention to an issue that's flown largely under the radar to date. The rule was expected to be issued as early as last year, and it will come on the heels of the administration cutting funds to Planned Parenthood and other federally funded health clinics that provide abortions.

Read more about the brewing fight here



Sponsored content - Pharmaceutical Care Management Association

A drug company's decision to increase the price of a forty-year-old drug by 1400% – despite no change in the supply chain – undermines drugmakers' attempt to blame their prices on the insurers, pharmacies, PBMs, and wholesalers through which patients access medicines. 



Wednesday roundup

The Senate Finance Committee released 22 bipartisan bills aimed at curbing the opioid epidemic and plans to mark up the legislation in the "coming weeks."


What we're reading

Medicare's stealth price hike: Seniors are paying more for generics even though the drug prices haven't increased (Los Angeles Times)

Is it a gag rule after all? A closer look at changes to Title X funding regarding abortion (Washington Post)

Drugmakers blamed for blocking generics have jacked up prices and cost U.S. billions (Kaiser Health News)


State by state

Tax bill and ObamaCare repeal are potent issues in California congressional races, poll shows (Los Angeles Times)

Virginia Senate GOP leaders push off budget debate over Medicaid (Associated Press)


From The Hill's opinion pages

Denial of services to same-sex couples can harm their health

Trump and Azar are rightly moving health care back to free-market policy

The problem isn't opioids -- it's how we're raising our kids