Overnight Healthcare

Overnight Health Care: Arkansas scraps Medicaid for thousands | Uninsured rate steady in Trump's first year | GOP counters ObamaCare attacks with talk of Medicare

Welcome to Wednesday's edition of Overnight Health Care. The House and Senate are back in session--briefly.

The Senate was scheduled to vote on a comprehensive opioid package, but that is now going to be pushed to next week. In the House, legislation to delay parts of ObamaCare, including the employer mandate, is poised for a vote tomorrow. Lawmakers hope to get out of town before Hurricane Florence barrels into the east coast.

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We'll start today in Arkansas, where new numbers have been released about the impact of Medicaid work requirements....


Arkansas scraps Medicaid coverage for thousands

Work requirements got real on Wednesday, with thousands of people getting kicked off of health coverage for failing to meet the requirements.

A total of 4,353 individuals have been booted from Medicaid in Arkansas for not reporting to the state on how they're meeting the requirements. Under the new program, those who miss three months of reporting in one year become ineligible for coverage the remainder of the year.

There could be more: While that number seems large, more people could lose coverage in the months ahead. In total, more than 16,000 people failed to meet the requirements in August.

The state's Department of Human Services said it conducted outreach from April through August to let beneficiaries know about the new requirements.

Bigger picture: Work requirements are a major priority of the Trump administration and they are trying to bring them to other states. Other places, like Kentucky, have been caught up in litigation on the issue, and the court battles are sure to continue. The Trump administration is forging ahead, though.

The view from Arkansas: "Personal responsibility is important. We will continue to do everything we can to ensure those who qualify for the program keep their coverage, but it is equally important that we make sure those who no longer qualify are removed," said Arkansas Gov. Asa Hutchinson (R).

Read more here.


After one year of Trump, the uninsured rate is... the same

The rate of Americans without health insurance remained flat in 2017 at 8.8 percent, according to data released Wednesday by the Census Bureau.

The 8.8 percent uninsured rate in 2017, which translates to 28.5 million people, was the same as the rate from 2016.

The data show that in the first year of the Trump administration, the uninsured rate remained the same as in the last year under President Obama.

Not as bad as some thought: The data is a contrast to data released in January from Gallup, which showed three million additional people without health insurance in President Trump's first year and drew condemnation from Democrats.

But it's not over yet: Larry Levitt, a health policy expert at the Kaiser Family Foundation, said that it is possible the uninsured rate could increase in 2018 or 2019, as the Trump administration's changes to ObamaCare take effect.

For example, the Trump administration has drastically cut back on funding for outreach to help people enroll in coverage. The repeal of the mandate to have coverage from the GOP tax law passed in December 2017, which takes effect in 2019, is expected to increase the uninsured rate.

Read more here.


GOP's counterargument to attacks over ObamaCare repeal: Medicare is at risk

Republicans are trying to blunt Democratic attacks on their ObamaCare repeal efforts by pointing to a different program: Medicare.

Republicans in tight midterm races are tying their Democratic opponents to a "Medicare for all" proposal from Sen. Bernie Sanders (I-Vt.), arguing the plan would bankrupt the government and damage traditional Medicare.

Examples: Florida Gov. Rick Scott (R), who is running in a close Senate race, recently tweeted: "If you want to protect Medicare, vote Republican. If you want a socialist experiment with Medicare, by all means vote Democrat."

In Maine, Rep. Bruce Poliquin (R) has a TV ad hitting his Democratic challenger, Jared Golden, for supporting Medicare for all. "A radical liberal politician, his risky scheme will end Medicare as we know it," the ad says, pointing to "massive costs."

Remember: Democrats are not proposing to cut Medicare in the way Republicans have, instead calling to expand the program, but the GOP argues that the massive costs associated with Medicare for all would be disruptive and make the whole program less stable.

Read more here.


Trump officials want more people to opt out of the individual mandate

The Trump administration is making it easier for people to seek exemptions to ObamaCare's individual mandate penalty. The Centers for Medicare and Medicaid Services put out a guidance today that will allow people to claim a hardship exemption without actually having to document it. All they will have to do is note it on their tax returns for the 2018 tax year.

Notable: This is the final year ObamaCare's individual mandate is in effect. The GOP tax law removed the penalty beginning in 2019, effectively repealing it.

End game: Without documentation, there really isn't a way for the IRS to track who is eligible for a hardship exemption.

Read more on the guidance here.


Baltimore health commissioner to lead Planned Parenthood

Baltimore's health commissioner Leana Wen will be the next president of Planned Parenthood, the organization announced Wednesday.

Wen will be the first physician to lead the organization in over 50 years. She succeeds Cecile Richards, who served as Planned Parenthood's president since 2006.

Wen led the Baltimore City Health Department since January 2015 and is an emergency physician. She's been on the forefront of combatting the city's opioid epidemic.

Wen has also been involved in the resistance against the Trump administration.

The city of Baltimore sued the Trump administration, on behalf of Wen and the health department, for cutting short federal grants for teen pregnancy prevention. The grants were restored.

Read more here


In other Planned Parenthood news...

The Planned Parenthood Action Fund is targeting GOP Sen. Susan Collins (Maine) with a six figure ad campaign as the fight over Supreme Court nominee Brett Kavanaugh enters a crucial stretch.

The group's ads went up Wednesday in Maine on both broadcast and cable, as well as online. The new ad buy comes as Collins is facing an onslaught of pressure to oppose the nomination. Democrats need to win over two Republicans, as well as keep their caucus completely united, in order to sink Kavanaugh.


FDA cracks down on e-cigarette sales to kids

The Food and Drug Administration (FDA) announced Wednesday that it has issued 1,300 warnings and fines against e-cigarette manufacturers and retailers for selling products to minors.

FDA Commissioner Scott Gottlieb said the coordinated enforcement actions are the largest in the agency's history, targeted at retailers who illegally sold JUUL and other e-cigarette products to minors.

The agency accused manufacturers and retailers of contributing to an "epidemic" of use among kids and teenagers.

The federal actions are the result of a months-long, nationwide, undercover blitz of brick and mortar stores and online retailers, officials said.

Read more here.


What we're reading

Health insurance scams soar amid ObamaCare changes (CBS News)

Trump eyeing 'disruptive' changes to drug pricing, health secretary says (Bloomberg)

Nearly 600 Russia-linked accounts tweeted about the health law (The Wall Street Journal)

Many 'recovery houses' won't let residents use medicine to quit opioids (NPR)


State by state

Florida ObamaCare navigators get $1.25 million -- 74 percent drop from last year (Orlando Sentinel)

Nebraska's top court: Voters to decide on expanding Medicaid (Associated Press)

A setback for Massachusetts in states' drive to contain Medicaid drug spending (NPR.com)


From The Hill's opinion page:

Infectious disease care is complex -- Medicare reimbursement rules should reflect that

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