Overnight Healthcare

Overnight Health Care: Work rules set to slash Medicaid rolls | Health groups sue over non-ObamaCare plans | Study finds opioid abuse only down slightly in 2017

Welcome to Friday’s Overnight Health Care. The weekend is almost here. If you don’t get our newsletter, click here to subscribe.


Today, North Dakota Republican Rep. Kevin Cramer is defending his record on pre-existing conditions in one of the nation’s most closely watched Senate races. Also, health groups are suing to block the Trump administration’s short-term insurance plan rule. And a new study is providing an update on the fight against opioids.

But we’ll start in Arkansas, which could be a test for other states that have imposed Medicaid work requirements.


Medicaid work requirements will slash enrollment

The thousands of people who lost Medicaid coverage this month in Arkansas for not following newly implemented work requirements may be a sign of what’s to come in other GOP-led states.

{mosads}As the Trump administration encourages states to push ahead with work requirements, Arkansas is likely to serve as a test case. It was the first state to implement work requirements, and this month it became the first state to kick off beneficiaries for not following them.

Kentucky was the first state granted federal approval to implement the requirements, but a federal judge blocked them from taking effect.

The numbers: Arkansas removed more than 4,000 people from the Medicaid rolls in the first three months, with some estimates saying that number could climb to 50,000 when the requirements are fully implemented in 2019.

Reasoning: About 95 percent of people who lost coverage didn’t file the necessary documents with the state. That led to their removal from Medicaid, though some may have been working the required 80 hours a month. It’s unclear why those participants didn’t file reports, especially if they were working, though some say it could be due to confusion, an inability to access a computer or general unawareness about the new requirements.

Promoting work or saving money? Conservatives argue that work requirements are a pathway out of poverty, and Arkansas officials said they’re disappointed so many people lost coverage. But advocates say the loss of coverage is deliberate, and that the true purpose of Medicaid work requirements is to cut spending for the federal program, a priority of conservatives for years.  

Read more on the debate here.


Patient groups sue to block expansion of short term insurance plans

Seven health-care groups on Friday sued to block the Trump administration’s expansion of non-ObamaCare health insurance plans, arguing that the move harms people with pre-existing conditions.

The lawsuit in federal district court in Washington seeks to stop the Trump administration’s rules issued last month expanding short-term health insurance plans, so that they can last up to one year instead of just three months.

The groups suing include the National Alliance on Mental Illness, the American Psychiatric Association and the Little Lobbyists, which represents children with complex medical needs.

The groups argue the expansion of short-term plans violates the text of the Affordable Care Act (ACA) and that plans that last up to one year do not meet any reasonable definition of “short term.”

The Trump administration argues these plans provide a cheaper alternative to costly ObamaCare plans, but opponents call them “junk” plans because they are not required to cover people with pre-existing conditions and can exclude coverage of certain health services.

We’ve got more on the lawsuit here.


New Cramer ad pushes back on health record

North Dakota Rep. Kevin Cramer (R), who is looking to take Sen. Heidi Heitkamp’s (D) seat in the upper chamber, is defending his record on health care in a new ad pushing back on Democratic attack.

The video addresses attacks from Heitkamp about how Cramer’s votes would impact people with pre-existing conditions.

Cramer says he supports pre-existing condition protections, and the ads cite his vote for the GOP’s American Health Care Act last year, which would have repealed much of ObamaCare.

“Here’s the truth: Kevin Cramer voted for guaranteed coverage for pre-existing conditions, and Heidi’s ads attacking Kevin on health care don’t pass the smell test,” a narrator says in the video.

The bill would not have allowed insurers to deny coverage of people with pre-existing conditions, but it would have allowed states to get waivers allowing insurers to charge those people higher premiums.

Read more here


Study: Opioid abuse down in 2017, still at high levels

The number of people abusing opioids in the U.S. dropped slightly in 2017 compared to the previous year, but remains at high levels, according to a new survey.

The Department of Health and Human Services (HHS) said in data released Friday that 11.4 million people abused opioids in 2017, compared to 11.8 million in 2016 and 12.7 million in 2015.

Of the people who abused opioids last year, the vast majority – 11.1 million, or 97 percent – used prescription painkillers, with Hydrocodone and Oxycodone being the most commonly abused, according to the HHS National Survey on Drug Use and Health.

Nearly 1 million people used heroin, while half a million used both prescription opioids and heroin.

The survey found that most people who abused prescription opioids got them from friends or relatives for free. Another 34.6 percent got them from a doctor, signaling that the overprescribing of opioids is still an issue, according to the survey.

Read more here.


What we’re reading

Top Sloan Kettering cancer doctor resigns after failing to disclose industry ties (The New York Times)

Congressmen give Paul Manafort donations to hospital, pregnancy center (Washington Examiner)

HHS supports FDA’s proposed e-cigarette crackdown, HHS chief Azar says (CNBC)


State by state

Premiums for state Health Connector plans to increase an average of 4.7 percent next year (Boston Globe)

A setback for Massachusetts in states’ drive to lower drug prices (NPR)

Wisconsin Lt. Gov. Rebecca Kleefisch (R), a cancer survivor, pushes back on ad suggesting pre-existing conditions protections are in jeopardy (Milwaukee Journal Sentinel)

Tags Heidi Heitkamp Kevin Cramer Paul Manafort
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