Overnight Health Care: Opioid legislation passes overwhelmingly | DOJ backs Cigna-Express Scripts merger | Senate passes ban on pharmacy gag clauses

Overnight Health Care: Opioid legislation passes overwhelmingly | DOJ backs Cigna-Express Scripts merger | Senate passes ban on pharmacy gag clauses
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Welcome to Monday’s Overnight Health Care.

The House is out all week, but the Senate is going to have to deal with the new allegation of sexual misconduct against Supreme Court nominee Brett Kavanaugh. Women’s and reproductive health groups, which already were against his selection, called on Kavanaugh to withdraw his nomination.

But outside of Kavanaugh, the Senate took a step towards tackling the country’s opioid epidemic by finally voting, 99-1, on its opioid legislation. The vote had been scheduled for last week, but was delayed because of Hurricane Florence.


The goal is to get the House and Senate to agree on common language as quickly as possible and then send the final bill to the president’s desk before the midterms, which would give lawmakers a major talking point in their campaigns.  

Additionally, it's Opioid and Heroin Epidemic Awareness Week, so the Trump administration is rolling out new efforts all this week from the Department of Health and Human Services to combat the opioid epidemic.

Senate advances opioid legislation

Key points:

The legislation passed 99-1. Sen. Mike LeeMichael (Mike) Shumway LeeThe Hill's Morning Report — AG Barr, GOP senators try to rein Trump in Overnight Defense: Senate votes to rein in Trump war powers on Iran | Pentagon shifting .8B to border wall | US, Taliban negotiate seven-day 'reduction in violence' The 8 Republicans who voted to curb Trump's Iran war powers MORE (R-Utah) was the lone "no" vote. 

Senate passes ban on pharmacy 'gag clauses'


The Senate also overwhelmingly passed legislation that would ban pharmacy "gag clauses," which prevent pharmacists from telling customers when they can save money on prescriptions by paying with cash instead of insurance.

The bill passed 98-2.

Earlier in the day, President TrumpDonald John TrumpChasten Buttigieg: 'I've been dealing with the likes of Rush Limbaugh my entire life' Lawmakers paint different pictures of Trump's 'opportunity zone' program We must not turn our heads from the effects of traumatic brain injuries MORE took to Twitter to urge the Senate to pass the bill.

"Americans deserve to know the lowest price at their pharmacy, but 'gag clauses' prevent your pharmacist from telling you! I support legislation that will remove gaga clauses and urge the Senate to act," Trump tweeted.

Gag clauses are sometimes inserted into contracts pharmacies have with insurers or pharmacy benefit managers (PBMs) — the middlemen that manage pharmacy benefits for insurance companies and employers.

The clauses prevent a pharmacist from telling a customer if, for example, their $20 co-pay is higher than the pharmacy's cash price for a drug. 

The House marked up its version of gag clause legislation last week. 

Justice backs Cigna-Express Scripts merger

Federal antitrust authorities have given a green light to Cigna's $52 billion takeover of PBM Express Scripts, the two companies announced Monday.

The merged company could reshape the health industry, as Cigna would encompass both health insurance and pharmacy benefits. The companies said they anticipate closing the deal by the end of the calendar year.

The merger still needs to be approved by by state regulators, but that's mostly a formality. The federal review was the largest hurdle the company needed to overcome.

Good news for that other big merger: Since the Department of Justice (DOJ) gave the nod to Cigna-Express Scripts, it seems likely they will also approve the pending CVS-Aetna deal. DOJ said merging a major insurer and PBM will not harm competition. The two industries aren’t direct competitors.


Will it help patients? The two companies say they could save money if they coordinated care with prescriptions, but they have not gone into specifics about how the merger would help lower costs for patients or employers.

Read more on the approval here.

What we’re reading:

Thousands of foster kids may be getting psychiatric drugs without safeguards (Associated Press)

Addiction doctors try to bring care to patients, rather than vice versa (STAT)

Children lose out on liver transplants, study finds (NBC News)


State by state:

Hating on ObamaCare is coming back to haunt this GOP candidate for governor (HuffPost)

Nevada’s Jacky RosenJacklyn (Jacky) Sheryl RosenSchumer reminds colleagues to respect decorum at State of the Union speech Senate confirms Trump's 50th circuit judge, despite 'not qualified' rating Hillicon Valley: Facebook to remove mentions of potential whistleblower's name | House Dems demand FCC action over leak of location data | Dem presses regulators to secure health care data MORE’s new ad shows latest Democratic push for health care in 2018 (CBS News)

Some CareFirst members poised to see first premium decreases in 20 years (Washington Business Journal)

From The Hill’s opinion page:

I'm dying of ALS, here's why health care will decide my last vote