Overnight Health Care: GOP plays defense over pre-existing conditions | Groups furious over new Trump immigration proposal | Public health advocates decry funding transfer over migrant children

Overnight Health Care: GOP plays defense over pre-existing conditions | Groups furious over new Trump immigration proposal | Public health advocates decry funding transfer over migrant children
© Greg Nash

Happy Monday, and welcome to Overnight Health Care. We hope your Monday morning was not as crazy as what congressional reporters went through, with rumors swirling about Deputy Attorney General Rod RosensteinRod Jay RosensteinEx-federal prosecutor: I would have 'owned' wearing a wire to record Trump The embarrassing return of Andrew McCabe The Hill's Morning Report — Presented by the American Academy of HIV Medicine — Trump, Congress prepare for new border wall fight MORE, as well as new accusations against Brett Kavanaugh.

In health care news, the final legislative package on the opioid crisis could come this week, and over in the House, lawmakers expect to vote on a bill. But first...


GOP plays defense on ObamaCare's pre-existing conditions

Amid a steady drumbeat of Democratic attacks over pre-existing conditions, Republicans are scrambling to show they support those protections.

The problem: GOP efforts are complicated by the lawsuit backed by the Trump administration seeking to overturn pre-existing condition protections, as well as GOP repeal votes last year.


Asked whether he supports the lawsuit, Young did not give a position, saying, "I'm just going to let that play out," and "I haven't paid too much attention to it."

He added that if the lawsuit succeeds, lawmakers should act "right away to protect folks."

Read more here.


Groups furious over new Trump immigration proposal

In a rare weekend announcement, the Trump administration on Saturday proposed denying green cards to legal immigrants who use public assistance, like Medicaid, or if the government anticipates they will use it in the future.

The proposal could have major consequences. In health care alone, it targets programs such as the Supplemental Nutrition Assistance Program (food stamps), Temporary Assistance for Needy Families (welfare), Medicaid, and Medicare Part D (prescription drug subsidies).

Millions of low-income immigrants may be forced to choose between health care and food or permanent residency in the United States. The administration said the proposal is aimed at making immigrants more self sufficient, but it will undoubtedly have a negative impact on all immigration to the United States -- a goal publicly championed by White House aide Stephen Miller.

Advocacy and stakeholder groups were outraged, and many pointed out that undocumented immigrants are already ineligible for most federal benefits.

The American Medical Association:

"Denying vital services to recent immigrants is no way to ensure they become productive citizens. Rather, it forces them to make choices about health care that may harm their families and worsen public health."

American Hospital Association:

"America's hospitals and health systems have serious concerns that those legally in the country could choose to forgo health care benefits – and therefore delay accessing care – out of fear of repercussions for themselves and their families. Forgoing care can exacerbate medical conditions leading to sicker patients and a higher reliance on hospital emergency departments."


"The latest proposed rule by the Trump administration is racist, petty and inhumane," said Derrick Johnson, President and CEO of the NAACP. "It seeks to brutally tear away piece by piece the humanity of immigrants, particularly the poor and immigrants of color and flies in direct contradiction to the ideas of acceptance and inclusion which have brought millions who sought refuge to our shores."

Read coverage of the proposal from over the weekend here


Meanwhile, in other immigration news...


Public health advocates decry funding transfer over migrant children

Public health advocates are sounding the alarm over President TrumpDonald John TrumpTrump nominates ambassador to Turkey Trump heads to Mar-a-Lago after signing bill to avert shutdown CNN, MSNBC to air ad turned down by Fox over Nazi imagery MORE's decision to divert nearly $200 million from health programs to fund the detention of unaccompanied migrant children who crossed into the country illegally.

Experts say that money should be spent on cancer research, vaccines for rare diseases and other health priorities.

What advocates are saying: "Separating children from their parents at the border unnecessarily, coupled with proposed changes in policy to detain families indefinitely, all have long-term costs and consequences," said Emily Holubowich, executive director of the Coalition for Health Funding. "This situation is particularly concerning because there doesn't seem to be a plan to deal with those long-term costs, and tapping already underfunded public health programs is not a solution," Holubowich added.

The backstory: The Department of Health and Human Services (HHS) last week notified Congress that it intends to transfer up to $186 million from elsewhere in the agency to pay for housing a growing number of migrant children.

Why is it so expensive? It's taking much longer for children to be released

HHS insists it is not because of the administration's "zero tolerance" policy, and they're mostly right. The main driver is the increasingly slow release of children from shelters. The administration is using "influx" shelters, which cost about three times as much as traditional shelters. So the longer kids are being held, the more it costs.

Read more about HHS's efforts here


Analysis: more companies are raising drug prices than lowering them

More drug companies raised their prices in the past year than cut them, according to an analysis by the Associated Press published on Monday.

The review, which used data provided by health information analytics firm Elsevier, found that there have been fewer price increases compared to past years, and that price hikes have been lower than in previous years.

Still, companies raised prices far more often than they cut them, according to the AP, which found that there were 96 increases for every one price cut from January to July.

This is happening despite a pledge from Trump:

President Trump has made cutting drug prices a major priority. He blasted the pharmaceutical industry for "getting away with murder" with steep drug prices during the campaign and since.

At the end of May, he promised that drug companies would be announcing "massive" voluntary drug price cuts within two weeks.

Right after that prediction, in June and July, there were 395 price increases and 24 decreases, the AP analysis found.

Compared to the same two months last year where there were only 15 price cuts, the two dozen decreases were an improvement, but increases still outpaced decreases by a ratio of 16.5-to-1, the analysis found.

Read more here


Dem Phil Bredesen is lukewarm on ACA

The Democratic Senate candidate in Tennessee does not sound super enthusiastic about ObamaCare, but he says he doesn't want to harm people who currently rely on it.

"I criticized the Affordable Care Act when it was proposed and still don't think it's the right long-term solution," Bredesen told the Herald-Citizen in Tennessee. "But many Tennesseans now depend on it, and they are becoming collateral damage to Washington's political gamesmanship. Senator Alexander's bipartisan plan to stabilize insurance markets is a good start toward fixing it."

Remember: Fellow Tennessean Sen. Lamar AlexanderAndrew (Lamar) Lamar AlexanderCongress must move forward on measure dealing with fentanyl GOP advances rules change to speed up confirmation of Trump nominees Key doctors group faces political risks on guns MORE (R-Tenn.) had a bipartisan deal with Sen. Patty MurrayPatricia (Patty) Lynn MurrayOvernight Health Care — Sponsored by America's 340B Hospitals — Dems blast rulemaking on family planning program | Facebook may remove anti-vaccine content | Medicare proposes coverage for new cancer treatment Overnight Health Care — Presented by PCMA — Senators seek answers on surprise medical bills | Red states move to limit Medicaid expansion | Two drug companies agree to testify Senate Dems block Sasse measure meant to respond to Virginia bill MORE (D-Wash.) last year to stabilize ObamaCare markets, but that deal fell apart since then over disputes over abortion and amid a changing state of play for the health law.

The politics: Bredesen is running in a red state and trying to score an upset victory to pick up a seat for Democrats in what has turned out to be a close race. But he definitely sounds less enthusiastic about the law than other Democrats touting the law's protections in the campaign.


The Hill Event

Join us on Thursday, Sept. 27, for "Evolution of Telehealth: Patient Awareness and Education," featuring Rep. Buddy CarterEarl (Buddy) Leroy CarterFor George and Barbara Bush, White House staff became family Congress must protect eye care patients from frightful prescriptions Trump signs bills banning drug pricing 'gag clauses' MORE (R-Ga.), Sen. Bill CassidyWilliam (Bill) Morgan CassidyIvanka Trump to meet with GOP senators to discuss paid family leave legislation Bipartisan senators ask industry for information on surprise medical bills Virginia abortion bill reignites national debate MORE, M.D. (R-La.) and Rep. Doris MatsuiDoris Okada MatsuiDem chair offers bill to crack down on robocalls Pelosi allies push back on proposed Speaker nominee rule change Congress must protect eye care patients from frightful prescriptions MORE (D-Calif.). Editor-in-Chief Bob Cusack will sit down with our speakers to discuss the growth of telemedicine, and how policymakers in Washington are responding to the shifting delivery of medical care. RSVP Here.


What we're reading:

One big problem with Medicaid work requirement: people are unaware it exists (The New York Times)

High hopes for a gene therapy come with fears over cost (The Wall Street Journal)

Black patients are being left out of clinical trials for new cancer therapies (STAT)

Gilead to slice list prices of liver drugs (The Wall Street Journal)


State by state:

Texas prisons often deny dentures to inmates with no teeth (Associated Press)

Virginia work rules, premiums won't happen immediately as Medicaid expansion rolls out (The Washington Post)

Romney and Wilson split on Utah's medical marijuana initiative (Salt Lake Tribune)  


From The Hill's opinion page:

Malnutrition Awareness Week spotlights the importance of national nutrition programs