Overnight Health Care — Presented by Purdue Pharma — Trump officials approve Medicaid work requirements in Wisconsin | Industry group wants FDA to stop studying drug importation | Dems demand hearing on funding for detained migrant children

Overnight Health Care — Presented by Purdue Pharma — Trump officials approve Medicaid work requirements in Wisconsin | Industry group wants FDA to stop studying drug importation | Dems demand hearing on funding for detained migrant children
© Victoria Sarno Jordan

Welcome to Wednesday's edition of Overnight Health Care.

A busy day on the health front. Wisconsin can impose work requirements and time limits on Medicaid beneficiaries, an industry group wants the FDA to stop studying drug importation, and a Halloween tweet from CMS has some people up in arms. 

We'll start in Wisconsin:...


Trump administration approves Wisconsin Medicaid work requirements

Wisconsin on Wednesday became the latest state to get approval from the Trump administration to impose work requirements on Medicaid beneficiaries.

The approval of the state's Medicaid waiver comes as Wisconsin's Republican Gov. Scott Walker is facing a tight race for reelection against Democrat Tony Evers, who does not support work requirements. The waiver approval also comes despite assessments from the state that thousands of people could lose Medicaid coverage.

What are the new rules? Beneficiaries aged 19-49 need to work 80 hours a month, or face a loss of coverage for six months. The state was also granted permission to charge monthly premiums of up to $8, along with $8 co-payments for emergency room visits for problems that aren't considered emergencies. The state can lock people out of coverage if they fail to pay.

Engaging in "healthy behaviors" can also help reduce premiums.

What didn't get approved? Drug testing. Walker wanted to make Medicaid eligibility contingent on drug screening and drug testing. However, the state can still ask questions about prior drug use as part of its screening for healthy behaviors.

The biggest takeaway: Wisconsin did not expand Medicaid. It's the only non-expansion state so far that's been given permission to impose work requirements on the "traditional" Medicaid population-- generally the poorest, sickest people in the state.

Will there be lawsuits? That's pretty much a guarantee, considering the Centers for Medicare and Medicaid Services (CMS) is already being sued in Arkansas over similar requirements, and a judge already struck down Kentucky's work requirements. Look for the non-expansion aspect of the waiver to play a big role in any litigation.

Read more here.





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Industry group wants FDA to stop studying drug importation

A coalition of insurers and drug manufacturers wants the Trump administration to stop its research into importing certain prescription drugs from foreign countries.

The Council for Affordable Health Coverage, which represents insurers, employers, pharmacy benefit managers and drug companies, said it wants the Food and Drug Administration (FDA) to disband an agency group examining drug importation.

In a letter sent to FDA and first shared with The Hill, the group said drug importation is a "risky scheme" that gambles with patient safety.

"Consumers would be well served by FDA disbanding the drug importation work group and instead convening stakeholders and administration personnel to continue a conversation on value-based solutions that do not threaten patient safety," the group wrote.

Background: The Trump administration first announced the working group over the summer. Its focus is on limited importation of drugs that have a dramatic price increase, and that are not protected by patents or exclusivities.

Read more here


Trump health official dubs 'Medicare for all' shirt 'scariest Halloween costume'

CMS Administrator Seema Verma decided to have some fun with Halloween on Twitter on Wednesday, though it provoked a swift response...

She tweeted a photo of a T-shirt printed with "Medicare for all," calling it "this year's scariest Halloween costume."

This year's scariest Halloween costume goes to... pic.twitter.com/QtRbdmiR8T

-- Administrator Seema Verma (@SeemaCMS) October 31, 2018

Verma's tweet on Wednesday going after the proposal provoked a quick reaction on social media.

"She runs Medicare and doesn't believe in it," tweeted Christina Reynolds, a spokeswoman for the Democratic group Emily's List. "The MO of the whole Trump administration."

Political contextRepublicans have been attacking "Medicare for all" this year while attempting to defend themselves from a barrage of Democratic attacks over GOP votes to repeal ObamaCare and its protections for people with pre-existing conditions.

Read more here.


Dem senators want hearing on funding for detained migrant children

A group of Senate Democratic appropriators have asked their Republican colleagues to hold a hearing regarding how the Trump administration has been funding the detention of unaccompanied migrant children.

In a letter to Senate Appropriations Committee Chairman Richard ShelbyRichard Craig ShelbyCongressional leaders to launch budget talks with White House Democrats agree to humanitarian aid for border as part of disaster package On The Money: New financial disclosures provide glimpse of Trump's wealth | Walmart, Macy's say tariffs will mean price hikes | Consumer agency says Education Department blocking student loan oversight MORE (R-Ala.) and health subcommittee chairman Roy BluntRoy Dean BluntHillicon Valley: Trump takes flak for not joining anti-extremism pact | Phone carriers largely end sharing of location data | Huawei pushes back on ban | Florida lawmakers demand to learn counties hacked by Russians | Feds bust 0M cybercrime group Top Republican says Senate unlikely to vote on any election security bills San Francisco becomes first city to ban facial recognition technology MORE (R-Mo.) first shared with The Hill, the Democrats said the Department of Health and Human Services (HHS) needs to provide more information about how much money the agency's Office of Refugee Settlement needs to house separated children.

"Since April when the Attorney General Sessions announced the family separation policy ... the funding needs of ORR have shifted dramatically. This policy has caused the needless separation of thousands of children from their parents," the Democrats, led by Sen. Chris Van HollenChristopher (Chris) Van HollenMnuchin signals administration won't comply with subpoena for Trump tax returns Dem lawmakers urge FCC to scrutinize broadcast workforce diversity Senate fails to override Trump's Yemen veto MORE (D-Md.), wrote.

Earlier this year, HHS told Congress it was reallocating nearly $200 million in funds from health programs this year to house the increased number of detained migrant children.

Van Hollen in July pressed HHS for more clarity about the funding transfer, but the agency has not responded. Since Republicans control the Senate, the Trump administration has little incentive to provide Democrats with any additional information.

Read more here


What we're reading

4 ways ObamaCare is changing for 2019 (CNN)

ObamaCare markets stabilize as premiums remain high for many (Bloomberg)

In swing districts, Republicans may pay for having tried to reverse the health law (Kaiser Health News)


State by state

How one state (Idaho) that hates ObamaCare still makes it work (Politico)

Billions in questionable payments went to California's Medicaid insurers and providers (California Healthline)

Medical marijuana push washes over one of the nation's most conservative states (STAT)


From The Hill's opinion page:

Protections for pre-existing conditions are being threatened