Overnight Health Care — Sponsored by America's 340B Hospitals — Powerful House committee turns to drug pricing | Utah governor defies voters on Medicaid expansion | Dems want answers on controversial new opioid

Welcome to Monday's Overnight Health Care.

The House Ways & Means Committee is turning its focus to drug prices. Also today, a troubling new report on health costs and how Utah's governor is defying voters on Medicaid expansion.


But first... Ways & Means' first hearing on drug prices focused on the greatest hits

The committee heard from a panel of health care experts about what's driving high drug prices in the U.S. But they didn't hear from any drug industry executives.

(That will come Feb. 26 in the Senate Finance Committee hearing focused on the same issue.)

Lawmakers had questions about policy proposals that have been batted around Capitol Hill for years, like Medicare price negotiation. There was also talk about some bipartisan proposals like the Creates Act, which would crack down on tactics brand name drug companies use to push stifle generic competition, and a bill sponsored by Sens. Chuck GrassleyCharles (Chuck) Ernest GrassleyWe've lost sight of the real scandal Grassley: Kavanaugh classmate didn't contact Senate panel State Dept sent explosive-detection dogs to Jordan despite evidence of mistreatment: report MORE (R-Iowa) and Amy KlobucharAmy Jean KlobucharMark Mellman: The most important moment in history? Democrats press for action on election security Antitrust enforcers in turf war over Big Tech MORE (D-Minn.) that would limit pay-off agreements between drug companies and their competitors that keep cheaper drugs off the market.

The bottom line: Democrats say addressing the high cost of prescription drugs is one of their top priorities. But big items like Medicare price negotiation are off the table while Republicans are in control of the Senate. Still, there might be action on the Creates Act, which has bipartisan support in both chambers. 
"This is not a Democratic or Republican issue," Ways and Means Chairman Richard NealRichard Edmund NealTrump urges judge to deny New York's motion to dismiss state tax return lawsuit Ten notable Democrats who do not favor impeachment Trump probes threaten to overshadow Democrats' agenda MORE (D-Mass.) said at Tuesday's hearing.

"It crosses the political spectrum. In fact, the President recently expressed his intent to address drug prices. If we are on the same page on this, there clearly is a problem."



Utah governor defies voters, signs limited Medicaid expansion

Utah's governor on Monday signed into law a limited Medicaid expansion plan, defying voters who approved a full expansion in November.

The bill signed by Gov. Gary Herbert (R) would cover far fewer people, and cost taxpayers more money, than the plan voters approved in November.

The new law calls for the state to ask the Trump administration for permission to launch a partial expansion of Medicaid for people earning up to 100 percent of the poverty level, rather than the 138 percent under ObamaCare.

In a statement, Herbert said the measure "balances Utah's sense of compassion and frugality. It is now time to set aside differences and move forward to get those in greatest need enrolled on Medicaid and on the federal health care exchanges."

Context: The legislation falls well short of a proposition approved by voters in November to expand Medicaid coverage to anyone earning between 100 and 138 percent of the federal poverty level, covering about 150,000 people. The limited expansion will cover 100,000 people and cost $50 million more. Legal challenges are possible.

Read more here.


Health care spending for individuals who receive employer-sponsored insurance has reached a record high, according to a study released Tuesday.

Average annual spending for people who get their health insurance through work was $5,641 in 2017, up 4.2 percent from $5,416 the previous year, the Health Care Cost Institute (HCCI) found in its analysis. The average includes the amount paid by workers, their employers and insurers.

Spending on health care is increasing because of higher prices, not because people are using more services, according to the study.

The overall use of health care services declined 0.2 percent between 2013 and 2017, while spending on health care increased 16.7 percent.

More from the study here.


Dem chair asks FDA for documents on powerful new opioid

In November, the FDA approved a controversial new opioid. Now Democrats want documents from the agency on its decision.

Rep. Diana DeGetteDiana Louise DeGetteLawmakers criticize EPA draft rule for curbing rights to challenge pollution permits Here are the 95 Democrats who voted to support impeachment Crucial for Congress to fund life-saving diabetes research MORE (D-Colo.), the chairwoman of the Energy and Commerce oversight subcommittee, and Sen. Ed MarkeyEdward (Ed) John MarkeyGreta Thunberg scolds Congress on climate action: 'I know you are trying but just not hard enough' Obama meets with Greta Thunberg: 'One of our planet's greatest advocates' Young insurgents aren't rushing to Kennedy's side in Markey fight MORE (D-Mass.) on Tuesday wrote to the FDA asking for documents that the agency relied on in approving the new opioid.

What's the controversy? Advocates and some lawmakers had warned against approving the powerful new opioid amid the epidemic of opioid overdoses.

Dsuvia is 10 times more powerful than fentanyl and 1,000 times more powerful than morphine.

FDA's view: In November when announcing the approval of the drug, FDA Commissioner Scott Gottlieb acknowledged its potential dangers but said it could be beneficial to the military.

He noted that the drug can be administered under the tongue, which could be helpful on the battlefield in situations where injecting a drug is difficult.  

Read more on the controversy here.



At no cost to taxpayers, the 340B program is critical to the health of our patients because it allows hospitals serving vulnerable communities to address the health care needs of their communities, including providing free or substantially discounted prescriptions to low-income and rural patients, operating free clinics, treating patients with substance use disorders, and sustaining access to other lifesaving services for patients. Weakening this vital program will hurt patients. Learn more.


Tomorrow: New Medicare buy-in bill

Look out tomorrow for the latest Democratic health care plan. This one is more narrow than some others in the Medicare for all realm: It would let people buy into Medicare starting at age 50.

The sponsors are Sens. Debbie StabenowDeborah (Debbie) Ann StabenowDemocrats seize Senate floor to protest gun inaction: 'Put up or shut up' Conservatives offer stark warning to Trump, GOP on background checks USDA cuts payments promised to researchers as agency uproots to Kansas City MORE (D-Mich.) and Tammy BaldwinTammy Suzanne BaldwinFederal funding for Chinese buses risks our national security Democrats threaten to withhold defense votes over wall The Trump downturn: Trouble ahead for the US economy MORE (D-Wis.), along with Reps. Brian HigginsBrian HigginsHere are the 95 Democrats who voted to support impeachment On The Money: Sanders unveils plan to wipe .6T in student debt | How Sanders plan plays in rivalry with Warren | Treasury watchdog to probe delay of Harriet Tubman bills | Trump says Fed 'blew it' on rate decision Democrats give Trump trade chief high marks MORE (D-N.Y.) and Joe CourtneyJoseph (Joe) D. CourtneyHouse committee heads demand Coast Guard Academy explain handling of harassment allegations House votes to repeal ObamaCare's 'Cadillac tax' Overnight Defense: Pompeo blames Iran for oil tanker attacks | House panel approves 3B defense bill | Trump shares designs for red, white and blue Air Force One MORE (D-Conn.).

They will hold a press conference at noon.


What we're reading

Three Obamacare tweaks that both parties can love (Politico)

A political 'bomb' over drug prices could threaten NAFTA 2.0 (Associated Press)

Sherrod BrownSherrod Campbell BrownBipartisan housing finance reform on the road less taken Hillicon Valley: Google to promote original reporting | Senators demand answers from Amazon on worker treatment | Lawmakers weigh response to ransomware attacks Senate Democrats want answers on 'dangerous' Amazon delivery system MORE separates from Dem pack on Medicare, 'Green New Deal' proposals (Politico)


State by state

Voters in four states have approved Medicaid expansion by ballot. Will Texas do the same? (Texas Tribune)

In Charlotte, Gov. Cooper renews Medicaid expansion push. Will it make a difference? (Charlotte Observer)


From The Hill's op-ed page

Our health depends on the passage of an achievable Green New Deal

Anti-vax and anti-abortion movements are filled with misinformation