Overnight Health Care — Sponsored by America's 340B Hospitals — Utah tests Trump on Medicaid expansion | Dems roll out Medicare buy-in proposal | Medicare for all could get hearing next month | Doctors group faces political risks on guns

Welcome to Wednesday's Overnight Health Care.

Today, we're watching Utah, where the state's decision to pursue a partial Medicaid expansion will be a key test for the Trump administration. Meanwhile, Democrats in the House and Senate rolled out their "Medicare buy-in" legislation, and a look at how the American Medical Association is taking on the gun industry.

We'll start in Utah:


Utah tests Trump administration on Medicaid

The Trump administration faces a key test with Utah's Medicaid program as the state seeks permission to use billions of federal dollars to expand coverage to only a fraction of the state's residents.

Utah Gov. Gary Herbert (R) this week signed into law a limited Medicaid expansion plan, defying voters who approved a full expansion in November.

The state now needs to seek approval from the Trump administration.

What they're asking for: States and the federal government share the costs of Medicaid. In Utah, the government currently pays about 68 percent of the costs. Under ObamaCare, the federal government pays states that choose to expand Medicaid 90 percent of the costs of doing so. But in Utah's case, the state is asking the administration for the more generous amount to cover fewer people.

Has anyone asked for partial expansion before? The administration last year essentially punted requests from Massachusetts and Arkansas. But those states were asking to scale back their coverage from a full expansion to a partial one.

Will it be approved? Most analysts seem to think the administration will say yes. Medicaid expansion gaining popularity in red states and granting approval for a smaller-scale plan like Utah's could be seen as a way to stem that tide. And Utah's plan has a big sweetener for conservatives: per person spending caps, which was a component of the GOP's ObamaCare repeal bill that failed in the previous Congress.

Read more on the plan here



Democrats roll out Medicare buy-in proposal

Democrats rolled out a proposal Wednesday to allow some older Americans to buy Medicare coverage.

The introduction comes amid an inter-party debate about the best path toward universal health care, with the left side of the caucus arguing for single-payer and Medicare for all.

But supporters of the buy-in say it's a proposal with broader political support and is the obvious next step toward improving the Affordable Care Act.

"I feel this is an effort that could both be implemented right away after passed and something that has broad support and a lot of enthusiasm in the country," said Sen. Debbie StabenowDeborah (Debbie) Ann StabenowDemocrats grill USDA official on relocation plans that gut research staff USDA expected to lose two-thirds of research staff in move to Kansas City GOP Senate challenger in Michigan raises .5 million in less than a month MORE (D-Mich.), the bill's sponsor.

More on the proposal here.


Medicare for all could get first hearing next month

Rep. Pramila JayapalPramila JayapalHouse Democrats delete tweets attacking each other, pledge to unify House approves bill raising minimum wage to per hour Progressive House Democrats describe minimum wage hike as feminist issue in Teen Vogue column MORE (D-Wash.) said her Medicare for all bill, which has not yet been introduced, will likely get its first hearing at the end of March in the Rules Committee.

Jayapal's spokesman said the bill would likely be introduced in the end of February.

Why it matters: The two chairmen of the committees with jurisdiction over Medicare -- Energy & Commerce and Ways & Means -- have not agreed to have hearings on Medicare for all, and say their main priority is shoring up ObamaCare.

In fact, E&C debated four bills Wednesday that would "reverse" the Trump administration's "sabotage" of the health care law.


Key doctors group faces political risks on guns

The American Medical Association is facing political risks from its vocal advocacy on the issue of stemming gun violence

This week, with physicians from around the country in Washington for the AMA's national advocacy conference, the issue is being given a prominent showcase. The group invited Rep. Mike ThompsonCharles (Mike) Michael ThompsonHere are the 95 Democrats who voted to support impeachment Democrats struggle with repeal of key Trump tax provision House panel approves bills on tax extenders, expanding tax credits MORE (D-Calif.), chairman of the House Gun Violence Prevention Task Force, to speak on the push for the Bipartisan Background Checks Act, a House Democratic bill that would institute universal background checks.

"I am just over the moon in regard to your position on gun violence prevention," Thompson told the conference on Tuesday. He thanked the AMA for endorsing his legislation.

"I can't tell you how helpful your support is. You guys have been fabulous," Thompson said.

Why is the AMA getting involved? One former AMA lobbyist said: "They must be responding to enormous pressure from their membership to engage in this space. They are a very democratic, with a small 'd,' organization that seeks to be responsive to its membership."

The AMA has become an increasingly vocal advocate for measures to prevent gun violence, dubbing it a "public health crisis" in June 2016. That advocacy is expected to intensify with the House Democrats making legislation a top priority. But those actions come with significant political blowback for the nation's largest doctors' group. And other medical groups are hoping to stay out of the fight.

Read more here.


Grassley on drug pricing: McConnell's not setting limits

Asked if Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellThe Hill's Morning Report: Trump walks back from 'send her back' chants GOP rattled by Trump rally Third Kentucky Democrat announces challenge to McConnell MORE (R-Ky.) is setting parameters on drug pricing legislation he is working on, Senate Finance Committee Chairman Chuck GrassleyCharles (Chuck) Ernest GrassleyScandal in Puerto Rico threatens chance at statehood Poll: McConnell is most unpopular senator Democrat: Treasury 'acknowledged the unprecedented process' in Trump tax return rejection MORE (R-Iowa) said no.

"I don't think that the Leader would try to give me any parameters," Grassley told reporters. "I mean if he did I'd want to know why because the committee's doing its work and we tend to rely on committees around here."

What's next: Watch out for the Finance Committee's hearing with drug company CEOs on Feb. 26.



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What we're reading

Why Democrats aren't taking up a bill to neutralize ObamaCare's latest legal threat (Vox.com)

McCarthy blames Republican loss of House majority on GOP health care bill (The Washington Post)

Anti-vaxxers are spreading conspiracy theories on Facebook, and the company is struggling to stop them (The Washington Post)


State by state

Kemp unveils plan seeking health care waivers in Georgia (Atlanta Journal-Constitution)

Maine congressional delegation takes aim at high drug prices (Lewiston Sun-Journal)

Iowa doctors blast anti-vaccine bill that would allow exemption for philosophical belief: 'it's a huge public safety threat' (Newsweek)


From The Hill's op-ed page

Trump's free market approach to drug pricing will help lower costs

Pre-existing conditions: Political versus financial reality