Overnight Health Care: Trump officials sued over Medicaid work requirements in New Hampshire | Analysis contradicts HHS claims on Arkansas Medicaid changes | Azar signals HHS won't back down on e-cigs

Overnight Health Care: Trump officials sued over Medicaid work requirements in New Hampshire | Analysis contradicts HHS claims on Arkansas Medicaid changes | Azar signals HHS won't back down on e-cigs
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Welcome to Wednesday's Overnight Health Care.

Lots of Medicaid news today. A new analysis shows people in Arkansas who lost Medicaid aren't actually getting jobs. Meanwhile, the administration is being sued over New Hampshire's Medicaid work requirements. But officials aren't slowing down on trying to overhaul the program, despite the legal challenges.   

We'll start with New Hampshire...


Trump administration sued over Medicaid work requirements in New Hampshire

The legal battles over the Trump administration's Medicaid work requirements are heating up.

The latest lawsuit: in New Hampshire.


"This approval will not promote coverage, but it will result in significant coverage losses, and that is the administration's goal – to weaken the Medicaid program and cull people whom it deems unworthy from it," said National Health Law Program (NHeLPlegal director Jane Perkins, who is helping lead the lawsuit.

Previous lawsuits: There are already lawsuits over work requirements in Arkansas and Kentucky. A ruling from a judge in those cases could by the end of the month.

Why it matters: Medicaid users in New Hampshire will begin losing coverage in August if they don't comply with the requirements of working or volunteering at least 100 hours a month.

Read more here.


Speaking of work requirements...


Analysis: Data contradicts HHS claims on Arkansas Medicaid work requirements

HHS Secretary Alex Azar defended work requirements at a Senate Finance Committee hearing last month.

But now a new analysis is challenging those claims.

Most of the 18,000 people who lost Medicaid coverage in Arkansas as a result of new work requirements have not found new jobs, according to an analysis of state data.

The analysis from the left-leaning Center on Budget and Policy Priorities also found that most of those unemployed people are still uninsured.

The data contradicts statements from Trump administration and state officials, who have claimed that most of the people who lost Medicaid have found jobs with health insurance coverage.

The numbers: According to state data, just over 18,000 Medicaid beneficiaries lost coverage in the first six months the program was in effect for not complying with the work requirement. Only about 1,900 of those people to date have re-enrolled in Medicaid.

Read more here.


The big picture: Trump officials take bold steps on Medicaid

The Trump administration is pulling out all the stops to encourage red states to make conservative changes to Medicaid without congressional input.

Administration officials are pushing ahead and granting approvals to states seeking to impose work requirements on Medicaid recipients, even in the face of legal challenges and large-scale losses in the number of people covered.

What's happening: Last week, the Centers for Medicare and Medicaid Services (CMS) granted Ohio's request for work requirements, the ninth such approval since President TrumpDonald John TrumpFauci says his meetings with Trump have 'dramatically decreased' McEnany criticizes DC mayor for not imposing earlier curfew amid protests Stopping Israel's annexation is a US national security interest MORE took office. HHS Secretary Alex Azar has also been quietly trying to sell states on the merits of imposing block grants, or a per-person spending cap, without congressional approval.

The issue with work requirements: The administration is being sued by advocacy groups over work requirements. The argument is that the coverage losses prove that work requirements do not advance the purpose of Medicaid as a health program.

Financing changes are a bigger problem: Conservatives have long talked about turning Medicaid from an open-ended entitlement to a program with enrollment and spending caps. But per capita caps and block grants have already been rejected by Congress; both were part of the GOP's ObamaCare repeal bill that failed in 2017. Allowing states to impose those same changes by statutory waiver, without congressional approval, would be extremely controversial and have widespread implications about the use of executive power.

"This is a separation of powers issue," said Georgetown University's Joan Alker. "Congress retains the authority to change Medicaid. The waiver was not intended to allow the executive branch to rewrite the Medicaid statute."

Read more about the administration's efforts here


Nikki HaleyNimrata (Nikki) HaleyThe truth behind Biden's 'you ain't black' gaffe A glimpse of our post-pandemic politics The Hill's Morning Report - Presented by Facebook - Will new therapy drug be a COVID-19 game changer? MORE to headline Susan B. Anthony List gala

The former UN ambassador and South Carolina governor will keynote the anti-abortion group's annual gala. Last year's speaker was Vice President Mike PenceMichael (Mike) Richard PencePence on Floyd: 'No tolerance for racism' in US Pence chief of staff owns stock affected by boss's coronavirus work: report Rep. Banks launches bid for RSC chairman MORE.

"We are proud to honor our longtime friend, Nikki Haley, for her strong pro-life leadership," said SBA List President Marjorie Dannenfelser.

"At the United Nations, America is often in the minority when we stand up for our values, but we proudly stand strong for them anyway, because it's right the thing to do," Haley said in a statement.

"At home, the Susan B. Anthony List reminds us of the importance of staying true to our values, and no value is more sacred than the right to life."


Azar signals HHS won't back down on e-cigarettes after Gottlieb leaves

HHS Secretary Alex Azar penned a joint op-ed with departing FDA Commissioner Scott Gottlieb warning of a regulatory crackdown on e-cigarettes if kids don't stop smoking them this year.

"Absent a reversal in the trends of youth e-cigarette use, we envision a world where the FDA will continue to narrow the off-ramp for adults seeking a less harmful alternative to combustible cigarettes, in order to close the on-ramp that has resulted in the widespread and increasingly frequent use of e-cigarettes by teens," they wrote.

"What happens in 2019 will go a long way to determine the future availability of these products."

Context: Anti-tobacco advocates feared Gottlieb's departure would lead to a slow-down at the FDA on e-cigarette regulation. Azar is showing that he's serious about the issue.


What we're reading

Fact-checking Trump's claim that McCain misled the White House on his ObamaCare repeal vote (CNN.com)

White House slams 'Medicare for All' as bad for Americans' health and wallets (CNN.com)

Jenny McCarthy's autism charity has helped its board members make money off dangerous, discredited ideas (Jezebel)

As Zika danger wanes, travel warnings are eased for pregnant women (The Washington Post)


State by state

Iowa Senate Republicans OK work requirements for some Medicaid patients (Des Moines Register)

The new Idaho Medicaid expansion bill puts people on private insurance. Here's what that really means (Idaho Statesman)

How Rhode Island's emergency 911 system failed Baby Alijah (Pro Publica)

Kansas House endorses Medicaid expansion -- but it's not a done deal yet (Wichita Eagle


From The Hill's opinion page:

Cuts to Medicare and Medicaid will cause overall health-care costs to rise