Overnight Health Care — Presented by the American Conservative Union — Trump ObamaCare move puts GOP in tough spot | Dems unveil plan to build up health law | Purdue Pharma settles with Oklahoma in opioid lawsuit

Welcome to Tuesday's Overnight Health Care.

Trump's Department of Justice stepped up its attack on ObamaCare in the Texas lawsuit. House Democrats, though, are viewing it as a political gift ahead of 2020 and have unveiled legislation to build up ObamaCare.

Meanwhile, Mike PompeoMichael (Mike) Richard PompeoGOP lawmaker: Trump administration 'playing checkers' in Syria while others are 'playing chess' Trump-Graham relationship tested by week of public sparring White House officials work to tamp down controversies after a tumultuous week MORE announced an expansion of the administration's controversial "Mexico City" policy against abortion, and Oklahoma entered into a landmark settlement with Purdue Pharma over the opioid epidemic.

We'll start with the fallout from DOJ's surprise court filing:


Trump's surprise ObamaCare move puts GOP in a tough spot

Republican lawmakers clearly didn't want to talk Tuesday about the Trump administration's call for ObamaCare to be struck down.

House Republican Leader Kevin McCarthyKevin Owen McCarthyTurkey sanctions face possible wall in GOP Senate How Trump and Pelosi went from bad to worse House Republicans 'demand the release of the rules' on impeachment MORE (R-Calif.): McCarthy declined to give his position when asked at a press conference, telling reporters to call his office.

His spokesman later issued a statement which did not directly say what McCarthy's position on the administration's move is but called ObamaCare a "broken law" and said that Republicans have been clear that "Americans with preexisting conditions will be protected."

Rep. Ann WagnerAnn Louise WagnerOn The Money: Tax, loan documents for Trump properties reportedly showed inconsistencies | Tensions flare as Dems hammer Trump consumer chief | Critics pounce as Facebook crypto project stumbles Tensions flare as Democrats urge consumer bureau to boost penalties Federal aid is reaching storm-damaged communities too late MORE (R-Mo.): "I do believe that the White House is in discussions with the majority here in the House, the Democrat majority, on prescription drug prices and some other things to lower that cost curve so that's what I'm in favor of." Did not give a firm position on the move.

Sen. Thom TillisThomas (Thom) Roland TillisTillis says impeachment is 'a waste of resources' GOP requests update on criminal referrals prompted by 2018 Kavanaugh probe The Hill's Campaign Report: Warren, Sanders overtake Biden in third-quarter fundraising MORE (R-N.C.): "Every time we say [repeal] we have to have a replace." Tillis, who is up for reelection next year, also did not give a firm position on whether he supports or opposes the administration's move.

The politics: Democrats won back the House last year in large part on the issue of health care, and were eager to get back to attacking Republicans over the issue after Special Counsel Robert MuellerRobert (Bob) Swan MuellerFox News legal analyst says Trump call with Ukraine leader could be 'more serious' than what Mueller 'dragged up' Lewandowski says Mueller report was 'very clear' in proving 'there was no obstruction,' despite having 'never' read it Fox's Cavuto roasts Trump over criticism of network MORE found no collusion between Trump and Russia.

Read more here.


Recap: If you missed the late news from Monday night... The Department of Justice (DOJ) on Monday announced that it is siding with a district court ruling that found the Affordable Care Act unconstitutional. The move is an escalation of the Trump administration's legal battle against the health care law.

The DOJ previously argued in court that the law's pre-existing condition protections should be struck down. Now, the administration argues the entire law should be invalidated. More on the move here.


Trump sends an optimistic note?

"Let me just tell you exactly what my message is: The Republican Party will soon be known as the party of health care. You watch," Trump told reporters as he visited the Capitol to meet with GOP senators.



Meanwhile, Democrats want to build up the health care law in the face of the new attack

House Democrats rolled out a proposal Tuesday to build up ObamaCare just one day after the Trump administration told a court that the entire law should be struck down.

The measure would:

  • Expand eligibility for tax credits while increasing the size of tax credits for everyone.
  • Reverse the Trump administration's expansion of non-ObamaCare health care plans that are cheaper but cover fewer benefits.
  • Block the administration from approving state waivers that would weaken ObamaCare's protections for people pre-existing conditions and its ten requirements for what insurance companies must cover, like maternity care and substance abuse treatment.
  • Reverse the Trump administration's cuts to ObamaCare's outreach and education budget, which funds enrollment efforts
  • Allow states to set up reinsurance programs that help insurers pay the claims of high-cost patients and set up a federal program for states that don't opt to do this.

Why it matters: Democrats concede that ObamaCare isn't perfect, but say they didn't get the chance to make fixes after Republicans took control of Congress. Now that they're in the House majority, they want to show what they will do once if they regain control of the Senate and the White House. So, for now, it's a messaging bill.

Democrats also hope to use it as a political weapon in 2020 against Republicans, who still want to repeal the ACA.

Read more here.


Pompeo says US to expand ban on foreign aid to groups that provide or promote abortion

Secretary of State Mike Pompeo on Tuesday announced an expansion of the so-called Mexico City policy that bans U.S. aid from going to foreign groups that promote or provide abortions.

The expansion closes a loophole, Pompeo said at a press conference, that allowed nongovernmental organizations that receive foreign aid to fund other groups that support abortion.

"This is decent, this is right and I'm proud to serve in an administration that protects the least amongst us," Pompeo said.

What it means: Under the Mexico City Policy, NGOs that want global health aid from the U.S. must certify that don't promote or provide abortions (even with non-U.S. money). Pompeo announcement today means these NGOs won't be eligible for foreign aid if they work with organizations that provide or promote abortions.

Reaction: Democrats and abortion rights advocates who opposed the original Mexico City Policy said its expansion will be even more dangerous for women around the world. Anti-abortion rights groups hailed Pompeo's move.

Planned Parenthood President Leana Wen: Further expanding the rule will have the most harmful impact on the people who already face barriers to care – including women and girls, communities of color, people with low incomes, youth, and LGBTQ communities. Further expansion of the global gag rule will harm millions of people around the world and have consequences for generations to come."

The Susan B. Anthony List President Marjorie Dannenfelser: Money is fungible and we are excited to see Secretary Pompeo taking additional steps to ensure that Americans' hard-earned dollars are actually used for health assistance, not funneled to groups that push abortion."

Read more here.


Purdue Pharma settles with Oklahoma in landmark opioid lawsuit

Purdue Pharma and the state of Oklahoma have agreed to a $270 million settlement in a lawsuit that claims the illegal marketing of OxyContin helped lead to the opioid crisis.

The deal could influence the thousands of lawsuits facing opioid companies across the country. Nearly every state has filed lawsuits against drugmakers, distributors and retailers.

Experts said the Oklahoma lawsuit is likely to be a preview of the legal arguments presented to a jury in a federal opioid trial in October. The settlement could be a sign Purdue will be willing to settle other claims as well.

Where's the money going: Much of the settlement from Purdue will go toward establishing a National Center for Addiction Studies and Treatment at Oklahoma State University in Tulsa.

  • Purdue will contribute $102.5 million to fund the creation of the National Center. Beginning Jan. 1, 2020, the center will receive an annual $15 million payment over a five-year period.
  • Members of the Sackler family, who own Purdue but were not defendants in the case, have pledged to contribute $75 million over five years.
  • Purdue said it will also donate $20 million worth of medication to support the Center's treatment mission.

The case: State Attorney General Mike Hunter in 2017 sued four drugmakers, claiming the effects of deceptive marketing campaigns over the last decade have fueled the state's opioid epidemic.

What's next: The settlement in Oklahoma is only with Purdue, and the state is still able to pursue litigation against Teva, Allergan and Johnson & Johnson. The companies are slated to go on trial May 28, and the presiding judge agreed to televise the proceedings live.

Read more on the settlement here.


What we're reading

Hospital finances improve after Medicaid expansion, but at whose expense? (NPR)

The measles virus was down and out. Now it's primed for a comeback (Stat)

Democratic allies of NAFTA 2.0 draw a line in the sand on drug-pricing changes (Miami Herald)


State by state  

Lawmaker urges increase in Medicaid payments to Nebraska nursing homes (Omaha World-Herald)

Proposed ban on abortion if fetal heartbeat is detected might not survive in Texas (Dallas News)

Dem Kentucky attorney general opposes GOP governor's Medicaid changes (Associated Press)


From The Hill's opinion page:

Sandy Hook and Parkland survivors need not suffer in silence

HHS moves forward with game-changing health care innovations