Overnight Health Care — Presented by PCMA — Sanders to roll out 'Medicare for all' bill | Dems target Juul over Altria ties | Measles cases spike nationwide

Welcome to Monday's Overnight Health Care.

Plenty of news on deck today. Bernie SandersBernie SandersBiden says he won't legalize marijuana because it may be a 'gateway drug' Democrats seize on report of FedEx's Bernie Sanders tax bill to slam Trump's tax plan If we want to save earth, we need to change how we eat MORE is going to introduce the newest version of his Medicare for all bill this week, pharmacy middlemen will face a Senate panel tomorrow, Senate Democrats are increasing scrutiny of Juul, and measles cases spiked in the past week.

We'll start with some news about Medicare for all:  



Sen. Bernie Sanders (I-Vt.) will roll out an updated version of his "Medicare for all" plan Wednesday on Capitol Hill.

Sanders, who is again seeking the Democratic nomination for president, will unveil the bill alongside Senate co-sponsors, some of whom are also candidates for president.

Sanders's bill would largely eliminate private insurance and institute a single-payer system managed by the government. There are also some tweaks from the 2017 version, including coverage for home and community-based care and long-term care, such as nursing homes.

Why it matters: Obviously, Medicare for all isn't going to pass this Congress. But the issue is playing a big role among the 2020 Democratic field of presidential candidates. Republicans have also seized on it to argue that Democrats want to eliminate private insurance.

A spokesperson for Sen. Cory BookerCory Anthony BookerBiden says he won't legalize marijuana because it may be a 'gateway drug' New poll catapults Buttigieg to frontrunner position in Iowa Deval Patrick: a short runway, but potential to get airborne MORE (D-N.J.), also a 2020 presidential candidate, said he would again sponsor the legislation, which he first backed in 2017.

But Sens. Kirsten GillibrandKirsten GillibrandMaloney primary challenger calls on her to return, donate previous campaign donations from Trump Senate confirms controversial circuit court nominee She Should Run launches initiative to expand number of women in political process MORE (D-N.Y.), Kamala HarrisKamala Devi HarrisIf we want to save earth, we need to change how we eat New poll shows four top-tier 2020 candidates in Iowa The Democratic race for president may not sort itself out MORE (D-Calif.) and Elizabeth WarrenElizabeth Ann WarrenBiden says he won't legalize marijuana because it may be a 'gateway drug' Democrats seize on report of FedEx's Elizabeth Warren tax bill to slam Trump's tax plan Warren 'fully committed' to 'Medicare for All' MORE (D-Mass.), all 2020 contenders who sponsored Sanders' Medicare for All proposal in 2017, didn't respond to requests for comment.


What to watch for: If those who backed the bill two years ago continue to do so, and if it picks up any more support. 16 senators backed the bill in 2017.

Read more on Sanders' plans here.



Dems target Juul over Altria ties, advertising tactics

Senate Democrats are pressing e-cigarette manufacturer Juul for information about its advertising practices and recent partnership with Altria, amid what government officials have called an "epidemic" of youth vaping.

Eleven Democrats, led by Sens. Dick DurbinRichard (Dick) Joseph DurbinGOP divided over impeachment trial strategy Democratic senators introduce bill to push ICE to stop 'overuse' of solitary confinement Pentagon watchdog declines to investigate hold on Ukraine aid MORE (Ill.) and Patty MurrayPatricia (Patty) Lynn MurraySenators press FDA tobacco chief on status of vaping ban Retirement bill blocked in Senate amid fight over amendments Senate Democrats call on White House to abandon plan to collect DNA from migrants MORE (Wash.), sent a sharp letter Monday, accusing the company of being more interested in "padding its profit margin than protecting our nation's children."

The senators pressed Juul for information on its sales and ad spending, as well as information given to insurers and providers about whether Juul is effective at helping people quit smoking.

Altria backlash: The senators requested detailed information about Juul's partnership with Altria, which makes Marlboro cigarettes, and how that will impact the company's stated goal of reducing youth vaping. Altria invested $13 billion in Juul late last year for a 35 percent stake in the company. The senators said the deal erases "what little remaining credibility the company had when it claimed to care about public health."

Following the money: The senators asked Juul to disclose any financial ties the company has to a collection of "conservative-leaning and anti-regulation organizations" that urged President TrumpDonald John TrumpTrump reversed course on flavored e-cigarette ban over fear of job losses: report Trump to award National Medal of Arts to actor Jon Voight Sondland notified Trump officials of investigation push ahead of Ukraine call: report MORE to intervene and stop FDA's crackdown on vaping products.

Read more on the letter here.


Measles cases spike to 465 nationwide in past week


The number of measles cases in the country spiked by nearly 100 in the past week, reaching a high of 465, the Centers for Disease Control and Prevention (CDC) said Monday.

This is the second greatest number of cases reported in the U.S. since measles was eliminated in 2000, the agency said. The worst year for measles since then was 2014, when there were 667 cases.

Last week, the CDC confirmed 387 cases across 15 states, which was more than there were in all of 2018.

We've got more details on the spike here.


DOJ says it could take two years to identify thousands of children separated at border

The Trump administration said it could take up to two years to identify all the children separated from their parents under the administration's "zero tolerance" policy.


The Department of Justice detailed the proposed timeline in a court filing late Friday. The DOJ had made progress reuniting many of the 2,700 children separated under the policy, but a federal court recently expanded the group to include thousands of children who were separated during an influx that began in 2017, before the "zero tolerance" policy was enacted.

The administration said there could be as many as 47,000 cases of unaccompanied children taken into government custody between July 1, 2017 and June 25, 2018.

DOJ officials said it would take at least a year, and as many as two years, to sort through all the children discharged by the Department of Health and Human Services's refugee office during that period and identify all the children who were separated.

Commander Jonathan White of the U.S. Public Health Service, who is overseeing family reunification for HHS, said in an affidavit he is trying to streamline the process as best he can, but the sheer number of cases makes identification difficult and will take time.

More on the issue here.


Pharmacy middlemen under scrutiny


The Senate Finance Committee tomorrow morning will hear from executives of five of the top pharmacy benefit managers-- including CVS Health, UnitedHealth's OptumRx and Cigna's Express Scripts-- about the role they play in drug pricing.

Both Chairman Chuck GrassleyCharles (Chuck) Ernest GrassleyBooker, Sanders propose new federal agency to control drug prices GOP eager for report on alleged FBI surveillance abuse Johnson opens door to subpoenaing whistleblower, Schiff, Bidens MORE (R-Iowa) and ranking member Ron WydenRonald (Ron) Lee WydenDemocratic senators introduce bill to block funding for border wall live stream Booker, Sanders propose new federal agency to control drug prices Hillicon Valley: Amazon to challenge Pentagon cloud contract in court | State antitrust investigation into Google expands | Intel agencies no longer collecting location data without warrant MORE (D-Ore.) have been critical of PBMs, which are often referred to as "middlemen." PBMs administer prescription drug plans for large employers and are tasked with negotiating discounts on drugs with pharmaceutical firms and insurers.

Drug pricing is excessively complicated, and it's hard to pin blame on one industry over the other. While Democrats and Republicans differ over some of the solutions to high drug costs, the one constant has been cross-industry finger pointing.

When drug company executives were grilled by the Finance Committee earlier this year, they said high prices were the fault of PBMs that pocket the discounts, instead of passing them on to patients. Tomorrow, expect the PBMs to blame the drug industry.  


Also on tap tomorrow:

The Senate Judiciary Committee will hold a hearing on the "Pain Capable Unborn Protection Act" at 10 a.m.

The House Education and Labor Committee will vote on a resolution blocking the Trump administration's expansion of short-term plans at 10:15 a.m.

The House Ways and Means Committee will markup a prescription drug bill at 10:30 a.m.

Speaker Nancy PelosiNancy PelosiSchumer calls on Trump to testify as part of impeachment inquiry Sunday shows — Spotlight shifts to Sondland ahead of impeachment inquiry testimony Perception won't be reality, once AI can manipulate what we see MORE (D-Calif.), Ways and Means Chairman Richard NealRichard Edmund NealKrystal Ball accuses Democrats of having 'zero moral authority' amid impeachment inquiry House Democrats object to giving Trump notice before seeking NY tax returns On The Money: Trump appeals to Supreme Court to keep tax returns from NY prosecutors | Pelosi says deal on new NAFTA 'imminent' | Mnuchin downplays shutdown threat | Trump hits Fed after Walmart boasts strong earnings MORE (D-Mass.) and Reps. Donna ShalalaDonna Edna ShalalaOvernight Health Care: Trump officials making changes to drug pricing proposal | House panel advances flavored e-cig ban | Senators press FDA tobacco chief on vaping ban House panel advances flavored e-cigarette ban Warren doubles down — to Democrats' chagrin, and Trump's delight MORE (D-Fla.) and Michael BurgessMichael Clifton BurgessShimkus announces he will stick with plan to retire after reconsidering Shimkus says he's reconsidering retirement Shimkus says he's been asked to reconsider retirement MORE (R-Texas) will speak at the American Hospital Association's annual meeting Tuesday. Check out the full schedule here.



PBMs serve as the check against drugmakers' pricing strategies by negotiating for consumers and clients to ensure prescription drugs are affordable. Learn how PBMs advocate for patients and payers at OnYourRxSide.org.


Mulvaney: Trump officials to release ObamaCare replacement plan 'fairly shortly'

We're back to waiting for a new ObamaCare replacement plan.

The administration will release a replacement plan "fairly shortly," acting White House chief of staff Mick MulvaneyJohn (Mick) Michael MulvaneySondland notified Trump officials of investigation push ahead of Ukraine call: report Schiff knocks Mulvaney over failure to testify in impeachment probe Lawmakers skeptical of progress on spending deal as wall battle looms MORE said Sunday.

Administration officials and White House aides, including Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma and Health and Human Services (HHS) Secretary Alex Azar, met for a Saturday summit at Camp David to discuss possible proposals.

"I do think you'll see a plan here fairly shortly," Mulvaney said on "Fox News Sunday."

The big question: What will actually be in the plan? And it will it be an entirely new plan, or will it build on actions the administration has already taken, like expanding cheaper, skimpier health plans and taking actions to bring down drug costs?

The politics: Democrats are reacting with glee at the prospect of President Trump running on health care in 2020, an issue that Democrats think clearly breaks in their favor.

Read more here.


What we're reading

Trump's health care brain trust says no thanks (Politico)

Health care CEO pay tops $1 billion in 2018 so far (Axios)

Are prescription drug prices soaring? It's complicated (Pittsburgh Post-Gazette)


State by state

Montana Medicaid expansion bill moves to state Senate floor (Associated Press)

Hunger and an 'abandoned' hospital: Puerto Rico waits as Washington bickers (New York Times)

Court challenge could halt Indiana's Medicaid work requirements (NWI.com)


From The Hill's op-ed page

Strong 'Medicare for All' legislation is like bargaining a strong union contract