Overnight Health Care — Presented by PCMA — McConnell delivers fierce attack on Medicare for all | Barr defends efforts to overturn ObamaCare | Senators push drug industry 'middlemen' over prices

Welcome to Tuesday's Overnight Health Care.

It was a day of high-profile hearings topped by Attorney General William BarrWilliam Pelham BarrAppeals court sides with Trump on federal execution policy Barr tells prosecutors to consider coronavirus risk when determining bail: report Decentralized leadership raises questions about Trump coronavirus response MORE testifying before Congress. While Barr was mostly pressed on his handling of special counsel Robert MuellerRobert (Bob) MuellerCNN's Toobin warns McCabe is in 'perilous condition' with emboldened Trump CNN anchor rips Trump over Stone while evoking Clinton-Lynch tarmac meeting The Hill's 12:30 Report: New Hampshire fallout MORE's report, he did make some health care news, defending the Justice Department's attack on ObamaCare. And over in the Senate, pharmacy benefit managers (PBMs) had their own grilling.

But first...



McConnell fiercely attacks 'Medicare for all' in visit to hospital group

Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellLawmakers outline proposals for virtual voting Overnight Health Care: Trump calls report on hospital shortages 'another fake dossier' | Trump weighs freezing funding to WHO | NY sees another 731 deaths | States battle for supplies | McConnell, Schumer headed for clash Phase-four virus relief hits a wall MORE (R-Ky.) is making clear that he thinks attacking Medicare for all -- and not talking about repealing ObamaCare -- is a winning strategy.

"This radical scheme would be serious bad news for America's hospital industry," McConnell told the American Hospital Association (AHA) conference about Medicare for All on Tuesday. "You should not be the guinea pigs in some far-left social experiment."

The politics: Attacking Medicare for all is a key part of McConnell's current health care strategy as he seeks to keep the focus on what he views as a Democratic weakness and away from the GOP's own efforts to repeal ObamaCare.

Remember that McConnell rejected President Trump's call to revisit ObamaCare repeal, telling him the Senate wouldn't move a bill before the 2020 election.

Far cry from the days of attacking ObamaCare: McConnell made no mention of the president (and his calls to repeal ObamaCare) and only mentioned the word


"ObamaCare" once, when he called for giving options to people hurt by "ObamaCare's failings."

Read more here.

The AHA conference had another big-name speaker... Nancy PelosiNancy PelosiLawmakers outline proposals for virtual voting Mattis defends Pentagon IG removed by Trump Overnight Health Care: Trump calls report on hospital shortages 'another fake dossier' | Trump weighs freezing funding to WHO | NY sees another 731 deaths | States battle for supplies | McConnell, Schumer headed for clash MORE.


Pelosi said advocates had to make sure Trump delivered on his campaign promises to lower drug prices.

Speaker Nancy Pelosi (D-Calif.) wants to get drug pricing legislation to Trump's desk and pressure him to sign it.

"Together we must hold the president to his campaign promises to ensure that he signs this legislation when it reaches his desk," Pelosi said in a speech to the American Hospital Association conference. "Every time I speak to him he says, 'Yes, yes we've got to lower the cost of prescription drugs.' We want to enable him to do that."

The context: Pelosi's comments come as her office is in talks with White House officials on drug pricing legislation. That measure includes Medicare drug price negotiation.

The Speaker said she wants to pressure Trump, based on his campaign promises, to support the bill.

Some progressives, however, are skeptical about Pelosi's office talking to the White House on drug pricing, saying they don't think the Trump administration will negotiate in good faith.

Read more here.


Drug middlemen in the spotlight


The pricing practices of pharmacy benefit managers (PBMs) faced scrutiny on Tuesday as senators from both parties grilled company executives over their role in rising drug prices.

"More transparency is needed. The current system is so opaque that it's easy to see why there are many questions about PBMs' motives and practices," Senate Finance Committee Chairman Chuck GrassleyCharles (Chuck) Ernest GrassleyPresident tightens grip on federal watchdogs Officials sound alarm over virus relief check scams Trump takes heat for firing intel watchdog during pandemic MORE (R-Iowa) said during a hearing.

The committee's top lawmakers indicated they are working towards legislation that could limit how PBMs make money and bring transparency to the system.

Grassley and ranking member Ron WydenRonald (Ron) Lee WydenHillicon Valley: Schiff presses intel chief on staff changes | Warren offers plan to secure elections | Twitter's Jack Dorsey to donate B to coronavirus fight | WhatsApp takes steps to counter virus misinformation Wisconsinites put lives on the line after SCOTUS decision Officials sound alarm over virus relief check scams MORE (D-Ore.) said they are asking the Department of Health and Human Services inspector general to launch an investigation of the issue of "spread pricing."

Under spread pricing, PBMs charge Medicare and Medicaid plans a certain amount for a drug, and then reimburse pharmacies at another, usually lower rate, for the same prescription and keep the difference.

"If there are changes that can be made to clamp down on this exploitation of Medicaid I hope the committee will consider it. In my view, it's as clear a middleman rip-off as you're going to find," Wyden said during the hearing.

Pushback: Drug companies have long painted PBMs and insurers as the villains in the pricing debate, and the industry has few backers. But the executives at the hearing pushed back. "Manufacturers continue to increase their list and net prices at unsustainable rates because the lack of competition allows them to," said John Prince, CEO of OptumRx.


We've got more on the hearing here.


TV biz fights Trump drug pricing rule

Broadcasting and advertising groups are giving the pharmaceutical industry a powerful ally in the fight against a controversial Trump administration proposal that would require drug companies to share prices in their commercials.

Critics worry the new rules could discourage Big Pharma from advertising on air, costing the nation's advertisers and television stations an important source of revenue.

The drug industry spends as much as $6 billion on television ads a year and advertising on television accounted for 73 percent of all ad spending on prescription drugs.

The rule: The Office of Management and Budget is currently reviewing a final rule from the Department of Health and Human Services that would require companies to include their list prices in direct-to-consumer ads. PhRMA, the nation's top drug lobby, has argued the rule would be confusing, noting that consumers often don't pay the actual list price for a drug. PhRMA has also come up with their own plan for member companies to follow.


The arguments: Various interest groups like the Association of National Advertisers, the National Association of Broadcasters and NCTA – The Internet & Television Association argue that the rule is likely to mislead consumers and could violate First Amendment protections. It's not clear if the groups will sue to challenge the rule.

Read more about the fight here.


Barr defends administration efforts to overturn ObamaCare in court

Attorney General William Barr on Tuesday defended the Department of Justice's (DOJ) decision to support a court ruling that would overturn ObamaCare.

The DOJ last month sided with a lower court ruling that held the Affordable Care Act was unconstitutional, going past its previous position that only part of the law should be struck down.

Asked by Rep. Matt CartwrightMatthew (Matt) Alton CartwrightOvernight Energy: Coal industry seeks fee rollbacks amid coronavirus | Ex-lawyer for trophy hunting group joins Trump agency | EPA sued over reapproval of Roundup chemical Coal industry asks for financially beneficial rollbacks amid coronavirus House Democrats jam GOP with coronavirus bill MORE (D-Pa.) why the DOJ would take such "dramatic and drastic action," Barr replied: "Do you think it's likely we're going to prevail?"

"We are in litigation and we have to take a position. If you think it's such an outrageous position, you have nothing to worry about. Let the courts do their job," he continued.

Why it matters: Democrats are seizing on the DOJ's decision and tying it to Republicans. Getting rid of protections for people with pre-existing conditions is bad enough, they say, but trying to get the whole law thrown out is destructive.

Read more 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.

Meanwhile, House Democrats are demanding more information from the Trump admin about the decision not to defend the ACA.

Top Democrats, led by Judiciary Chairman Jerrold NadlerJerrold (Jerry) Lewis NadlerHouse Judiciary Committee postpones hearing with Barr amid coronavirus outbreak House Democrats plead with key committee chairman to allow remote voting amid coronavirus pandemic Pelosi rejects calls to shutter Capitol: 'We are the captains of this ship' MORE (N.Y.) and Oversight Chairman Elijah CummingsElijah Eugene CummingsMaryland postpones primary over coronavirus fears Maryland governor: 'Simply not enough supplies' on hand to tackle coronavirus Meadows joins White House facing reelection challenges MORE (Md.), sent letters Tuesday to the White House and departments of Justice as well as Health and Human Services demanding access to materials that explain the decision and identifies the officials involved in making it.

"This refusal appears to be violating longstanding policies to defend and enforce Acts of Congress; will have a significant negative impact on the accessibility of healthcare for Americans; and appears to be driven by political considerations rather than considered legal arguments," the Democrats wrote in the letter to the DOJ.

Why it matters: See above. Democrats want to make this an election issue in 2020.

Read more here.


The Justice Department on Tuesday announced charges against 24 people in a $1.2 billion Medicare scheme that sold unnecessary orthopedic braces to seniors.

Officials said the scheme involved offering Medicare beneficiaries orthotic braces, saying they were free to them and covered by Medicare. Patients who expressed interest were reportedly patched through to call centers in the Philippines and Latin America that were in on the scam, which would verify the beneficiaries' coverage and transfer them to telemedicine companies.

Those charged in the scheme include doctors accused of writing bogus prescriptions, call center owners and medical equipment companies.

Read more here.


What we're reading

Hikes on Medicare drug premiums could be delayed until after 2020 elections (The Washington Post)

In Boston visits, Trump health officials ridicule 'Medicare for All' plans (The Boston Globe)

Why does Medicine cost so much? Here's how drug prices are set (Time)

Consumers rejected drug plan that mirrors Trump administration proposal (Kaiser Health News)


State by state

Here are the ways Idaho's Medicaid expansion bill might break the law (Idaho Statesman)

Bill to provide MaineCare coverage for abortion moves forward (Associated Press)


From The Hill's op-ed page

There are so many flaws with 'Medicare for all'

Women's health in Syria: An American imperative