Overnight Health Care — Presented by Campaign for Accountability — Measles outbreak tops 830 cases in US | Inslee signs nation's first public option insurance bill | Maryland raises tobacco buying age to 21

Overnight Health Care — Presented by Campaign for Accountability — Measles outbreak tops 830 cases in US | Inslee signs nation's first public option insurance bill | Maryland raises tobacco buying age to 21

Welcome to Monday's Overnight Health Care.

Today, Washington Gov. Jay InsleeJay Robert InsleeFight against flavored e-cigarettes goes local Krystal Ball: What Harris's exit means for the other 2020 candidates Bullock drops White House bid, won't run for Senate MORE (D), a presidential contender, signed the nation's first public option insurance bill, measles cases are still rising, and Maryland is raising the tobacco purchasing age.

We'll start with the latest measles news...



Measles outbreak tops 830 cases across the country

The number of measles cases in the U.S. has reached 839 across 23 states, according to the Centers for Disease Control and Prevention (CDC), as outbreaks across the country show no sign of slowing.

There have been 75 new cases reported in the past week, and the total number of cases is inching closer to the record 963 cases reported in 1994. The current outbreak is still the largest since the disease was declared eliminated in 2000.

Some good news: No new states reported outbreaks in the past week. So, the outbreaks remain in Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oregon, Pennsylvania, Texas, Tennessee, and Washington.

The bad news: The number of cases in New York has continued to climb. As of May 6, the state reported 466 cases in Brooklyn and Queens since September. Most of these cases have involved members of the Orthodox Jewish community. As of May 10, there have been 225 reported cases in Rockland County.

How we got here: Measles is extremely contagious. The outbreak began when an unvaccinated child traveled to Israel, and returned home infected with measles. The child infected others, most of whom were also unvaccinated. Nine out of 10 unvaccinated children will catch the disease if exposed to it, according to the CDC.


Read more on the outbreak here.




Maryland raises legal tobacco purchasing age to 21

The legal age to buy tobacco and nicotine products in Maryland will be raised from 18 to 21, and the state will add vaping devices to the list of tobacco products, under legislation signed Monday by Gov. Larry Hogan (R).

The law was passed in response to an uptick in teen vaping, which federal officials have declared an "epidemic." The law will take effect in October.

It's a trend: The rise in teen vaping has helped propel more states to try to raise the legal age to purchase tobacco. According to the American Lung Association and the Campaign for Tobacco-Free Kids, the law makes Maryland the 13th state to pass some version of "tobacco 21" legislation. Similar bills are moving through legislatures in Arizona and in Florida.

Will it help?: Somewhat. Raising the legal age will likely make it more difficult for teens to purchase cigarettes and vaping products, but advocates say the public health response to ending the youth smoking epidemic needs to include much more, including bans on the sale of flavored tobacco.

Suprising support: Maryland's law is supported by public health advocates as well as tobacco companies. Kevin Burns, CEO of the leading e-cigarette company Juul, commended Hogan and the state legislature. Public health groups have said any tobacco industry support makes them wary.

Backstory: Tobacco companies have been on the front line pushing for "tobacco 21" legislation at the federal and state levels recently, mainly in an effort to stave off stronger regulations that could have disastrous effects on the industry.

Read more Maryland's move here.



44 states accuse generic drug companies of price-fixing

Connecticut Attorney General William Tong (D) led 43 states in suing Teva Pharmaceuticals and 19 other generic drug makers alleging a "broad conspiracy" to "artificially inflate and manipulate prices."

In a 510-page complaint filed May 10 in the U.S. District Court for the District of Connecticut, the states allege that the companies routinely communicated to divide up customers and maintain anti-competitively high prices.

The complaint placed Teva at the heart of the controversy, alleging that it conspired to increase prices of 86 drugs between July 2013 and January 2015.

"Teva and its co-conspirators embarked on one of the most egregious and damaging price-fixing conspiracies in the history of the United States," the complaint said.

Teva has denied the allegations.

Why it matters: Members of Congress and President TrumpDonald John TrumpSenate gears up for battle over witnesses in impeachment trial Vulnerable Democrats tout legislative wins, not impeachment Trump appears to set personal record for tweets in a day MORE say addressing high drug prices is a top priority, but serious reform is unlikely at the federal level. State governments have led the way in cracking down on drug companies over the past few years. Two former drug company executives have entered into a settlement agreement in a similar state-led lawsuit filed in 2016.


More on the allegations here.


Washington governor and presidential candidate Jay Inslee signed off on the first-in-nation public option insurance plan

The state will offer public health care plans that cover standard services to all residents, regardless of income, by 2021.

The plans will still be administered by private insurance companies, but the terms will be set by the state.

Why it's noteworthy: Other states like Colorado and New Mexico have proposed public options, but Washington is the first to pass legislation.

The plans are expected to cost up to 10 percent less than private insurance, mostly due to caps on payments to doctors, hospitals and health care providers.


Why it matters for 2020: As Bernie SandersBernie SandersSaagar Enjeti says Buttigieg's release of McKinsey client list shows he 'caved to public pressure' Sanders endorses Young Turks founder Cenk Uygur for Katie Hill's former House seat Biden hires Clinton, O'Rourke alum as campaign's digital director MORE' 'Medicare for All' bill dominates the 2020 debate over health care, Inslee is endorsing a more modest approach to expanding access to coverage. In fact, while Sanders' bill would largely eliminate private insurance as we know it, Inslee's bill would expand the industry's role in the state's health care system.


Dem health bills on tap this week

The House will vote on a package of seven health care bills that Democrats say will lower health care and prescription drugs costs.

Among the measures are bills to ban the sale of short-term health plans, which Democrats decry as "junk insurance," as well as a measure to fully fund ObamaCare advertising and outreach programs, which the administration has slashed.

There was some controversy over whether to package bipartisan drug pricing bills in with pro-ObamaCare legislation that Republicans oppose, but Democrats want to make the vote difficult for Republicans.

"I hope Republicans join with us to strengthen health care and lower prescription drug costs instead of continuing their efforts to sabotage our health care system," House Majority Leader Steny HoyerSteny Hamilton HoyerOn The Money: Lawmakers strike spending deal | US, China reach limited trade deal ahead of tariff deadline | Lighthizer fails to quell GOP angst over new NAFTA Lawmakers strike spending deal to avert shutdown Vulnerable Democrats feel heat ahead of impeachment vote MORE (D-Md.) said in a statement.



The Trump administration is quietly giving away millions of dollars intended for family planning services to a religious organization that refuses to provide contraception. Learn more.


Health industry to clash over surprise medical bills

Three powerful players in the health care industry are gearing up for battle over surprise medical bills.

Doctors, hospitals and insurers have all pledged to protect patients from being hit with massive, unexpected bills for out-of-network care, but no one wants to take on the added costs that come with it.

That reluctance is setting the stage for a fight, with the insurance industry on one side and hospitals and doctors on the other. The conflict could make it difficult for lawmakers to come up with a plan that doesn't disappoint at least one major sector of the health industry.

Setting the stage: The Trump administration last week released a list of broad principles on surprise medical bills that they hope will be the base of upcoming legislation. The administration said its top priority is to make sure patients no longer receive separate bills from out-of-network doctors, an approach known as a "bundled payment."

Doctors and hospitals don't like it: The provider groups argue that "bundling" puts too much pressure on hospitals to contract with physicians, and essentially turns a hospital into a payer. Instead, doctors and hospitals want an independent arbitrator to examine the amount the doctor is charging and what the insurer is agreeing to pay -- and then determine which one is fairer.

Insurers have a different view: Insurers are opposed to arbitration, and they're pushing for Congress to set reimbursement rates.

Where does Congress stand: The arbitration approach is favored by a bipartisan group of lawmakers, led by Sens. Bill CassidyWilliam (Bill) Morgan CassidyThis bipartisan plan is the most progressive approach to paid parental leave Obstacles remain for deal on surprise medical bills Key House and Senate health leaders reach deal to stop surprise medical bills MORE (R-La.) and Maggie HassanMargaret (Maggie) HassanHillicon Valley: Twitter to start verifying 2020 primary candidates | FTC reportedly weighs injunction over Facebook apps | Bill would give DHS cyber unit subpoena powers | FCC moves to designate 988 as suicide-prevention hotline Senate bill would give DHS cyber agency subpoena powers Senate confirms Trump's nominee to lead FDA MORE (D-N.H.), working on surprise billing legislation. Cassidy has said he's not married to arbitration, he just wants something that works. But an arbitration law has a proven track record in states where it's been implemented, like New York. A bill introduced this month by Sen. Rick Scott (R-Fla.) also relies on arbitration to settle differences.

What happens next: Senators want to put a bill on the floor by July. That's not a lot of time for either side to try to make its mark on the legislation. And it will be hard for Congress to overcome some very loud voices in the room advocating for certain policies over others. But now that the White House is involved, it could give them an added push. The administration's wish list is pretty broad, giving Congress lots of room to take the lead. Lawmakers also don't have to follow what the administration laid out. If there's enough support for a certain approach that it can get 60 votes and pass the Senate, President Trump will likely take it in order to claim victory.

Read more here on the fight over surprise medical bills.


Cory BookerCory Anthony BookerTrump neck and neck with top 2020 Democrats in Wisconsin: poll Booker says he will not make December debate stage White House makes push for paid family leave and child care reform MORE backs safe injection sites, 'comprehensive' approach to opioid epidemic

Booker, a Democratic senator from New Jersey and a presidential candidate, told a high school student in New Hampshire Sunday night that he supports safe injection sites, which allow addicts to inject drugs in supervised settings.

"It has to be a comprehensive approach, and a lot more resources have to go into the gruesome crisis that's going on in our communities," he said.

"It's not just resources -- we need to be investing heavily in evidence-based interventions that we know actually work," he said, adding that more prevention programs and more beds in treatment centers are also needed.


What we're reading

The House's big bill to lower drug prices and shore up ObamaCare, explained (Vox.com)

Grandstanding, not real change: Why drug prices in TV ads will be confusing and irrelevant (Stat News)

'Medicare for All'? How About 'Medicaid for More'? (Governing)   


State by state

Maryland makes more progress on ObamaCare rates -- but there's more to do (Baltimore Sun editorial)

50,000 Texas children a year lose Medicaid over paperwork. A bill to change that died. (Houston Chronicle)

California Gov. Newsom changes course on plan to pay for immigrant health coverage (Kaiser Health News)

Vape giant Juul to bring 500 jobs to Lexington County, S.C., this summer (The State)


From The Hill's opinion page:

Understanding social reasons for poor health helps to fix inequality

Mental health coverage needs to include eating disorders