Overnight Healthcare

Overnight Health Care: Top Trump official privately warned against ObamaCare changes | Drugmakers sue over TV ad rule | Court rules against Trump policy on abortions for undocumented teens

Welcome to Friday's Overnight Health Care.

There lots of health care news as the week draws to a close. Seema Verma privately warned the White House against ObamaCare changes, drugmakers are suing the administration over a new price transparency rule, and the Trump administration suffered another defeat in federal court.

We'll start with the ObamaCare news...

 

Top Trump health official warned against controversial ObamaCare changes in private memo

A new memo released by House Democrats shows that a top Trump administration health official privately warned against a series of controversial changes that could undermine ObamaCare.

Centers for Medicare and Medicaid Services Administrator Seema Verma warned the changes would have resulted in more than a million people losing health insurance. The administration went ahead and finalized one of changes, despite the warning. The other two have not yet been proposed but remain under consideration.

House Democrats seized on the memo, which lawmakers obtained as part of an oversight investigation. Lawmakers said the fact that the administration approved an alteration that could undermine ObamaCare over the objections of one of its own top officials shows that the Trump administration is intent on "sabotage" of the Affordable Care Act.

Window into Verma's thinking: The August 2018 private memo to Secretary of Health and Human Services (HHS) Alex Azar shows Verma was concerned with keeping ObamaCare markets stable and preventing disruption, but on at least one front was overruled by others in the administration.

Verma warned against three practices: Changing how the law's subsidies are calculated, banning insurers from "silver loading," a workaround that has helped prevent premium increases before, and ending automatic enrollment.

Read more on the memo here.

 

Drugmakers sue over Trump administration TV price disclosure rule

Three drug companies and a national advertising group are suing the Trump administration over its new policy of requiring prescription drug manufacturers to disclose list prices in TV ads.

The lawsuit was expected; drugmakers and advertising groups had signaled they were likely to sue whenever the rule was made final.

The lawsuit seeks to overturn one of the administration's boldest moves to bring transparency to the medication pricing system, and it may have a shot at succeeding.

The pharmaceutical companies -- Amgen, Merck, and Eli Lilly -- were joined by the Association of National Advertisers. In a statement, Amgen said it doesn't disagree with the need for transparency, but the administration's final rule raises "serious freedom of speech concerns."

Under the new policy, which was announced by HHS Secretary Alex Azar last month, drug manufacturers will have to state the list price of a 30-day supply of any drug that is covered through Medicare and Medicaid and costs at least $35 a month.

According to HHS, the idea behind the rule is to make patients better informed so they can talk about the affordability of their medicines with their doctors, and to make Medicare and Medicaid run more efficiently. At the time, Azar said there's no reason patients should be kept in the dark about the full prices of the products they're being sold.

What the lawsuit argues: The final rule, which is set to take effect in July, "mandates an approach that fails to account for differences among insurance, treatments, and patients themselves," Amgen said. The price disclosure will confuse consumers, they argue, because a drug's list price is often much higher than what the patient will actually pay. According to the lawsuit, the rule exceeds the Department of Health and Human Services's (HHS) statutory authority and violates the First Amendment.

"Americans deserve accurate information about the price they will pay for prescription drugs," the complaint states. The final rule "purports to further that objective, but will instead frustrate it -- by misleading patients about their out-of-pocket costs for prescription drugs in a manner that even HHS admits may 'confuse' and 'intimidate' patients."

Read more on the lawsuit here.

 

Appeals court rules against Trump policy on abortions for undocumented teens

The Trump administration suffered another defeat in federal court Friday. The D.C. Circuit Court of Appeals said the administration cannot block undocumented pregnant teenagers in federal custody from obtaining abortions.

In the opinion, the judges wrote that they "are unanimous in rejecting the government's position that its denial of abortion access can be squared with Supreme Court precedent."

In March 2017, the Office of Refugee Resettlement said shelters were "prohibited from taking any action that facilitates an abortion without direction and approval from the director." That director was Scott Lloyd, who has since left the agency.

Lloyd denied all abortion requests delivered to him during his tenure, even when the pregnancy resulted from rape. It has since been revealed that Lloyd used spreadsheets to track how far along unaccompanied girls were in their pregnancies, and also monitored their menstrual cycles. He also personally visited pregnant minors to pressure them to continue their pregnancies.

The judges ruled that allowing the teenagers to have abortions is not the same as facilitating an abortion.

The case was brought by the American Civil Liberties Union after a 17-year-old migrant girl sought an abortion in 2017, drawing attention to a Department of Health and Human Services (HHS) policy of tracking and denying abortion requests from unaccompanied migrant girls.

Read more here.

 

Trump touts new health care move to expand choices for small businesses

President Trump showed off his administration's new health care rule in the Rose Garden on Friday.

What it does: The rule allows employers to use tax-exempted funds, known as health reimbursement arrangements, to allow workers to purchase coverage in the individual market, as opposed to through a traditional employer-sponsored health plan.

The politics: This is part of the Trump administration's emphasis on expanding health care options, which they have been ramping up after their efforts to repeal ObamaCare failed.

The new action is less controversial than some other moves Trump has taken on ObamaCare. Congressional Republicans praised the new rules as expanding choices for workers and businesses, while Democrats pivoted to attacking the Trump-backed lawsuit seeking to overturn ObamaCare.

"This announcement is a monumental victory for small businesses," Trump said.

Read more here.  

 

The Hill event

On Tuesday, June 25th, The Hill will host Cost, Quality and Care: The Medicare Equation at the Newseum in Washington, DC. The Hill's Editor-at-Large Steve Clemons and Editor-in-Chief Bob Cusack will sit down with Reps. Brett Guthrie (R-Ky.) and Doris Matsui (D-Calif.) and an expert panel for a discussion on how leaders in Washington and the health industry can bring down drug costs for Medicare patients while continuing to ensure quality of care for those who depend on the program. RSVP here.

 

What we're reading

World Health Organization says Ebola outbreak not an international emergency (The Hill)

In combating surprise bills, lawmakers miss sky-high air ambulance costs (Kaiser Health News)

Architecture for landmark nationwide opioid settlement unveiled (NPR)

GSK may be reviving incentive pay for sales reps, but it's not returning to its old ways: executive (FiercePharma)

 

State by state

After thousands booted from Medicaid rolls, Louisiana to spend $400M less under program's projections (The Advocate)

This family has dedicated their lives to helping women get abortions in the south (BuzzFeed News)

Eager to limit exemptions to vaccination, states face staunch resistance (The New York Times)

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