Overnight Healthcare

Overnight Health Care: Trump officials defend changes to family planning program | Senators unveil bipartisan package on health costs | Democrats pass $1T spending bill with HHS funds

Welcome to Wednesday's Overnight Health Care.

House Democrats passed a massive spending bill Tuesday, the Trump administration was on the defensive about changes to a federal family planning program, and two senators released a new version of a major package targeting high health costs.

We'll start over in the House at a hearing on some contentious Trump administration moves...


Trump administration defends controversial changes to family planning program on Capitol Hill

Diane Foley, HHS deputy assistant secretary for population affairs, and a Trump appointee, testified before Congress for the first time Wednesday about the administration's changes to Title X, a decades-old grant program for family planning clinics that offer contraception and preventive health services to low-income women.

It was the first time Foley has talked publicly about the changes, which have been temporarily blocked in the courts.

A refresher: The Trump administration rule would require a financial and physical separation between Title X services and abortion services. It would also ban Title X providers from referring for abortions and lift a requirement that providers tell women about abortion as an option.

What Foley had to say: The administration has grave concerns that Title X funds can be misused for abortions but she was unable to tell Democrats on a House Energy and Commerce subcommittee if there was any evidence of this happening.

Foley said banning referrals is an attempt to comply with federal law and lifting the counseling requirement is an effort to protect the conscience rights of providers who oppose abortion.

"There are many providers that avoid being part of the Title X program because the current regulations states that are required to refer for abortions and required to have counseling," she said.

Read more here on the hearing.


Democrats passed a $1 trillion spending package, which included the Labor-HHS funding bill

Lawmakers passed the spending package in a 226-203 vote that fell largely along party lines. Seven Democrats voted against the measure, as did all Republicans.

Many of the provisions are unlikely to be taken up in the Senate but are instead a message to the Trump administration and voters. Highlights:

  • The bill includes $99.4 billion for HHS, an increase of $8.9 billion above the 2019 level.
  • It would repeal the Mexico City policy, which bans foreign aid to non-governmental organizations that promote or provide abortions.
  • It would block the Trump administration from implementing its Title X changes and give the program its first funding boost in years.
  • It also includes the Hyde Amendment, a decades long ban on federal funding for abortion.
  • It would direct $25 million for the Centers for Disease Control and Prevention to study gun violence prevention.
  • And it offers $140 million to support the CDC's goal of reducing new HIV infections by 90 percent in 10 years.


Senators unveil bipartisan package to lower health care costs

A pair of key senators on Wednesday unveiled a revised version of their bipartisan package aimed at lowering health care costs, ahead of a committee markup expected next week.

Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) released the package, which takes steps to protect patients from receiving massive "surprise" medical bills when they get care from an out-of-network doctor. It also cracks down on anti-competitive clauses in hospital contracts with insurers that can drive up costs, and encourages the introduction of cheaper generic drugs.

One of the most significant and contentious decisions in the new bill is on the mechanism for protecting patients from surprise medical bills.

Why it matters: Alexander and Murray are known as two of the best bipartisan dealmakers in the Senate.

Their previous signature health care effort in 2017 and 2018 to shore up ObamaCare eventually failed amid the bitter partisan divide over the health law.

Alexander says the new effort is intended to focus on other areas in health care that are less partisan.

Read more on the proposal here.


But hold on...Chris Murphy may oppose bipartisan health bill unless it addresses ObamaCare 'sabotage'

There's some drama on the bipartisan health care package released Wednesday by Sens. Patty Murray (D-Wash.) and Lamar Alexander (R-Tenn.)

Sen. Chris Murphy (D-Conn.) said he might vote against it next week in committee unless it addresses what he called "sabotage" of ObamaCare.

Murphy told reporters he is worried that there is "no language in the measure to counteract the massive sabotage campaign that's happening by the administration."

The politics: This gets at the balance Democrats are trying to strike of both attacking Republicans for their assaults on ObamaCare, an issue that has borne political fruit, while also working in a bipartisan way on health care legislation.

Read more here.


Grassley announces opposition to key Trump proposal to lower drug prices

Another divide between congressional Republicans and President Trump:

Senate Finance Committee Chairman Chuck Grassley (R-Iowa) told reporters that he opposes a plan that Trump announced in October to lower the prices Medicare pays for certain drugs by tying them to lower prices paid in other countries, an idea known as the International Pricing Index.

"I don't think that this administration's approach on international pricing is going to be to the benefit of the adoption of and research for modern drugs," he said.

"You've heard me say in these meetings before that I'm going to wait until there's a real proposal to put out before I take a stand, but I think I've studied it long enough now that I'll stick by what I just told you," he added.

What this means: There has been some speculation the Trump administration will never finalize the proposal, which has not yet gone into effect, and is instead using it as an incentive for industry to come to the table with other ideas.

The opposition from Grassley, a powerful chairman in Trump's own party, makes it even harder for the administration to move forward.

Read more here.


Durbin urges HHS chief to help stop youth vaping

Sen. Dick Durbin (D-Ill.), frustrated at what he says is a lack of trust in leadership at the Food and Drug Administration, is making an appeal to the top. On Wednesday, Durbin sent a letter to Health and Human Services Secretary Alex Azar calling on him to use the "full force of his agency" to tackle the youth vaping epidemic.

"It has become clear to me that the FDA, under [Acting Commissioner Ned] Sharpless' leadership, will not use its existing authority on tobacco products to protect our nation's children from a lifetime of addiction," Durbin wrote. "As Secretary of the Department of Health and Human Services (HHS)--which oversees the FDA--and as a father to two children, I urge you to put the full force of your agency behind a robust effort to tackle the youth vaping epidemic."

Durbin wrote that he is "extremely skeptical" that FDA will do anything to stop the massive rise in youth vaping, and so he urged Azar to intervene and force the agency's hand.

"Will you use your authority to protect our children?" Durbin wrote.

Backstory: At the end of last month Durbin wrote to Sharpless, saying he did not understand why FDA wasn't taking immediate action, and didn't trust that Sharpless had any intention of acting to curb youth vaping. Durbin asked the acting FDA commissioner to prove him wrong. But less than a month later, Durbin doesn't seem to want to wait, and is intent on provoking some kind of response.


The Hill events

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.


On Wednesday, June 26th, The Hill will host the Future of Healthcare Summit at Long View Gallery in Washington, D.C. We will discuss some of tomorrow's biggest questions in healthcare with policymakers, health officials and industry leaders. Speakers include Sen. Bill Cassidy (R-La.), FDA's Dr. Amy Abernethy, Dr. Ezekiel Emanuel, Nano Vision CEO Steve Papermaster and many more. RSVP and learn more about the summit here.


What we're reading

Meet the New York couple donating millions to the anti-vax movement (The Washington Post)

Black leaders denounce Juul's $7.5 million gift to medical school (The New York Times)

Religion and vaccine refusal are linked. We have to talk about it. (Vox)

"We didn't cause the crisis:" David Sackler pleads his case on the opioid epidemic (Vanity Fair)


State by state

California vaccine bill amended to appease governor (California Healthline)

Study: Arkansas Medicaid work requirements hit those already employed (Kaiser Health News)

Squandered Big Tobacco money a cautionary tale in opioid cases (Bloomberg Law)


From The Hill's opinion page

NBA finals injuries are a game-changing warning for an aging America

Quality standards for biologics protects patient safety -- don't make it optional