Overnight Healthcare

Overnight Health Care — Presented by Partnership for America's Health Care Future — Pelosi unveils signature plan to lower drug prices | Trump says it's 'great to see' plan | Progressives pushing for changes

Welcome to Thursday's Overnight Health Care.

It was a big day for politicians to unveil new policies. Pelosi released her signature prescription drug pricing bill, Pete Buttigieg unveiled his health care platform, and two senators have a bill to ban flavored e-cigarettes. 

We'll start with the big news on drug pricing...


Pelosi unveils signature plan to lower drug prices

Speaker Nancy Pelosi (D-Calif.) on Thursday unveiled her long-awaited plan to lower prescription drug prices, one of the top priorities for Democrats this year.

The plan would allow the secretary of Health and Human Services to negotiate the price of up to 250 drugs per year, and the lower prices would apply to people both with private insurance and those on Medicare.

Pelosi is aiming for a House vote on the plan by the end of October or early November, sources say.

The plan is far-reaching and significantly left of center, which would likely make it very difficult to get passed through the Republican-controlled Senate. However, it does include at least one White House-supported policy -- it would cap the negotiated price at 120 percent of what a handful of foreign countries pay for the same drug. 

The hope among Democrats is that if President Trump supports the plan, it would put pressure on congressional Republicans to support the measure as well. Trump has railed against high drug prices, but his support of the Speaker's plan is far from assured.

House politics: On Thursday, House Republicans said the bill is dead in the water. All 24 Republicans on the House Energy and Commerce Committee called it a "socialist" proposal, and pushed for smaller, bipartisan legislation. 

Senate politics: Majority Leader Mitch McConnell (R-Ky.) also said the bill has no chance of passing the Senate.

But, it could give a needed boost to a bipartisan bill from Sen. Chuck Grassley (R-Iowa). Grassley's bill is much more moderate than Pelosi's, but even he has Republicans warning about "price controls." Now Grassley can point to the Pelosi bill as the alternative. Republicans definitely don't like her plan, so if they want to lower the cost of prescription drugs, Grassley's bill will be the way forward.

Read more on Pelosi's bill here.



Progressives want changes

Progressive House lawmakers are pushing for Pelosi's bill to go further.

The lawmakers have not denounced the bill and praised its overall approach, but say that important changes need to be made to make it stronger before it goes to the House floor.

The main complaint is that the measure sets a minimum of just 25 drugs to be negotiated each year. Progressives say all drugs, or at least many more, should be subject to negotiation to lower the prices.

"We need to expand the number of drugs, it can't just be a minimum of 25," said progressive Rep. Ro Khanna (D-Calif.). "It needs to cover the vast majority of drugs."

Pelosi's response: The speaker met with the Congressional Progressive Caucus on Thursday, a meeting that aides described as amiable. Pelosi said that she is open to changes as the measure works its way through the committee process.

More on the concerns from the left.


And what about Trump?: President says its 'great to see' Pelosi plan

President Trump tweeted Thursday that it is "great to see" Speaker Nancy Pelosi's (D-Calif.) bill to lower drug prices. 

Trump offered more praise to a bipartisan bill in the Senate from Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.).

It wasn't quite an endorsement of Pelosi's bill. But it was also markedly different from the way GOP leaders were describing the proposal. Senate Majority Leader Mitch McConnell (R-Ky.) told Politico that he would not bring it up for a vote in the Senate. 

McConnell has not said if he will bring up Grassley's legislation. 

Secretary of Health and Human Services Alex Azar met with Democratic lawmakers on Thursday to push for a bipartisan agreement on lowering drug prices. He did not give an opinion on Pelosi's bill because he said he has yet to read it. Much of the discussion centered on the Grassley-Wyden proposal, and Wyden, who was in attendance, walked through some of the details of the bill, per lawmakers in the room. 

Read more on Trump and Azar here.


Buttigieg unveils Medicare plan preserving private insurance

Democratic presidential candidate Pete Buttigieg released a health care platform Thursday that would expand Medicare coverage while allowing Americans to keep their private health insurance plans.

The South Bend, Ind., mayor's "Medicare for All Who Want It" would aim to achieve universal coverage by introducing a public option, putting limits on medical prices, and increasing subsidies for private insurance.

Buttigieg has said he would like "Medicare for All" someday, but the short transition proposed by other Democratic candidates like Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.) will make people too wary of a government-controlled health system.

The proposal is similar to what former Vice President Joe Biden is calling for -- building on ObamaCare without completely upending the current health care system.

Uninsured Americans would automatically be enrolled into the government insurance plan, while those with employer-provided insurance would be able to opt in.

The health care proposal also includes measures to address surprise billing and an out-of-pocket spending cap for Medicare. It would set a ceiling on what doctors, hospitals and other providers can charge when they haven't successfully negotiated with insurers to be part of their networks.

Buttegieg is polling close to 6 percent, according to the Real Clear Politics polling aggregate. 

Read more on Mayor Pete's plan here.


During a CNN interview later Thursday, Buttegieg went after Warren directly

Buttegieg called Warren "evasive" for not saying whether her health care plan would raise middle class taxes. 

"Senator Warren is known for being straightforward and was extremely evasive when asked that question, and we've seen that repeatedly," Buttigieg said Thursday during an interview on CNN.

Warren didn't directly answer a question asked by Stephen Colbert during an appearance on The Late Show Tuesday. 

"I think that if you are proud of your plan and it's the right plan, you should defend it in straightforward terms," Buttigieg said. "And I think it's puzzling that when everybody knows the answer to that question of whether her plan and Senator Sanders' plan will raise middle class taxes is 'yes.' Why you wouldn't just say so, and then explain why you think that's the better way forward?"

More on the exchange here.


Vaping-related illnesses surge as officials search for the cause

The number of people nationwide who have contracted a lung illness linked to vaping has climbed to 530, with seven confirmed deaths, and federal health officials on Thursday said they still don't know what is making people sick.

The number of illnesses has spiked dramatically from the 380 patients identified last week. Patients have been found in 38 states and one territory. Officials said they have yet to identify any one consistent e-cigarette or vaping product, brand or substance linked to all the illnesses.

The stats: According to the CDC, more than half of the people who have become sick are younger than 25, and 16 percent are younger than 18. Officials said nearly three-quarters of the patients are males. 

Criminal investigation: Meanwhile, the Food and Drug Administration has opened up a criminal probe in parallel with the public health investigation. Mitch Zeller, director of the FDA's Center for Tobacco Products, said the agency's criminal enforcement arm has begun an investigation focused "on the supply chain," but would not go into more specifics. 

In an attempt to allay fears of people who have been using vaping products containing THC, Zeller stressed the agency is not pursuing any prosecutions associated with personal use of controlled substances. One of the problems investigators have been encountering is that some people have been hesitant to say what vaping products they were using, because they contained potentially illegal drugs. 

"I wish we had more answers," said Anne Schuchat, the principal deputy director of the Centers for Disease Control and Prevention (CDC). "People are dying." 

Read more here.


But by the time the CDC's press conference ended, the death toll had risen to eight. 

A Missouri man died of a vaping-related illness this week, state officials said Thursday, marking the first reported death of its kind in the state.

Missouri Department of Health and Senior Services said the man was in his mid-40s and had normal lung function before he started vaping in May, based on lung samples taken by the department. 

He developed mild respiratory symptoms that worsened and was hospitalized on Aug. 22. He was later transferred to Mercy Hospital St. Louis on Sept. 4, where he died. 

"This is an unfortunate case of a young man with no prior lung illness who started vaping because of chronic pain issues," said Dr. Michael Plisco, Mercy critical care pulmonologist and medical director of Mercy's extracorporeal membrane oxygenation (ECMO) program.

More here.


Meanwhile, in Washington...


Senators draft bipartisan bill to ban flavored e-cigarettes

Senators are making a bipartisan push to ban flavored vaping products, following reports that the number of underage users of e-cigarettes has spiked.

Sens. Jeff Merkley (D-Ore.) and Mitt Romney (R-Utah) on Thursday introduced legislation that would ban all flavors of e-cigarettes except tobacco, effective within 90 days of the bill being enacted. It also would attempt to crack down on refillable "e-liquid" cartridges.

The legislation mirrors a similar path outlined last week by the Trump administration, which is moving to ban all non-tobacco flavors of e-cigarettes.

In addition to the flavor ban, Romney and Merkley's bill would require standards on the design of e-cigarettes, monitor the public health risks associated with the use of tobacco products, including e-cigarettes, and apply existing tobacco taxes to e-cigarettes.

"Vaping companies have hooked millions of our children on nicotine using e-cigarette flavors like 'gummy bear,' 'scooby snacks,' and 'strawberries and cream.' This means massive health consequences for the next generation, and we have to end this addiction crisis. We need to get these flavors off the market," Merkley said.

Read more on the bill here.


O'Rourke unveils plan to legalize marijuana, end war on drugs

Presidential hopeful Beto O'Rourke on Thursday unveiled a plan to legalize marijuana and end the war on drugs.

The former Texas congressman would grant clemency to those currently serving sentences for marijuana possession, establish a model for marijuana legalization and give grants to those affected by the war on drugs to help them benefit from the new industry.

The "Drug War Justice Grants" would be given to those formerly incarcerated for nonviolent marijuana offenses in state and federal prison.

Several other Democratic contenders have backed legalizing marijuana and expunging the records of those incarcerated for nonviolent related offenses.

Read more on O'Rourke's plan here.


Sponsored Content - Partnership for America's Health Care Future

Families deserve quality care they can afford. But unaffordable proposals like Medicare for All, Medicare buy-in and the public option could cost hardworking families $32 trillion in higher taxes. Learn more.


What we're reading

All the Democratic health-care proposals have one big problem (Bloomberg)

Next time, voters want a health care debate that hits closer to home (Morning Consult)

McConnell warns Pelosi's drug-pricing plan is DOA (Politico)

Doctors and nurses with addictions often denied a crucial recovery option (Kaiser Health News)


State by state

As Texas cracks down on abortion, Austin votes to help women defray costs (KUT)

Bill to extend health insurance benefits to low-income workers finally gets started (North Carolina Health News)

GOP's Medicaid expansion compromise is back on the table after surprise budget vote (News & Observer)


From The Hill's opinion page:

Millions of us are living in poverty -- we need investments to raise the standard of living

Sexual trauma is a global public health issue