Overnight Health Care: Top health official defends contract payments to Trump allies | Vaping advocates confident Trump will turn from flavor ban | Sanders gets endorsement from nurses union

Overnight Health Care: Top health official defends contract payments to Trump allies | Vaping advocates confident Trump will turn from flavor ban | Sanders gets endorsement from nurses union
© Aaron Schwartz

Welcome to Tuesday's Overnight Health Care.

Seema Verma defended her use of GOP communications contractors, Bernie SandersBernie SandersKaine: Obama called Trump a 'fascist' during 2016 campaign Des Moines Register endorses Elizabeth Warren as Democratic presidential nominee Sanders faces lingering questions about appeal to women voters MORE landed an endorsement from the nurses union, a new poll highlights high prescription drug costs, and vaping advocates are growing confident they will prevail.

We'll start with Verma...


Top health official defends federal contract payments to Trump allies

A top administration health official on Tuesday defended her office's spending of hundreds of thousands of dollars on outside GOP communications consultants with close ties to President TrumpDonald John TrumpKaine: Obama called Trump a 'fascist' during 2016 campaign Kaine: GOP senators should 'at least' treat Trump trial with seriousness of traffic court Louise Linton, wife of Mnuchin, deletes Instagram post in support of Greta Thunberg MORE.

Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma said the use of contractors was appropriate, because the agency did not have the necessary communications staff in place to enact her "vision" for the department.


"When I came to CMS, my vision for the comms department was very different than what we had. I wanted to make sure that we were communicating with our patient population ... and the provider community," Verma told reporters. 

Verma said on Tuesday that the agency regularly uses consultants to help with the rollouts of short-term projects and specific initiatives. 

She also said she felt CMS needed consultants with specialized expertise, and pointed to efforts to launch podcasts and blogs, give more public speeches, and make policy documents more "readable."

What she was pushing back on: Verma was responding to a report by Politico that found CMS had paid GOP consultants, including at least eight former Trump campaign and transition officials, hundreds of thousands of dollars for work that is normally handled by career civil servants.

The Health and Human Services Department's inspector general is investigating the $2.25 million contract to determine whether Verma complied with federal ethics rules. Congressional Democrats in the House and Senate are also investigating. 

Read more on the controversy here.


Verma spoke to reporters after a speech to the National Association of Medicaid Directors, where she went on the offensive

Speaking about Medicaid work requirements, Verma attacked the groups who have sued the administration over Medicaid changes -- and won.

"We cannot allow those who prefer the status quo to weaponize the legal system against state innovation," Verma said. "And let's be clear, it not just state community engagement programs that are under attack."

The Trump administration has suffered numerous legal setbacks related to work requirements. A federal judge blocked work requirements in Arkansas, New Hampshire and Kentucky. Meanwhile, Arizona and Indiana have suspended their policies as a result of lawsuits. 

In Arkansas, 18,000 people lost coverage as a result of the work requirements during the six months they were in effect, but Verma said people shouldn't use those results to draw long-term conclusions.

"Less than a year does not allow us to distinguish between the operational challenges of implementation, and the long-term effects of the policy itself. Those with an axe to grind may wish to draw fatal conclusions from the early experiences of one state, but objective observers would do well to be more cautious," Verma said. 

Block grants coming: Verma also hinted that a long-awaited guidance giving states permission to convert Medicaid into a block grant, or put a cap on Medicaid funding, will be coming "soon." The guidance has been under review at the White House Office of Management and Budget since June. Democrats already object to work requirements, so block grants and per capita caps will likely lead to even more vocal objections-- and lawsuits. 


Poll: 1 in 5 US adults report trouble affording prescription drugs

About 1 in 5 U.S. adults say that they or someone in their household has been unable to afford drugs that were prescribed to them in the past 12 months, according to a new Gallup poll. 

The survey found that 22.9 percent of U.S. adults said there had been a time in the past year when their household was unable to pay for drugs they were prescribed, up from 18.9 percent in January. 

Political context: Backers of drug pricing legislation on Capitol Hill quickly seized on the data to make the case for their bills. Speaker Nancy PelosiNancy PelosiClinton says Zuckerberg has 'authoritarian' views on misinformation Trump defense team signals focus on Schiff Trump legal team offers brisk opening defense of president MORE's (D-Calif.) office sent out an email pointing to the findings and Sen. Chuck GrassleyCharles (Chuck) Ernest GrassleyGraham vows Biden, Ukraine probe after impeachment trial Social security emerges as latest flash point in Biden-Sanders tussle Trump to sign USMCA next Wednesday MORE (R-Iowa) tweeted about it as well. Both Pelosi and Grassley are pushing for rival plans to lower drug prices. 

The Gallup survey also finds the public is mostly negative on Trump's performance on the issue so far, with 66 percent of adults saying he has done "not very much" or "none at all" to fight high drug prices. Twenty percent said he had done a "fair amount" and 7 percent said "a great deal."

Read more here.


Vaping advocates feel confident Trump will turn from flavor ban

Vaping advocates are optimistic that the Trump administration will back off its plan to ban the sale of all flavored e-cigarette products. 

President Trump and some of his top advisers have questioned in recent days whether the flavor ban it promised two months ago could have an adverse effect on the economy. They've also worried it could make it harder for adults who use the products to try to quit smoking.

Those are the same objections vaping advocates have raised in the past several weeks as they seek to derail the ban, an attempt by Trump's health appointees to curb rising youth vaping rates. 

"At the moment we are cautiously optimistic that President Trump has heard our voice and there's room for reasonable compromise that protects both adults and youth," said Gregory Conley, president of the American Vaping Association, an advocacy organization that opposes a flavor ban and is funded in part by companies that make liquids used in e-cigarettes. 

Trump tweeted Monday morning that he plans to meet with representatives of the vaping industry, medical professionals and state representatives to "come up with an acceptable solution to the vaping and e-cigarette dilemma." 

Why it matters: The White House concluded its review of the FDA guidance last week and canceled meetings with stakeholders. So that Trump is scheduling another meeting is significant. There's no word from the White House on when the meeting is or who will attend, however. It signifies Trump is looking for a compromise to banning flavors outright.

Read more here


Sanders lands endorsement from nurses union

Democratic presidential contender Sen. Bernie Sanders (I-Vt.) on Tuesday announced an endorsement from National Nurses United (NNU), the largest union of registered nurses in the U.S.

The group cited Sanders's "Medicare for All" proposal as one of the reasons it was backing the Vermont senator's White House bid. 

The group also endorsed Sanders in 2016.

"We are so proud that together, in 2016, Bernie Sanders and NNU elevated Medicare for All to the national mainstream, where it has advanced to a top 2020 presidential race issue," the group's executive director, Bonnie Castillo, said in a statement. "Nurses are beyond tired of watching our patients suffer and die needlessly, simply due to inability to pay, and we know Bernie Sanders is and has been, leading on Medicare for All through his advocacy and Senate legislation."

More on the endorsement here.


What we're reading

Sen. Casey: After report, Google removes false online ads for ObamaCare 'junk plans' (Pittsburgh Post-Gazette)

It's tiny biotechs -- not big drug makers -- that fear 'nuclear winter' from Pelosi's drug pricing bill (Stat News)

What do GOP efforts to undo Affordable Care Act mean for pre-existing conditions? (PolitiFact)  

Some academics quietly take side jobs helping tobacco companies in court (Nashville Public Radio)

Facing 'certain death,' boy with vaping injury gets double lung transplant (The New York Times)


State by state

Unsure of your state's abortion laws? Check your smartphone (The New York Times

Cannabis commission quarantines marijuana oil vapes, effectively extending ban (Boston Globe)

More adolescents seek medical care for mental health issues (California Health Line)

MD Anderson patient feds reported dead is still alive (Houston Chronicle)