Overnight Health Care — Presented by Purdue Pharma —Senate debates highlight fight over pre-existing conditions | Support grows for Utah Medicaid expansion measure | Arkansas health official defends work requirements

Welcome to Friday’s edition of Overnight Health Care.

The debate over protections for pre-existing conditions is dominating the election season, and last night’s Senate debates with vulnerable Democrats from red states were no different.

Incumbent Democratic Sen. Heidi Heitkamp faced off in a debate against her challenger, GOP Rep. Kevin Cramer, in North Dakota, and in Missouri, Democratic Sen. Claire McCaskill debated Republican Attorney General Josh Hawley.

 

Let’s start in North Dakota…

Heitkamp criticized Cramer for backing North Dakota’s participation in a lawsuit that seeks to eliminate ObamaCare and its pre-existing condition protections. Cramer tried to deflect by saying he “has not and would not” support any legislation that cuts guaranteed coverage for pre-existing conditions.

Cramer’s defense is the same as others Republicans who’ve been attacked on the issue. Cramer supported the House ObamaCare repeal and replacement bill, which technically would not have eliminated protections for pre-existing conditions. The bill would have made it possible for insurers to charge people with pre-existing conditions thousands of dollars more.

 

Meanwhile in Missouri…

Hawley is one of the 20 Republican state attorneys general who have signed on to the lawsuit to dismantle ObamaCare, so McCaskill’s attacks were more pointed. Several times during the debate, he expressed his support for rules protecting coverage for pre-existing conditions, while also saying ObamaCare is a flawed law that needs to be eliminated.

Democrats have said if Hawley truly cared about protecting people with pre-existing conditions, he would drop the lawsuit. But earlier this month, Hawley said he has no regrets about supporting the legal challenge.

Hawley knows he is vulnerable on the issue and is one of many Republicans to tell personal stories to try to show his support for pre-existing condition protections.

In an ad, Hawley says his oldest son has a pre-existing condition. “We know what that’s like,” he says.

 

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In non-campaign news…

 

Support for Utah’s Medicaid expansion ballot measure is growing.

A new Salt Lake Tribune-Hinckley Institute of Politics poll found 59 percent of voters support the measure, which would extend coverage to about 150,000 people in the state.

A similar survey conducted in June found 54 percent of voters supported the measure.

The new poll was conducted by the Hinckley Institute from Oct. 3 to 9. It included responses from 607 registered Utah voters and has a margin of error of 4 points, according to the Tribune.

Republican state lawmakers are opposed to the ballot measure, arguing that expanding Medicaid will destroy the state’s budget and lead to bankruptcy. According to local news outlets, one state senator this week said he would introduce legislation to repeal the expansion if the ballot measure passes.

Utah is one of three conservative states that will vote next month on whether to expand Medicaid.

Read more here

 

Arkansas health director defends work requirements

The intent of Arkansas’ work requirements is to help people advance out of poverty, not to kick them off of Medicaid, Arkansas Department of Human Services (DHS) director Cindy Gillespie said during a panel discussion in Washington on Friday.

Nearly 8,500 people have lost Medicaid coverage under the state’s newly imposed work requirements. The program launched in June after receiving approval from the Trump administration. National health-care advocates are suing the administration over the state’s work requirements, arguing they violate federal law.

Gillespie said the requirements are still new, and there will be improvements. She said the state has put a significant effort into informing people about the requirements; they sent 160,000 letters, 150,000 calls, as well as e-mail and social media outreach.

“This is an experiment,” Gillespie said, and the state and beneficiaries will learn as the program moves forward.    

 

Also today…

Iowa Gov. Kim Reynolds (R) unveiled a new policy proposal that would allow women to get contraception at pharmacies without prescriptions.

And the Michigan pharmacist who refused to refill a woman’s miscarriage medication because he was a “good Catholic male” is no longer with the pharmacy company he was working for at the time.

 

What we’re reading

St. Luke’s in Houston replaces heart transplant surgical director after program loses Medicare funding (Pro Publica/Houston Chronicle)

Children across U.S. are becoming inexplicably paralyzed. Some parents and experts say federal officials aren’t doing enough (Los Angeles Times)

Eight midterm races putting pharma — and its influence — front and center (Stat)

 

State by state

University of Southern California reaches tentative $215 million settlement over gynecologist accused of sexually assaulting hundreds of students (Los Angeles Times)

The ballot revolt to bring Medicaid expansion to Trump country (Politico)

Legal battle over Missouri clinic could foretell abortion fights in other states (NPR)