Health Care

Overnight Health Care: Drug industry scrambles after rare loss in budget deal | Idaho insurer to sell plans outside ObamaCare rules | US health spending to hit $5.7T in 2026

Pharmaceutical companies are pushing to repeal or roll back a provision in last week’s budget deal that delivered a rare loss to their industry, according to two lobbyists familiar with the situation.

A provision included in the budget deal approved last week raised the share of costs that drug companies have to pick up as part of closing the “donut hole,” a gap in drug coverage for Medicare Part D beneficiaries.

Drug companies are quickly mobilizing to try and undo the change, or at least roll it back in some fashion. The most likely avenue is the long-term government funding bill that Congress is expected to pass in March, the lobbyists said.    

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The budget deal raised the share of costs in the donut hole that drug companies have to pick up from 50 percent to 70 percent. The drug companies are pushing proposals that would put the share at 60 percent or even lower, sources say.

One powerful figure involved with the issue, Senate Finance Committee Chairman Orrin Hatch (R-Utah), is concerned about the provision in the budget deal and is in favor of changing it, his office said.

“Some of the offsets, particularly related to Medicare Part D that my Democratic colleagues insisted being in this package, are very troubling to me,” Hatch said on the Senate floor last week, referencing the provision. “And I look forward to working with my colleagues to address this moving forward.”

But Democrats are pushing back.

Read more here.

 

Sessions makes a remark about opioids, starts a discussion about pain

Attorney General Jeff Sessions drew criticism last week when he suggested the opioid epidemic could be eased if people “take some aspirin sometimes and tough it out a little bit.”

The attorney general’s point was that doctors are giving out too many painkillers, and that this had contributed to people becoming addicted to opioids.

Some saw the comments as insensitive. But to others, he was essentially on the mark.

“He’s absolutely correct. There are too many opioids being prescribed,” said Dr. Martin Makary, the director of the Center for Opioid Research and Education and a Johns Hopkins University professor of surgery.

Sessions’s remarks reveal the larger debate the country is grappling with over how to combat the opioid epidemic.

Read more here.

 

Idaho insurer to sell plans outside ObamaCare rules

Blue Cross of Idaho on Wednesday announced that it will offer health insurance plans that do not meet ObamaCare requirements after a controversial executive order from the state’s Republican governor.

The move by the insurer is a step further for Gov. Butch Otter’s plan to bring cheaper options into the market. He says ObamaCare plans are too expensive and more healthy people need to be drawn into the marketplace.

But his proposal is legally questionable and has drawn backlash from Democrats who say he is simply ignoring federal law.

The new Blue Cross plans, which still need to be formally approved by the state, appear to have cheaper premiums than ObamaCare plans, but they also would charge people with pre-existing conditions more and have a limit of $1 million in claims per year, according to the Idaho Statesman.

Both of those features are not allowed under ObamaCare.

Read more here.

 

HHS head says he will uphold ObamaCare as law

The top federal health official on Wednesday said he will uphold ObamaCare as long as it remains the law.

Health and Human Services Secretary Alex Azar told lawmakers he has a responsibility to enforce the law in response to questions about a controversial plan in Idaho to allow insurers to sell plans that don’t meet ObamaCare requirements.

“I’m not aware that our opinions or views have been solicited,” Azar said. “There are rules, and there’s a rule of law that we need to enforce.”

But Azar avoided saying if he would step in and stop the plans.

Read more here.

 

172 Dems ask Trump official to reject Medicaid work requirements

More than 170 House Democrats asked Health and Human Services (HHS) Secretary Alex Azar to reject requests from states to require Medicaid beneficiaries to work.

“Such actions to tie health coverage to work are motivated purely on the basis of ideology and mistaken assumptions about what Medicaid is and who it covers,” the Democrats wrote to Azar.

The administration recently approved Medicaid work requirements for Indiana and Kentucky.

Azar and other HHS officials describe work requirements as a “pathway out of poverty.”

But Democrats argue such requirements are harmful.

Read more here.  

 

US spending on health care estimated to reach $5.7 trillion in 2026

Spending on health care in the U.S. will grow faster than the overall economy for the foreseeable future, according to a government report released Wednesday.

Health spending is expected to increase 5.5 percent annually through 2026, actuaries at the Department of Health and Human Services say.

That’s 1 percentage point faster than economic growth.

Overall, health spending is projected to make up 19.7 percent of the U.S. economy in 2026, up from 17.9 percent in 2016. In total, spending on health in the U.S. is estimated to reach $5.7 trillion in 2026, about two trillion higher than this year.

Read more here.

 

VA chief of staff covered up travel expenses

Veterans Affairs (VA) Secretary David Shulkin‘s chief of staff doctored an email in an effort to cover up travel expenses for Shulkin’s wife, according to a VA inspector general’s report released Wednesday.

The report found that Shulkin’s chief of staff, Viveca Wright Simpson, made changes to an official email to get approval for taxpayer funding for Shulkin’s wife’s flights costing more than $4,000.

The report also said Shulkin misused government resources by accepting Wimbledon tickets and airfare for his wife when he took a trip to Europe last summer.

Shulkin, who served as a VA official during the Obama administration and was nominated as secretary by President Trump, had said the Wimbledon tickets were from a personal friend, according to the report.

However, the inspector general found that Shulkin had only met the woman who provided the tickets — Victoria Gosling, an adviser for the Invictus Games — three times at official events.

Read more here.

 

Update: Shulkin says he reimbursed government for wife’s travel

Veterans Affairs (VA) Secretary David Shulkin said he has reimbursed the government for travel expenses for his wife after the VA inspector general found Shulkin’s chief of staff attempted to cover up the expenses.

Shulkin told USA Today that he mailed a $4,312 check to the government Wednesday to cover the cost of his wife’s airfare and said he would reimburse Victoria Gosling, an adviser for the Invictus Games, for Wimbledon tickets he received.

He told the newspaper “there was never anything intentional” to covering up the expenses.

“We act with the highest ethical character,” Shulkin said. “I relied upon my staff to do this, and in retrospect, I wish that I had asked more questions.”

Read more here.

 

What we’re reading

Planned Parenthood goes on the offense (The Washington Post)

How a police chief, a governor and a sociologist would spend $100 billion to solve the opioid crisis (The New York Times)

 

State by state

Rhode Island offered all inmates addiction treatment. Overdose deaths plunged. (Stat)

Oregon House OKs health care as a right, funding questioned (ABC News)