Overnight Health Care — Presented by Purdue Pharma — Trump officials move to require drug prices in TV ads | 4,000 more people lose Medicaid in Arkansas | New top official for Medicaid

Welcome to Monday’s edition of Overnight Health Care.

The Trump administration and the pharmaceutical industry are battling over drug pricing transparency and a new report out of Arkansas shows the latest impact of the state’s Medicaid work requirements.

We’ll start with the drug advertising wars:

 

Trump administration wants to force companies to disclose list prices in TV ads

The proposed rule, announced by Health and Human Services Secretary Alex Azar Monday, is the next step in the administration’s efforts to bring down drug prices.

Every drug that costs more than $35 would be subject to the requirement.

“Patients deserve to know what a given drug will cost when they’re being told about the benefits and risks it may have,” Azar said during a speech Monday in Washington, D.C.

“And they deserve to know when a drug company has pushed its prices to abusive levels, and they deserve to know this every time they see a drug advertised to them on TV.”

The administration is pushing ahead with the move after Congress failed in its own efforts to pass a similar measure. House Republicans in September blocked the proposal from being included in a government funding bill

Read more here.

 

Earlier on Monday, PhRMA moved to preempt the administration’s announcement

The group, which represents some of the largest brand name drug manufacturers, announced a voluntary new initiative to make price and cost information more accessible to the public. All of PhRMA’s members agreed to include either text or a voiceover in television ads directing patients to seek more information off-air– likely on a website.

The companies will include the list price, but also additional information like estimations on how much patients could pay out-of-pocket, as well as any financial assistance programs to help patients cover the costs. It’s a step in the direction of transparency, but falls short of what the administration is proposing.

Industry’s view: PhRMA president Steven Ubl was forceful in pushing back on the idea of disclosing list prices in television ads. He said it could discourage patients from seeking medical treatment because a high list price might make them think they will pay more than they really will. “We think putting out the list price in isolation is very confusing,” Ubl said. “It’s misleading, lacks appropriate context, and isn’t what patients want or need.”

What’s next: The industry hasn’t escaped unscathed from President Trump’s plans to bring down drug costs. They’ve been forced to accept some policies they don’t agree with, but on the whole, nothing has been too damaging. But that might change if this proposal becomes final. Ubl did not say it outright, but there was an implied threat of legal action, particularly on First Amendment grounds. PhRMA officials said there was no way any policy requiring list price disclosure can be legal.  

Read more on PhRMA’s efforts here.

 

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4,000 more people lose Medicaid under Arkansas’ work requirements

According to numbers released by the state on Monday, 4,109 Medicaid beneficiaries were removed from the program in October.

Under the Arkansas program, beneficiaries subject to the requirement who don’t meet it for three months in one year lose their benefits.

Arkansas removed 4,353 individuals from the Medicaid program last month, bringing the total number of people who have lost coverage under the state’s new work requirements program to nearly 8,500.

Why it matters: Arkansas is the first state to implement work requirements after receiving approval from the Trump administration. But a lawsuit targeting the requirements is pending in court right now. The federal judge who blocked similar requirements in Kentucky this summer will preside over the Arkansas’ case.

Read more here.

 

Study: Poor more likely to forgo medical care in states without Medicaid expansion

A new study from the nonpartisan Government Accountability Office provides evidence to supporters of Medicaid expansion over its benefits for low-income people getting health care.

Key findings:

• 20 percent of low-income people in non-Medicaid expansion states did not get needed medical care in the past 12 months due to costs. That figure was less than half — 9 percent — in states that did expand the program.
• 18 percent of low-income people in non-Medicaid expansion states said they needed but could not afford prescription medication in the past 12 months, compared to 10 percent in Medicaid expansion states.

What to watch for in the election: Four states will decide in next month’s election if they will expand Medicaid, with ballot initiatives in Montana, Utah, Idaho and Nebraska.

Medicaid expansion supporters are hoping to push Medicaid expansion into these red states.

Read more here.

 

Speaking of Medicaid, the program has a new top official

The Trump administration on Monday announced that Mary Mayhew will become the head of the Center for Medicaid within the Centers for Medicare and Medicaid Services.

Mayhew used to work for Maine Gov. Paul LePage (R), who is currently refusing to implement Medicaid expansion despite voters approving the expansion last year.

Pro-ObamaCare group Protect Our Care called Mayhew a “health care obstructor.”  

 

Vulnerable Republicans throw ‘Hail Mary’ over pre-existing conditions

Dozens of vulnerable House Republicans have recently signed on to bills or resolutions in support of pre-existing conditions protections, part of an eleventh-hour attempt to demonstrate their affinity for one of ObamaCare’s most popular provisions.

Thirty-two of the 49 GOP incumbents in races deemed competitive by the nonpartisan Cook Political Report have backed congressional measures on pre-existing conditions in the past six weeks, according to an analysis by The Hill.

The moves, coming in the final weeks of the midterm campaign cycle, mark a course reversal for members of a party that for years railed against ObamaCare and called for its repeal.

Now, facing the threat of a “blue wave” and an onslaught of health-care attacks from Democratic candidates, vulnerable Republicans are running ads on pre-existing conditions and co-sponsoring measures that critics deride as meaningless.

Why it matters: The resolutions and bills aren’t going to get a vote and are more of a political gesture than a policy solution. But it shows Republicans are in a panic as Democrats hit them on their records on pre-existing conditions and election forecasters continue to predict Democrats will win back the House.

Read more here. 

 

What we’re reading

Democratic attack ad falsely knocks Republican on preexisting conditions (Washington Post)

Emotional Lou Barletta calls foul on Bob Casey health care ad (Roll Call)

 

State by state

Have N.J. Rep. Tom MacArthur’s (R) Obamacare repeal efforts hurt his re-election chances? (NJ.com)

The Ohio governor’s election is a gut check for Democratic messaging on health care (NBC News)

Illinois GOP governor skeptical about value of ACA-funded Medicaid expansion to Illinois taxpayers (The State Journal Register)

 

Op-eds in The Hill:

‘Medicare for All’ would compromise the pro-life movement

Health is in our hands