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Trump administration asks how to use Obamacare to sell insurance across state lines. Health officials want to know how to take advantage of a little-known part in Obamacare called a “healthcare choice compact.” The provision, which is in section 1333 of Obamacare, lets states create compacts permitting insurers to sell coverage in any state participating in the compact, as long as they follow specific rules. The law required the compacts to be up and running by 2016, but the Obama administration never fully implemented the provision.
Republicans, including presidential candidates over several cycles, have long looked to allow the sale of insurance across state lines, saying that it would boost competition, lower the cost of coverage, and give people more options. But the provision is difficult to implement under Obamacare regulations. Obamacare requires health insurers to offer a wide range of benefits, meaning there tend to be few differences among health insurance plans sold in different states or in what they cost. When Republicans propose letting states buy insurance across state lines, they mean a system in which Obamacare’s regulatory structure is no longer in place. Further, insurers and states have faced several obstacles when they’ve considered the compacts. Insurers would have to calculate premiums for markets in which they haven’t done business, and they have to understand the different hospital and doctor networks in new states.
The pro-Obamacare group Protect Our Care blasted the announcement in a statement Wednesday, casting in as the Trump administration’s attempt to “sabotage” the healthcare system. “The Trump Administration wants to let insurance companies pick the state with the least regulation, and allow insurers to bypass much needed consumer protections,” Leslie Dach, campaign chair for the group, said in a statement. “This has nothing to do with choice, competition, or affordability for consumers; it is about increasing profitability for the insurance companies and guaranteeing worse coverage for the rest of us.”
Welcome to Philip Klein’s Daily on Healthcare, compiled by Washington Examiner Executive Editor Philip Klein (@philipaklein), Senior Healthcare Writer Kimberly Leonard (@LeonardKL), and healthcare reporter Cassidy Morrison (@CassMorrison94). Email [email protected] for tips, suggestions, calendar items, and anything else. If a friend sent this to you and you’d like to sign up, click here. If signing up doesn’t work, shoot us an email and we’ll add you to our list.
House dives into gun violence as a public health issue. The House Appropriations Committee this morning is weighing how much funding the Centers for Disease Control and Prevention will need to study gun violence and what community programs could help reduce gun deaths and injuries. One of the witnesses, Dr. Ronald Stewart, who heads the trauma committee at the American College of Surgeons, will say that his organization recommends appropriations of $50 million next year for the CDC to study the issue. Rather than explore the broader implications of guns on public health, Republicans have tended to focus on the idea of limiting the availability of guns to people with a mental illness, given that two-thirds of gun deaths are suicides. Gun rights advocates and many Republicans have pushed back on casting gun violence as a public health issue, saying that framing it as such ultimately is aimed at limiting gun rights. They believe instead instead that gun violence should remain under the purview of law enforcement. Tune in.
Brain behind GOP bill to protect abortion survivors blames Sasse for sparing Democrats. The architect of high-profile Republican legislation to clarify that babies who survive attempted abortions must receive medical care is frustrated by the “timidity” of Sen. Ben Sasse, R-Neb.
Sasse and other Republicans, he believes, failed to follow his original scheme for the bill and to punish Democrats for favoring abortion rights. “That has been my complaint about Ben Sasse, is he didn’t stick with it,” said Hadley Arkes. “Timidity or want of imagination is why … people [have] been so slow with picking up the fact that this kind of thing really resonates with the public.”
Arkes, a legal scholar who founded the James Wilson Institute on Natural Rights and the American Founding, is widely credited for coming up with the idea for the Born-Alive Abortion Survivors Protection Act, which Sasse introduced and was blocked by Senate Democrats last month. He said the legislation should have included a preamble he drafted that set forth a legal theory that new rights the courts found enumerated in the Constitution can be regulated by Congress. He envisioned the legislation as a vehicle for Congress to establish its right to regulate abortion — beginning with protecting infants who survive abortion and slowly asserting its right to legislate overall abortion. Arkes said he had lobbied senators to have his preamble attached to the bill but that they did not want to interfere with Sasse’s version, which didn’t include it.
Senate confirms judicial nominee tied to anti-Obamacare lawsuit. The Senate on Wednesday confirmed Chad Readler 52-47 for a lifetime appointment to the 6th Circuit Court of Appeals in Ohio. Democrats fought the nomination because Readler had worked for the Department of Justice and authored the Trump administration’s decision to side with Republican state officials who have asked the courts to invalidate Obamacare. Democrats therefore cast the decision as a war on Obamacare’s protections for pre-existing illnesses. No Democrat voted to support the nomination. Sen. Susan Collins, R-Maine, joined Democrats and Sen. Joe Manchin, D-W.Va., did not vote. “Every Senate Republican who voted today to confirm Chad Readler to the federal bench made crystal clear their opposition to pre-existing condition protections,” Senate Minority Leader Chuck Schumer, D-N.Y., said in a statement. “The American people were reminded to believe what Republicans do — not what they say, when it comes to these vital health care protections.”
Manchin and Capito urge HHS secretary to give complete physicians complete medical histories of patients. A bipartisan group of senators on Wednesday asked the Department of Health and Human Services to write new rules that would let doctors see all of their patients’ medical records to find out whether a patient has a history of substance abuse. Current regulations requiring multiple consent documents make it hard for doctors to access the information, which results in them sending patients with a history of addiction home with prescription painkillers and increases the chance of overdose and death.
The letter was led by Sens. Joe Manchin, D-W.V., and Shelley Moore Capito, R-W.V., with 11 colleagues signing on. The letter asks for similar measures as a bill they introduced last Congress, called the Protecting Jessica Grubb’s Legacy Act. The bill is named after Grubb, who had remained sober for seven years before undergoing surgery for a running-related injury. Although her parents told doctors that she had a history of addiction, the discharging physician who claimed to not have heard that sent Grubb home with a prescription for 50 oxycodone.
Joint Amazon-JPMorgan-Berkshire Hathaway healthcare venture finally gets a name. The joint healthcare venture created by Amazon, Berkshire Hathaway, and JPMorgan Chase announced its name on Wednesday: Haven. The Boston-based company will work to help the three businesses’ 1.2 million workers and their families better afford prescription drugs and other medical treatment, as well as improve their access to care and make it easier for them to navigate the healthcare system. The organization said it was looking to hire software engineers, data scientists, and clinicians. “We want to change the way people experience health care so that it is simpler, better, and lower cost,” Atul Gawande, Haven’s CEO, said in a statement. “We’ll start small, learn from the experience of patients, and continue to expand to meet their needs.” Gawande, who is also a renowned author and surgeon, has been asking employees from the three companies how their experiences in healthcare have been.
Senate Judiciary power duo demand investigation into allegations of sexual abuse against minors at HHS facilities. A bipartisan power duo from the Senate Judiciary Committee on Wednesday urged HHS’s watchdog to investigate alleged sexual abuse of minors in their facilities at the U.S.-Mexico border. “Recent public reports allege that many cases of sexual assault in child care centers are not fully investigated by HHS,” Sen. Chuck Grassley, R-Iowa, and the panel’s ranking member, Sen. Dianne Feinstein, D-Calif., said in a letter to Inspector General Daniel Levinson. “We find it intolerable and inexcusable that child care operators are not immediately investigating reports.” HHS received 4,556 complaints of sexual assault of unaccompanied minors between 2014 and 2018, according to an internal agency report released last week by Rep. Ted Deutch, D-Fla. In addition, 1,300 complaints were reported to the Department of Justice.
ICE testing 10-year-old migrant girls for pregnancy due to risk of sexual assault. Homeland Security Secretary Kirstjen Nielsen said Wednesday that every female child over the age of 10 is being given a pregnancy test after being taken into custody by federal law enforcement at the border because of the high risk of sexual assault during their journey to the U.S. Nielsen said girls who arrive without parents as part of large smuggled groups or those who travel with their parents are both at risk for being raped while traveling more than 1,000 miles from Northern Triangle countries to the U.S.-Mexico border. The DHS secretary said the leaders of El Salvador, Guatemala, and Honduras have told her they want minors who arrive alone to be returned back to their home countries, but that the U.S. government is legally not permitted to do that because of trafficking laws that seek to protect legitimately trafficked kids.
The Rundown
Washington Post Alabama judge allows man to sue clinic on behalf of aborted fetus
STAT Gottlieb’s replacement? A roundup of likely, possible, and you-never-know contenders
The New York Times Good news: Opioid prescribing fell. The bad? Pain patients suffer, doctors say.
The Hill Departing FDA chief says youth vaping crackdown will continue
Reuters New mothers suffer nerves, guilt as maternity leave ends
Axios Pharma companies hire drug pricing middlemen, too
Calendar
THURSDAY | March 7
House and Senate in session.
March 7-8. Ronald Reagan Building. 1300 Pennsylvania Ave NW. Medicare Payment Advisory Commission meeting. Details.
10 a.m. 138 Dirksen. Senate Aging Committee hearing on “The Complex Web of Prescription Drug Prices, Part II: Untangling the Web and Paths Forward.” Watch live.
10 a.m. 1100 Longworth. House Ways and Means hearing on “Hearing on Promoting Competition to Lower Medicare Drug Prices.” Details.
10 a.m. 2154 Rayburn. House Oversight and Government Reform Committee hearing on “Trump Administration’s Response to the Drug Crisis.” Details.
10:30 a.m. 2358-C Rayburn. House Appropriations Committee hearing on “Addressing the Public Health Emergency of Gun Violence.” Details.
2 p.m. 2141 Rayburn. House Judiciary Committee hearing on “Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Healthcare Markets.” Details.
MONDAY | March 11
Noon. 214 Massachusetts Ave NE. Heritage Foundation event on “Affirming Ethical Options for the Terminally Ill.” Details.
TUESDAY | March 12
Noon. 2123 Rayburn. House Energy and Commerce Committee hearing on the Department Health and Human Services budget. Details.
WEDNESDAY | March 13
March 13-14. America’s Health Insurance Plans health policy conference. Agenda.
10 a.m. 2123 Rayburn. House Energy and Commerce Committee hearing on “Lowering the Cost of Prescription Drugs: Reducing Barriers to Market Competition.” Details.
THURSDAY | March 14
10 a.m. Arkansas Medicaid work requirement oral arguments in the U.S. District Court for the District of Columbia. Kentucky oral arguments follow at 11 a.m.
