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Key Obamacare lawsuit to be argued just ahead of midterm elections. The Trump administration will be asking a federal court to strike down key Obamacare regulations protecting patients with pre-existing illnesses just two months before the midterm elections.  A judge has set the oral argument for Sept. 10 for the case, filed in the U.S. District Court for the Northern District of Texas. The date is also roughly six weeks before Obamacare’s Nov. 1 open enrollment, during which certain customers can sign up for coverage that is subsidized by the federal government while others are expected to learn they will be facing stiff premium hikes. Democrats have made the Obamacare lawsuit a centerpiece of their attacks against Republicans and President Trump. They argue that the party is intent on “sabotaging” Obamacare, including the more popular parts of the law. They also have warned that the case could make it to the Supreme Court under a new makeup and further threaten Obamacare regulations. The lawsuit is the result of a suit filed by 20 states, arguing that because the tax bill signed into law by Trump late last year eliminated the Obamacare penalties for going uninsured beginning in 2019, the individual mandate can no longer be justified as a constitutional exercise of taxing power and thus must fall, along with the rest of the law. Instead of defending Obamacare, lawyers for the Department of Justice agreed with the plaintiffs that Obamacare wasn’t constitutional, but specifically asked the court to strike down the regulations requiring insurers offer coverage to people with pre-existing conditions, such as cancer or diabetes, without charging them more. These parts, the Trump administration is arguing, cannot be severed from the individual mandate that requires most people to obtain healthcare coverage.

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Kavanaugh to meet with two red-state Democrats today. Supreme Court nominee Judge Brett Kavanaugh on Wednesday will meet with a pair of Senate Democrats who could break with their leadership and vote to confirm him. White House officials said Kavanaugh is scheduled to meet with Sens. Joe Donnelly, D-Ind., and Heidi Heitkamp, D-N.D., on Wednesday afternoon in the offices of the lawmakers. It will mark Kavanaugh’s second and third visit with Democrats — he met with Sen. Joe Manchin, D-W.Va., last month. Manchin, Heitkamp, and Donnelly represent states that voted for Trump by double digits, and all three are up for re-election in November. The trio voted for Supreme Court Justice Neil Gorsuch in 2017 and are considered the most likely Democrats to break with the party leadership and support Kavanaugh. Republican leaders said they aim to confirm Kavanaugh in time for the Oct. 1 start of the court’s next term. But Democratic leaders say the GOP is rushing the confirmation process.

Abortion rights groups hold rally Wednesday as part of anti-Kavanaugh tour. Planned Parenthood and several  off a national tour called “Rise up for Roe” with a rally Wednesday featuring Sen. Kirsten Gillibrand, D-N.Y., to fight Supreme Court pick Brett Kavanaugh. The rally is part of a 10-city, 14-day national tour that kicked off on Sunday. Demand Justice Initiative and NARAL Pro-Choice America are teaming up with Planned Parenthood Action fund for the tour. The series of rallies is the latest effort by abortion rights groups to halt Kavanaugh’s nomination. It also comes to D.C. the same day that Kavanaugh is expected to meet with several red state Democrats. Confirmation hearings for Kavanaugh are expected next month, and Republicans hope to hold a confirmation vote in October.

Arkansas residents sue to turn over Medicaid work rules. A group of three Arkansas residents sued in federal court Tuesday to end Arkansas’ Medicaid work requirements, the latest court challenge to the controversial rules. The lawsuit, filed in the U.S. District Court for the District of Columbia, claims that the work requirements for able-bodied residents in the state were put in place without congressional approval and violate the Constitution. “Almost 60 percent of people covered by Medicaid expansion in the state already work, and nearly all the rest either have a disability or look after family,” said Ken De Liban, an attorney with Legal Aid of Arkansas, one of three groups representing the plaintiffs. The lawsuit charges that the administration’s bid to expand work requirements to able-bodied Medicaid beneficiaries is part of an effort to undermine Obamacare and thus violates the constitutional requirement for the executive branch to faithfully execute the nation’s laws. It also charges that the administration doesn’t have the authority to impose the work requirements without Congress. Furthermore, the lawsuit claims that the mandatory online reporting system for the requirements unfairly kicked some beneficiaries out of the program.There were 7,464 people who didn’t satisfy the reporting requirements, the state said. The state’s Medicaid program covers nearly 1 million people.

Arkansans hopes for same success as Kentucky lawsuit. The lawsuit comes after a federal judge in June rejected Kentucky’s work requirement program. A group of 15 Medicaid beneficiaries in Kentucky filed the lawsuit. The National Health Law Program and Southern Poverty Law Center represented the plaintiffs in that lawsuit and are joining Legal Aid in representing the Arkansas plaintiffs. The judge found that Kentucky’s push for work requirements didn’t consider whether it would bring medical care to citizens, one of the goals of the program.

PBMs push back that rebates are to blame for high drug prices. The pharmacy benefit manager lobby released a report Wednesday to push back on the Trump administration’s assertion that drug rebates are a key driver of high drug prices. The Pharmacy Care Management Association released a report on Wednesday that rebates aren’t a factor in a drug maker’s decision to set high prices. A drug maker and PBM, which oversees drug plans for employer and union-sponsored health plans, negotiate rebates with drug makers to lower the cost of prices. But the administration charges that the rebate system creates a perverse incentive for high list prices because the insurers and PBMs get a cut of the rebate and therefore only will cover drugs that have higher list prices in order to get a higher rebate. The report from PCMA looked at brand name drugs sold on Medicare Part D, the program’s prescription drug plan, and Medicare Part B which reimburses for drugs administered in a doctor’s office like a vaccine or chemotherapy. It said that a large number of prescription drugs that have “extraordinary” drug prices are in Medicare Part B, where private plans and PBMs don’t negotiate for rebates. The report references the chemotherapy drug BiCNU increased from $391 in 2012 for Medicare Part B to $8,530, an increase of 2,084 percent. The report comes as the administration is considering nixing the rebate system via a proposed rule that is yet to come out.

Ron Wyden pursues answers on oversight of nursing homes. The Trump administration needs to change how it regulates nursing homes in light of a report that found most homes overstated their staff numbers, Democrat Ron Wyden said Tuesday. The Oregon senator sent a letter Tuesday to Centers for Medicare & Medicaid Services Administrator Seema Verma calling for reform of the star rating used to judge nursing homes as a response to the New York Times report published last month. Wyden, the top Democrat on the Senate Finance Committee, said that the New York Times story calls into question how CMS gets data for quality measures, which is self-reported by nursing homes. He cited the problems with getting staff data detailed in the New York Times story as a reason to fear that other data might be bad.

Trump signs bill into law funding medicines for animals. President Trump has signed a bill into law that extends a program funding medicines for pets and livestock. The legislation, collectively known as the Animal Drug and Animal Generic Drug User Fee Amendments of 2018, or ADUFA, charges fees for drug and device applications and uses that money to speed up their review. That way, products can head to market faster, and animal owners can have less expensive or more effective drugs to use on animals who fall ill. The measures are directed at both generics and the animal equivalent of brand-name drugs, and are part of the Food, Drug, and Cosmetic Act, the law that gives the FDA its power. The latest version of the user fee bill directs FDA to give drugmakers more information about what kind of data it can accept when it reviews drug applications, and will require drugmakers to submit applications electronically starting Oct. 1. The user fees will also increase, which will help speed up the approval of medicines.

Trump signs law giving suicide lifeline a makeover. President Trump has signed a bill into law that aims to reduce the suicide lifeline from 10 digits to three. The legislation, the National Suicide Hotline Improvement Act, directs government agencies to look into changing the current National Suicide Prevention Lifeline number, 800-273-TALK, to three digits that people can easily remember. The idea is to come up with a number people can recall when they are in a crisis situation, as they do with 911. The bill was passed unanimously by both the Senate and House at a time when federal data revealed that suicides in the U.S. have risen by more than 30 percent since 1999, surpassing 45,000 in 2016. Suicide is the 10th-leading cause of death in the U.S., according to the Centers for Disease Control and Prevention. Among 15- to 19-year-olds, it is the second-leading cause of death.

Advocates skewer FDA over ‘junk science’ blaming kratom for deaths. The Food and Drug Administration falsely blamed kratom for deaths that can instead be linked to other drugs, a suicide, tainted products, or other medical conditions, kratom advocates alleged in a new white paper released Tuesday. The American Kratom Association accused the Food and Drug Administration of deliberately publishing “junk science” in a report laying out 44 deaths associated with the Southeast Asian tea leaf kratom. The FDA, the paper alleges, is pushing a false narrative in order to have kratom banned in the U.S. To arrive at its conclusions, the American Kratom Association combed through death certificates and offered a counter-explanation for each. The deaths occurred over the course of nine years. The research suggests that while people may have taken kratom, other factors killed them. Certain death certificates, for instance, showed that people had been abusing other drugs at the same time or took powdered kratom that contained toxic chemicals. One of the deaths was attributed to falling through a window, another was a homicide in which someone was shot in the chest, and another involved a person suffering a heart problem while swimming. The group also found two instances where deaths were reported twice.

In rare move, Nevada to run own Obamacare marketplace. Nevada will run its own Obamacare insurance exchange starting in 2020, becoming the first state under the Trump administration to leave the federally run healthcare.gov that 38 states ues. Nevada Health Link, the state’s insurance marketplace, announced on Tuesday a contract with the company GetInsured to set up the state-run insurance marketplace starting for the 2020 coverage year. GetInsured currently operates the health insurance marketplaces in seven other states. Some states, like Nevada, operate their own marketplace but use the healthcare.gov platform for residents to sign up for Obamacare. Nevada will no longer use healthcare.gov starting in 2020, mainly to save money. By operating its own marketplace, the state would pay an estimated $5.1 million, compared to the $13.2 million it would owe under healthcare.gov.

Maine rejects new applicants for Medicaid expansion. Maine is rejecting applicants for coverage under the Medicaid expansion while a lawsuit rages over the expansion, according to a report in the Portland Press Herald. The rejection comes after Republican Gov. Paul LePage declined to install the expansion after voters approved a ballot measure last year. LePage’s decision is currently being challenged in court. The nonprofit group Maine Equal Justice Partners encouraged people to apply for Medicaid, but the Press Herald said it isn’t known how many have done so. The group said that it discovered several people who got denial letters from the state’s health department saying they were ineligible for coverage.

DC sued over failure to help children with mental health troubles. Hundreds of emotionally troubled children have been placed into “harmful and unnecessary” detention centers or psychiatric facilities because the District of Columbia failed to help them as required under federal law, according to a class action lawsuit filed Tuesday. The lawsuit, filed by mental health and disability groups in the U.S. District Court of the District of Columbia, was advanced on behalf of two teenage girls with mental health diagnoses, and encompasses as many 300 children up to the age of 21 who similarly did not receive care.The lawsuit accuses D.C. of failing to provide children with mental health disorders with social and medical services in their homes, neighborhoods, or at school, an arrangement required under federal law.

Nebraska the first to use fentanyl to carry out death penalty. Nebraska has executed convicted murderer Carey Dean Moore with fentanyl, the drug responsible for accelerating overdose deaths across the U.S. during the nation’s opioid crisis. States have limited access to lethal injection drugs because they have become heavily controlled by pharmaceutical companies that do not want their products associated with the death penalty. Opponents of the death penalty also have argued that lethal injection constitutes “cruel and unusual punishment” because in some cases inmates do not die right away, and instead show signs of suffering. Officials executed Moore on Tuesday using a combination of four drugs that haven’t been used before, including fentanyl as well as the sedative diazepam, the muscle relaxant cisatracurium, and potassium chloride.

RUNDOWN

Axios Doctors argue that Cuba ‘sonic attacks’ may have been mass hysteria

The Hill New York becomes 27th state to sue opioid maker Purdue Pharma

Wall Street Journal Insurer stops reimbursing for some MiMedx products

Kaiser Health News States leverage federal funds to help insurers lower premiums

STAT News Tapered to zero: Oregon’s Medicaid program weighs cutting off chronic pain patients from opioids

Associated Press Medical device maker settles suit over psychologist’s death

Stateline For addicted women, the year after childbirth is the deadliest