Daily on Healthcare: Trump’s healthcare agenda dealt another blow

TRUMP’S HEALTHCARE AGENDA DEALT ANOTHER BLOW: A federal judge has struck down a rule letting individuals and small businesses pool together to buy health insurance, threatening a program the Trump administration facilitated as an escape hatch from high Obamacare premiums.

The ruling, issued Thursday by U.S. District Judge John Bates, an appointee of former President George W. Bush, came after 11 states and the District of Columbia sued saying that the rules violated Obamacare and the Employee Retirement Income Security Act, or ERISA.

Bates agreed, concluding in his opinion that the rule, issued by the Department of Labor, was “clearly an end-run around” Obamacare. He also stated the Trump administration didn’t have the authority under ERISA to change the rules.

It was not immediately clear whether the administration’s up-and-running alternatives, known as “association health plans,” would still be allowed to operate. Bates in his ruling asked the Department of Labor to state whether any part of the rule could still stand.

So far, association health plans have been covering the same benefits that Obamacare plans do, even though they are not obligated to, according to analyses by the industry publication Modern Healthcare and another by AssociationHealthPlans.com.

But critics have warned it is too early to conclude these benefits would remain. Unlike Obamacare, the plans are allowed to charge people more based on their health status, and prices could increase for next year. People who have pre-existing conditions, such as cancer or diabetes, can be asked to pay higher premiums that lead them to be priced out of the plans entirely.

Health insurers have been allowed to run the plans since September 2018, and association-created coverage was only allowed beginning in January 2019. New associations that form were supposed to kick off in April.

Obamacare had ended association health plans to encourage more people to go into the exchanges and also because past plans had become insolvent, leaving people holding the bag for costly medical expenses.

Good morning and welcome to the Washington Examiner’s Daily on Healthcare! This newsletter is written by senior healthcare reporter Kimberly Leonard (@LeonardKL) and healthcare reporter Cassidy Morrison (@CassMorrison94). You can reach us with tips, calendar items, or suggestions at [email protected]. If someone forwarded you this email and you’d like to receive it regularly, you can subscribe here.

TRUMP DOUBLES DOWN ON HEALTHCARE: “The Republican Party will become the Party of Great HealthCare! ObamaCare is a disaster, far too expensive and deductibility ridiculously high – virtually unusable! Moving forward in Courts and Legislatively!” President Trump tweeted Thursday. The White House later released a statement saying that the Republican healthcare plan would address pre-existing illnesses, high prices for prescription drugs, and surprise medical bills.

The White House also attacked Democrats, saying that the party was planning a “total takeover” of healthcare by offering legislation that would force everyone to enroll in government policies. Such a plan, detailed in the Medicare for All Act, is supported by 107 House Democrats and nearly every Democratic senator running for president, but doesn’t have the support of Democratic House leaders.

Still, it illustrates how Republicans will attack the opposing party on healthcare: By warning voters that if they elect Democrats then they will see their current coverage taken away. Democrats have a similar argument about Republicans, focusing specifically on the danger the party faces in protecting pre-existing illnesses.

TRUMP SAID HE ASKED GOP SENATORS TO CRAFT OBAMACARE REPLACEMENT PLAN: Trump said Thursday that he has asked a group of Republican senators to come up with a replacement for Obamacare. The contingent of four or five senators tasked with working on an alternative healthcare proposal includes Sens. John Barrasso of Wyoming, Rick Scott of Florida, and Bill Cassidy of Louisiana, Trump told reporters before departing the White House for a rally in Grand Rapids, Mich.

“They are going to work together, come up with something that’s really spectacular, maybe we will even get support in the House from Democrats,” Trump said. “But it’s going to be far better than Obamacare.”

SCOTT INTRODUCES AMENDMENT TO PROTECT PRE-EXISTING CONDITIONS: Scott on Thursday introduced an amendment that would offer health insurance protections to people with pre-existing illnesses. The amendment came during a budget hearing and says it would provide funding “related to supporting congressional efforts to preserve pre-existing condition protections with respect to health insurance.”

SCOTT INTRODUCES DRUG TRANSPARENCY BILL: Scott then on Friday introduced the Transparent Drug Pricing Act, which obligates pharmacists to tell patients whether paying for a medicine out of pocket would be cheaper than using their health insurance to buy it. If patients do pay out of pocket, then the amount they pay would go toward their deductible. The bill also obligates insurance companies list how much drug prices will be two months before people enroll in plans, and blocks drug companies from charging more in the U.S. than they do in other developed countries.

ARKANSAS URGES TRUMP ADMINISTRATION TO QUICKLY APPEAL MEDICAID WORK RULES: Arkansas Gov. Asa Hutchinson is asking the Trump administration appeal a federal judge’s decision to strike down the state’s Medicaid work requirements. “I remain fully committed to the work requirement and we are in this for the long haul because we believe it is the right policy,” Hutchinson, a Republican, said in a press conference Thursday.

Hutchinson said that he thought Judge James Boasberg’s ruling striking down the work rules was wrong, and that he had just gotten off the phone with members of the Trump administration, who remained committed to the program.

Trump administration mum on whether it will appeal: The Department of Health and Human Services confirmed that the phone call took place with Deputy Secretary Eric Hargan and other officials. Caitlin Oakley, HHS spokeswoman, said that no appeals decisions had been made yet and referred the Washington Examiner to the Department of Justice, which will make the decision. DOJ declined to comment. Seema Verma, administrator for the Centers for Medicare and Medicaid Services, said in a statement that her agency “will continue to defend our efforts to give states greater flexibility to help low income Americans rise out of poverty.”

Next steps: If DOJ does appeal, the case is likely to go before the U.S. Court of Appeals for the District of Columbia, and then may go to the Supreme Court. For now, the requirement to report work in Arkansas is no longer in effect, Hutchinson said.

TRUMP PICK WITHDRAWS FROM NUMBER THREE SPOT AT DOJ OVER ROLE WITH PRO-ABORTION GROUP: Jessie Liu removed herself from consideration for associate attorney general at the Department of Justice Thursday after Sen. Mike Lee, R-Utah, opposed her ties to the National Association of Women’s Lawyers, NBC News reported. Years ago she served as vice president and president-elect of the group focused on supporting women lawyers and legal issues that affect women, including abortion rights.

GOTTLIEB ADDRESSES CONCERNS ABOUT FENTANYL, E-CIGARETTES IN FINAL HEARING BEFORE EXIT:

FDA doesn’t have full control over fentanyl coming in from China: Outgoing Food and Drug Administration Commissioner Scott Gottlieb said in his final Appropriations Committee hearing Thursday that the government was struggling to control the influx of illicit fentanyl through the mail, the vast majority of which comes from China. “I don’t know that I can tell you that we really have a handle on [fentanyl coming from China],” he said. “I can’t even tell you that we have a full measure of the scope of the challenge for us, the government.”

More actions on vaping may not come until the summer: Sen. Tom Udall, D-N.M., asked about removing all flavored e-cigarettes from the market until FDA review. Gottlieb said any motion to remove the products must wait for the 2019 Youth Tobacco Survey set to be released this summer, which would reveal whether uptake among teens had gone up or down.

BIG PHARMA LAMENTS OPIOID EPIDEMIC BUT SAYS IT’S NOT TO BLAME: Purdue Pharma, the maker of OxyContin, and Janssen Pharmaceuticals pushed back on Thursday against New York Attorney General Letitia James’s claims that manufacturers engaged in years of misleading marketing, masking chances of addiction, and targeting doctors who could prescribe the medication and pharmacists who could hand it out. The allegations by James, made in a lawsuit filed in Suffolk County Supreme Court on Thursday, mark the latest twist in efforts by state and federal regulators to stem abuse that claims about 130 lives in the U.S. every day, including nine in the state of New York.

PROTECT OUR CARE HITS TRUMP FOR LEGAL ASSAULT ON OBAMACARE: Protect Our Care, an advocacy group dedicated to preserving the Affordable Care Act, released a video Thursday contrasting Trump’s recent announcement to undermine Obamacare in the courts with Democratic attempts to improve and support it, especially is protections for those with pre-existing conditions.

CDC LAUNCHES NATIONAL FIREFIGHTER REGISTRY: The Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health has launched a voluntary registry to conduct research into health and safety risks for firefighters nationwide. NIOSH wants in put to help study chronic illnesses that firefighters are susceptible to, including cancers and mesothelioma. NIOSH began researching deaths due to on-the-job exposure in 2010.

MEDICARE PART D ENACTS SAFETY MEASURES FOR OPIOID PRESCRIPTIONS: The Centers for Medicare and Medicaid Services has enacted a new policy for Medicare Part D beneficiaries to prevent misuse of opioids. Most significantly, pharmacists will monitor the quantity of pills prescribed and decide not to fill prescriptions for dangerous drug combinations.

A MEDICAL FIRST: HIV-POSITIVE PATIENT RECEIVES KIDNEY FROM HIV-POSITIVE DONOR: A Johns Hopkins Medicine team completed the first-ever living donor HIV-to-HIV kidney transplant on Monday. People living with HIV haven’t been able to donate kidneys until now, because there were worries that HIV was too much of a risk factor for kidney disease in the donor. However, the doctors’ recent research on people living with HIV showed that the new prescription treatments for HIV are safe for the kidney, and that those with well-controlled HIV have basically the same risks as those without HIV and are healthy enough to donate kidneys. The doctors say both the donor and the recipient are doing well.

OPINION: TRUMP DEALT LEGAL BLOW IN MUCH MORE IMPORTANT OBAMACARE CASE

The Rundown

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Stat North Dakota doesn’t have enough psychiatrists. Telemedicine is helping to fix that

Kaiser Health News Doughnut hole is gone, but medicare’s uncapped drug costs still bite into budgets

Modern Healthcare Senate bill on health homes for kids put on hold again

Los Angeles Times Californians continue to sour on death penalty, poll finds, feeding momentum to end it

Calendar

FRIDAY | March 29

March 26-29. St. Louis. National Association of County and City Health Officials preparedness summit. Details.

MONDAY | April 1

April 1-2. Sheraton Pentagon City Hotel. AIDSWatch meeting. Details.

TUESDAY | April 2

10:15 a.m. 2175 Rayburn. House Education and Labor Committee Health Subcommittee to hold hearing on surprise medical bills. Details.

10:30 a.m. 2322 Rayburn. House Energy and Commerce Committee to hold hearing on the rising cost of insulin. Details.

WEDNESDAY | April 3

9 a.m. 1789 Massachusetts Ave NW. Sen. Bill Cassidy, R-La., discusses paid family leave with the American Enterprise Institute. Details.