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Senate to start debate on spending bill — here are the key healthcare items. The Senate will start debate on a major appropriations bill that lumps in funding for defense and several federal agencies including the National Institutes of Health and Health and Human Services. Here are some top health highlights from the ‘minibus:’

• NIH gets another big boost. The NIH will get a nearly $2 billion increase over its current funding levels, the latest boost for the popular research agency. Congress has increased funding by $9 billion since 2013, a 30 percent increase. Sen. Roy Blunt, R-Mo., touted the increase in funding to Alzheimer’s research on the Senate floor Wednesday. “This bill, for the first time, reaches a long-held goal of the National Plan to Address Alzheimer’s disease of getting that annual research dollars up over $2 billion. In fact, it’s $2.34 billion, exceeding what it had been the long-term goal.”
• Bill includes targeted funding to fight opioid epidemic. The bill has $1.5 billion for grants to states to combat opioid abuse. “There’s more money for community health centers to expand behavioral health and substance abuse disorder services,” Blunt said.
• Durbin pushes amendment to get drug companies to add prices to TV ads. It remains unclear what amendments to the “minibus” will definitely get a vote on the floor, but Sen. Dick Durbin, D-Ill., made the case for his amendment to install a part of the Trump drug pricing blueprint. Durbin said that a senator in the pocket of the pharmaceutical industry is blocking the amendment that would to force drug companies to disclose the price of their products in TV ads. He refused to name the senator.
• Planned Parenthood defunding amendment blocked. Senate leaders blocked an amendment from Sen. Rand Paul, R-Ky., to defund Planned Parenthood. Senate GOP leadership was worried that the amendment could be a “poison pill” and blocked it from being considered in the “minibus.

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Opiod bill update. The bill, called the Synthetics Trafficking and Overdose Prevention (STOP) Act, is one of several that the Senate is expected to take up in the coming weeks. Sen. Lamar Alexander, R-Tenn., who is shepherding the bills along in the Senate, told reporters Wednesday that the goal is to take up the bills the first week after the Senate returns from it’s Labor Day recess.

Federal watchdog bashes Trump administration’s oversight of Obamacare exchanges. The Trump administration has to do a better job of managing Obamacare’s insurance exchanges after it cut outreach funding, the Government Accountability Office found. The federal watchdog recommended on Thursday that the administration set a goal for enrollment signups, a move the Obama administration did every year but the Trump administration eschewed. The Trump administration cut outreach funding for 2018 open enrollment to $10 million from $100 million in 2017. It also reduced funding by 42 percent for navigators, nonprofits that sign up people for Obamacare. Democrats and Obamacare allies charged the moves by the Trump administration were acts of “sabotage” to undermine the law. While the Trump administration also said it wanted to improve the user experience on healthcare.gov, “it did not measure aspects of the consumer experience it had identified as key in 2017, such as successful outreach events,” the report said.

Chinese nationals charged for manufacturing deadly drugs that led to two American deaths. Two Chinese nationals have been indicted for their role in manufacturing and selling deadly drugs in 37 states and a minimum of 25 countries, the Justice Department announced Wednesday. The men — Fujing Zheng and his father Guanghua Zheng — were also accused of selling drugs that led to deadly overdoses of two Americans in Akron, Ohio, according to the 43-count indictment that was unsealed on Wednesday. The men face a variety of charges such as conspiracy to manufacture and distribute controlled substances, conspiracy to import controlled substances into the U.S., operating a continued criminal enterprise, money laundering, among other charges. The indictment outlines that the men used multiple companies to manufacture and distribute drugs such as fentanyl analogues, and established websites to promote the illegal drugs in more than two dozen languages. A Senate probe released earlier this year found that it is incredibly easy to buy fentanyl online from overseas. President Trump earlier this week called on the Senate to take up a bill to give the U.S. postal system more tools to identify and seize suspicious shipments of illicit fentanyl.

Federal court strikes down Alabama abortion law. A federal appeals court found Wednesday that an Alabama state law that bans a common abortion procedure is unconstitutional, becoming the first appeals court to weigh in on such a ban. The ruling issued Wednesday by the U.S. Court of Appeals for the 11th Circuit pertains to a 2016 state law banning a procedure called dilation and evacuation, which is used in second trimester abortions done between the 15th and 18th weeks of pregnancy. No federal appeals court had previously decided on the constitutionality of banning dilation and evacuation, according to the American Civil Liberties Union, which fought the law.

Facing attacks, North Dakota GOP hopeful pledges support for pre-existing conditions. North Dakota Republican Senate candidate Kevin Cramer fended off attacks from his Democratic opponent by committing Wednesday to ensuring health insurance coverage for people with pre-existing conditions. His remarks provided a preview for how Republicans could respond to election-time criticism that they want to gut health insurance protections for sick people, one of the most popular parts of Obamacare. Democrats believe healthcare will be a winning issue for them in the 2018 midterm elections, thanks to the unpopularity of Republicans’ Obamacare repeal efforts.

Dialysis patients fight back against insurers seeking to cut offset in opioid bill. A dialysis patient advocacy group is bashing insurers for opposing an offset in an opioid bill that forces the insurer to pay more for dialysis treatment. The Dialysis Patient Citizens group sent a letter to Senate leaders on Wednesday over an offset in a bill intended to fight the opioid epidemic. The bill would redirect Medicare funds that cover kidney care services like dialysis to instead cover addiction treatment programs. The bill looks to private plans to cover the loss of the funds. Currently, under federal law, employer-based plans are responsible for kidney care for 30 months. After that period, Medicare becomes the primary payer. However, the House bill would extend that timeframe to 33 months starting in 2020. A collection of insurance groups told the Senate that they would be forced to cut coverage or benefits if they have to pay the extra three months. But it is “disingenuous and hypocritical to claim that allowing ESRD patients to remain on their private plans for an additional three months could force them to increase premiums or reduce coverage to the broader population,” said Hrant Jamgochian, the group’s executive director in a statement. The bill, which includes numerous reforms to Medicare and Medicaid to combat opioid abuse, passed the House in June and the Senate is expected to take it up next month.

Senate bill to ensure dental coverage for children born with abnormalities and birth defects. A bipartisan duo of senators introduced a bill to ensure dental coverage for babies born with a congenital defect, birth abnormality or disorder. The bill from Sens. Tammy Baldwin, D-Wis., and Joni Ernst, R-Iowa, would close gaps in dental coverage for such babies. “while health insurance plans provide coverage for most treatments and procedures for these conditions, claims for dental and oral-related procedures for congenital defects or birth abnormalities are typically denied,” a release on the bill said. “The Ensuring Lasting Smiles Act would close this coverage gap.” Ernst joined Baldwin in supporting the legislation after meeting a family in Iowa whose six-year-old daughter was diagnosed with a rare abnormality that caused misplaced and missing teeth, with no insurance coverage to pay for providing functional teeth.

Insurers, patient groups want FDA to finalize guidance that could boost use of biosimilars. A collection of insurers, pharmacies, hospitals and patient groups is clamoring for the Food and Drug Administration to finalize a regulatory guidance that could proliferate the use of biosimilars, which are cheaper versions of pricey specialty drugs. The collection of groups sent a letter to FDA Commissioner Scott Gottlieb Thursday on guidance for how a biosimilar could be interchangeable with a biologic drug. Interchangeability means that a pharmacist could substitute a biologic prescription for a biosimilar at the pharmacy. Currently a pharmacist can interchange a generic drug for a brand name product, but can’t do the same thing for a biosimilar. The FDA has approved 12 biosimilar products, but only three have made it to market and none have been deemed interchangeable with the reference product. “We are concerned that this continued dynamic will discourage further investment from biosimilar developers, and ultimately reduce the number of interchangeable biologics on the market,” the letter said. A proposed regulatory guidance on biosimilar interchangeability was released in January 2017 but it hasn’t been finalized yet. Patient advocacy groups Public Citizen and Patients for Affordable Drugs signed on to the letter. As did pharmacy chain CVS, insurance groups such as America’s Health Insurance Plans and the major hospital group American Hospital Association.

RUNDOWN

Axios Healthcare execs homing in on Amazon

Tennessean After years of price hikes, Obamacare will likely be cheaper next year across Tennessee

The Hill Dem Senate candidate in Arizona opposes Medicare for All

Reuters Life expectancy declines in U.S. and other high-income countries

STAT News Medicare struggles to even set the agenda as it weighs how to pay for CAR-T therapies

NPR NYU’s move to make medical school free for all gets mixed reviews

Kaiser Health News A black eye for Blue Shield: Consumers lash out over coverage lapses