Daily on Healthcare: Big Trump administrative changes coming to Obamacare

By | November 8, 2018

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Trump administration rolls back Obamacare’s birth control rule. The Trump administration will exempt employers from providing insurance coverage for birth control if it conflicts with their religious or moral beliefs, scaling back a mandate created by the Obama administration.

The new rule, released Wednesday, will take effect in 60 days and will affect between 6,400 and 127,000 women, according to the Trump administration.

Susan B. Anthony’s List, an anti-abortion group that morally objects to certain types of birth control, praised the change. The group’s president, Marjorie Dannenfelser, in a statement slammed the original rules created by the Obama administration as “repeated violations of conscience” that were “deeply contrary to the core of our nation.” But the American Civil Liberties Union lashed out at the rule, saying it would allow “virtually any employer to claim a religious exemption that enables it to deny any employee insurance coverage for contraception.”

Trump administration to scrutinize Obamacare plans for abortion funding. The Trump administration is set to ramp up enforcement of rules against Obamacare plans paying for abortions. The Centers for Medicare and Medicaid Services released a proposal Wednesday to ensure that Obamacare plans, which the federal government subsidizes, collect separate funds when their policies include abortion coverage.

The rule is likely to provoke a clash with states such as California and Oregon, which obligate all insurers to cover abortions. It also is likely to receive backlash from Democrats, who refused to support a bill to shore up Obamacare earlier this year because it contained language that would have restricted the funding from going toward paying for medical plans that provide abortions. Obamacare includes weaker anti-abortion language than most healthcare laws, rules that are not satisfactory to social conservatives. Obamacare is restricted from paying for abortions through an executive order signed by former President Barack Obama, a concession made in order to win over anti-abortion Democrats to the law.

Another proposal would more closely scrutinize customer subsidies. The proposal released Wednesday also suggested that the agency undertake a more careful review of customer data to make sure that people are appropriately receiving federal subsidies. Insurers have said that people who should be on Medicaid or Medicare, which are both government programs, are being improperly enrolled in the private health insurance marketplace. CMS also noted that certain customers may be enrolled in more than one program. “This administration is committed to making sure taxpayer dollars are spent appropriately,” said CMS Administrator Seema Verma said in a statement. “Maintaining a high level of program integrity on the exchange is essential, including ensuring that premium tax credits only go to those who are eligible for them.”

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Pelosi: ‘Healthcare was on the ballot and healthcare won.’ House Minority Leader Nancy Pelosi declared healthcare the issue that tipped the House of Representatives in favor of the Democrats on Election Day. “Healthcare was on the ballot and healthcare won,” the California Democrat told reporters Wednesday. Pelosi helped pass Obamacare in the House in 2010, shortly after former President Barack Obama took the White House. The law provided ammunition to Republicans for several election cycles, but after the party’s failed attempts to repeal the law, Democrats became comfortable running on the issue. The political strategy had mixed results in the Senate, but Democrats widely said it helped bring them to victory in the House. Pelosi said that after Trump’s victory, Democrats decided to stay united to defend Obamacare. She pointed to the Women’s March, in which people rallied across the U.S. to protest President Trump, as evidence that the public was mobilizing in favor of healthcare policy.

“From the beginning we focused on healthcare,” she said, calling the midterm elections a “resounding victory” against Republican plans for Medicare, Medicaid, and Obamacare.

Democrat Andy Kim declares victory over Obamacare repeal architect Tom MacArthur in New Jersey House Race. Andy Kim has declared victory on Wednesday in his bid to defeat Rep. Tom MacArthur, R-N.J., after a slew of vote-by-mail ballots put him ahead by about 2,600 votes, according to Politico. But MacArthur has yet to concede the race and no major news organization has called it for Kim, a former Obama administration official. MacArthur played a key role in getting Obamacare repeal through the House in May 2017. He engineered a compromise that let states ignore pre-existing condition protections. The compromise brought on board conservatives who wanted to get rid of the protections. But MacArthur’s role in the repeal bill, which died in the Senate, was a major part of Kim’s campaign.

Democrats call for Trump to pull anti-Obamacare lawsuit. Pelosi challenged Republican state officials and the Trump administration to show a sign of “good faith” and “prove” they were committed to protecting patients with pre-existing illnesses by pulling a pending lawsuit on Obamacare. A decision is expected from a federal judge any day and could result in the law being thrown out, or an end to its requirement that insurers cover people with pre-existing illnesses. Senate Minority Leader Chuck Schumer, D-N.Y., also said in a separate press conference that he supported Pelosi’s call to pull out of the lawsuit. “I mean they say one thing that they want to keep pre-existing conditions and on the other hand they support a lawsuit that would get rid of them,” Schumer said, referring to Republicans. “Either come clean and you don’t want to protect pre-existing conditions or drop the lawsuit.”

Leaders suggest they’re willing to work together on drug prices. Pelosi during a press conference Wednesday brought up prescription drug prices as an area in which Democrats could work with Republicans. Trump and Senate Majority Leader Mitch McConnell, R-Ky., both said they were open to a bipartisan deal in this area as well. Trump indicated that having a divided government could work in his favor, saying that instead of resisting any changes, Democrats may come to him with proposals and that they would be able to negotiate. “It really could be a beautiful bipartisan type of situation,” Trump said. Pelosi said the government should set drug prices, a policy that is a nonstarter for Republicans.

Trump suggests he has a secret ‘solution’ to abortion issue. Trump indicated Wednesday that he had a compromise solution between Republicans and Democrats on abortion policy, but wouldn’t elaborate on the plan. “I won’t be able to explain that to you, because it is an issue that is a very divisive, polarizing issue,” Trump said at a press conference following the midterm elections in which Democrats took the House of Representatives. “But there is a solution. I think I have that solution, and nobody else does. We are going to be working on that.” “I’m just going to push, I’ve been pushing,” Trump said when asked a question over how he would advance his “pro-life agenda.” “I’ve done a very good job, too. We’re very happy with me.”

Fearing House Democrats, anti-abortion groups seek to protect ban on abortion funding. Anti-abortion groups fear that Democrats taking the majority in the House of Representatives next year will pursue a long-held goal of allowing federal funding for abortion by ending the Hyde Amendment, language barring funding for abortion regularly attached to spending bills. “The pro-life movement cannot be complacent,” Marjorie Dannenfelser, president of the anti-abortion group Susan B. Anthony’s List, said in a statement Wednesday. “We must be prepared to fight to hold the line on important pro-life policies such as the Hyde Amendment.” Hyde, though, is protected by the GOP Senate majority and the fact that Democrats and abortion rights groups haven’t indicated that they’ll attack it.

Nearly 400,000 sign up for Obamacare in first three days of enrollment. Healthcare.gov saw 371,676 people select health insurance plans during the first three days of open enrollment, according to data provided Wednesday by the Centers for Medicare and Medicaid Services. Comparisons are inexact, in part due to national attention on the midterm elections, but enrollment appears to be slightly behind last year, when more than 600,000 people signed up for plans during the first four days of enrollment.

Montana voters reject nicotine tax as funding for Medicaid expansion. The tobacco industry was successful in urging voters to reject a $ 2-a-pack cigarette tax and 33 percent tax on other nicotine products, including e-cigarettes, to make Montana’s Medicaid expansion permanent. Without funding, as many as 90,000 people in the state risk losing Medicaid. The industry spent nearly $ 18 million fighting against the tax through a political action committee dubbed Montanans Against Tax Hikes.

‘Best Congress we’ve ever had’ for marijuana legalization, Democrat says. Whether congressional elections were better for Democrats or Republicans may be up for debate, but they were a clear win for cannabis. Not only did three states — Utah, Missouri, and Michigan — legalize some use of marijuana, voters “have given us the best Congress we’ve ever had” as far as easing federal restrictions on the drug, Rep. Earl Blumenauer, an Oregon Democrat who captured 73 percent of the vote in his district, told reporters on Wednesday. Rep. Pete Sessions, a Texas Republican long viewed as a major obstacle to laws easing a federal ban on marijuana, lost his bid for re-election, Blumenauer noted, and House Speaker Paul Ryan, R-Wis., and Virginia Republican Rep. Bob Godlatte, who chaired the Judiciary Committee, didn’t seek re-election. Not only is American support for legalizing cannabis — which critics have long decried as a gateway to abuse of harder drugs like cocaine and heroin — at an all-time high, Canada began allowing the use, possession, and sale of marijuana last month.

32 states have legalized medical marijuana and 10 will let you smoke it. Marijuana policies remained a hot issue for voters in the 2018 elections, with several states joining the roster of those that have already legalized pot either for recreational or medical use. Of the four pot policies that were voted on in Michigan, Missouri, North Dakota, and Utah, all but one received majority support. Two-thirds of states have passed laws allowing medical marijuana. Missouri and Utah became the 31st and 32nd states to join those ranks Tuesday. Michigan became the 10th state — and the first in the Midwest — to allow recreational use. The others are Washington, Oregon, Nevada, California, Alaska, Colorado, Michigan, Vermont, Maine, and Massachusetts. Former White House communications director Anthony Scaramucci said in a recent interview he believes President Trump will legalize pot on a national level during his time in office.

Missouri tax on medical marijuana will fund veterans’ healthcare. Missouri voters on Tuesday decided to legalize medical marijuana and to use revenues from the 4 percent tax to fund healthcare services for military veterans. The version that was approved beat out an alternative proposal to fund veterans’ healthcare with a 2 percent sales tax, or fund biomedical research through a 15 percent sales tax.

Frank Pallone announces bid to chair House Energy & Commerce Committee, which has authority over health issues. Rep. Frank Pallone, D-N.J., a top congressional foil of Republican attempts to replace Obamacare, announced a bid Wednesday to lead the House Energy and Commerce Committee by calling for preserving net neutrality and tackling high drug prices. Pallone has served as the top Democrat on the committee since 2015 and has served on the committee since 1992. “Next year, we will follow through on pushing policies that build a stronger economy, create more good-paying jobs and protect consumers from skyrocketing costs that make it increasingly difficult to make ends meet,” Pallone said in a statement.

RUNDOWN

The Hill Dem overtures to Trump on drug pricing worries pharma industry

STAT News Bob Hugin concedes defeat, but doesn’t concede his pharma background played a role

New York Times When Medicaid expands, more people vote

Politico Here come the Roe v. Wade challenges

Kaiser Health News Midterm election boosts Medicaid expansion, but challenges remain

Boston Globe In defeat, ballot question raises awareness of nurse stress and burnout

CNBC Health experts propose a red meat tax to recoup $ 172 billion in healthcare costs

THURSDAY | Nov. 8

11 a.m. Food and Drug Administration advisory meeting on vaccines and related biological products. Details.

Nov. 8-9. Capital Hilton. Health and Human Services Secretary Alex Azar to deliver remarks 10:15 a.m. Nov. 8. Agenda.

FRIDAY | Nov. 9

12:30 p.m. National Press Club. 529 14th St. NW. Luncheon with Veterans Affairs Secretary Robert Wilkie. Details.

SATURDAY | Nov. 10

Nov. 10-13. National Harbor. American Medical Association Interim Meeting of the House of Delegates. Details.

Nov. 10-14. San Diego. American Public Health Association Annual Meeting. Details.

MONDAY | Nov. 12

Nov. 12-14. Washington Hilton. National Association of Medicaid Directors fall conference. Agenda.

WEDNESDAY | Nov. 14

Nov. 14-16. Renaissance Washington. U.S. News & World Report Hospital of Tomorrow conference. Agenda.

8:30 a.m. Ritz-Carlton Hotel. Hatch Center Policy Symposium on “The Root of the Issue: America’s Social Determinants of Health.” Details.

THURSDAY | Nov. 15

8 a.m. Ajax. The Atlantic event on “A Generation in the Middle.” Details.

9 a.m. Heritage Foundation Anti-Poverty Forum. Agenda.

Healthcare