Overnight Health Care: Trump officials create new mandate exemptions | Insurance official warns of premium spikes | Dem questions hiring of drug pricing official

Welcome to Overnight Health Care, where senators are back from their spring recess, even though it still feels like winter. (House members fly back tomorrow for evening votes.)

New ObamaCare rule out from the Trump administration—and it rolls back parts of the individual mandate

Nothing says Monday like a new 522-page ObamaCare regulation. Most of these are fairly wonky changes but a few of the highlights below. And the full story is here.

1. New exemptions from ObamaCare’s individual mandate (until the mandate expires altogether next year) for people living in counties with zero or one insurer or people with objections to plans that cover abortion.
2. New flexibility from the law’s Essential Health Benefits, but no drastic changes. They all still need to be covered.
3. New income checks to crack down on people the administration says are wrongly qualifying for the law’s subsidies.
4. While not in the rule, CMS Administrator Seema Verma did not rule out future changes to block the practice known as “silver-loading,” which limits premium increases to certain plans. States have been using that to mitigate President Trump’s decision to cancel key payments to insurers (known as CSRs) last year. Verma said only that the policy is “under review.”

Top insurance official warns of coming ObamaCare premium hikes

Democrats on Monday seized on comments from the incoming head of the insurance lobby AHIP, Matt Eyles.

Eyles blamed several Republican policies, such as repeal of the individual mandate in the tax bill, and new skimpier, cheaper insurance policies known as short-term plans, for coming premium increases.

Key quote: “When you think about things like the individual mandate going away, some of the other proposed rules that are being put in place, whether it be around association plans, short-term policies, it’s just still a nasty soup right now that’s brewing and we’re looking ahead to 2019 and it’s not a really great picture right now.”

Looking ahead: Expect Democrats to make this a big issue in campaigns, especially given premium hikes are expected to be announced in October, shortly before the election.

Read more here.

The FDA announced new restrictions Monday on the sale of Essure, a brand of permanent birth control that has received thousands of complaints over the years.

Essure will now only be sold to health-care facilities that provide full information about the device’s risks and benefits, the FDA said.

The birth control was approved in 2002, but given the strongest safety warning label in 2016. That warning followed thousands of complaints from women who said it caused pelvic pain, hair loss, muscle weakness, perforation of the uterus and other issues. Some women have argued they were never told the potential side effects of using Essure.

Read more here.

A key Democrat is questioning why HHS hired a former pharmacy executive to oversee drug pricing reform.

Rep. Keith Ellison (D-Minn.), in a letter to HHS Secretary Alex Azar, says the hiring of Dan Best poses a potential conflict of interest, because of his previous work at CVS and Pfizer.

“The decision to hire him poses significant potential for conflicts of interest, placing him in a position to make decisions that may pit the income of his former employers against the interests of patients in reducing prescription drug prices,” Ellison wrote in a letter to HHS Secretary Alex Azar.

Looking ahead: We’ll be watching to see if Best divests from any interests related to CVS, Pfizer, or related companies, or any other steps he will take to mitigate potential conflicts of interest. Such conflicts plagued former HHS Secretary Tom Price and former CDC Director Brenda Fitzgerald.

The takeaway:  While lowering drug prices is a bipartisan issue, Democrats aren’t letting President Trump off the hook. Ellison is one of the more liberal members of Congress, and could be trying to ensure Democrats’ voices are heard on drug price reforms.

Read more here.

A leading anti-abortion group in D.C. is taking issue with Pope Francis’ recent comments on abortion, in which he said caring for the poor and destitute is just as important as defending the “innocent unborn.”

The two cannot be equated, said Marjorie Dannenfelser, president of the Susan B. Anthony List.

“It is impossible to equate the moral weight of abortion – the direct killing of innocent unborn children occurring on a daily massive scale, here in America and abroad – with any other social justice issue,” Dannenfelser said.

“We all affirm the absolute dignity of the migrants and those suffering from poverty. How we solve these issues are matters of prudential judgment on which Catholics can disagree. Today’s exhortation blurs lines and causes confusion.”

What we’re reading

The disappearing doctor: How mega-mergers are changing the business of medical care (The New York Times)

To curb rising health insurance costs, some states try ‘reinsurance pools’ (Stateline)

State by state

In key Kentucky House race, healthcare anxieties loom large (Reuters)

Officials laud mental health care changes in Iowa (Sioux City Journal)

An ambitious California bill would put the state in charge of controlling prices in the commercial health care market (Los Angeles Times)

Medicaid work debate gets a Tennessee twist (Roll Call)