Overnight Health Care: Deadline to reunite migrant children nears | Hundreds of children remain separated | Trump officials won’t give up on Medicaid work rules | Modest premium hikes complicate Dem midterm message

Welcome to Thursday’s Overnight Health Care. The House has left town for the rest of the summer, but we’ll still be here to round up the day’s health news.

Today, the Trump administration pushing ahead with its goal of approving Medicaid work requirements in every state that requests them. Democrats’ messaging on premiums may need more nuance … and a group of states are suing the Trump administration over association health plans.  

 

But first:

It’s deadline day for the Trump administration to reunite separated children with their families.

Thousands of migrant children have been separated from their parents as part of the administration’s zero tolerance policy, and tonight is the deadline for all of them to be reunited.

{mosads}

The Department of Health and Human Services and the Department of Homeland Security have been making progress, as evidenced by recent case updates, but not all children will be reunited. The government is set to submit a status update to a federal court in San Diego by 6pm.   

A court filing this week showed that more than 900 children aren’t eligible to be reunified because of factors including their parent’s criminal history.

The government initially identified 2,551 children who were separated and placed into HHS custody when their parents crossed the southern border illegally, and only 1,634 parents who would be eligible for reunification with their children.

In as many as 463 cases, the parents might have been deported without their kids. Administration officials have maintained that parents who were deported without their children willingly gave up custody.

But immigration advocates have expressed concern that parents who were deported without their children signed papers waiving their rights without knowing what they were signing. 

 

Update:

The deadline to reunite separated families is at midnight. A new court filing Thursday night, though, shows there are still hundreds of parents who have not seen their children.

The government reported that Immigration and Customs Enforcement (ICE) has 1,442 children in custody with their parents. But there’s still another 711 children in care of the Office of Refugee Resettlement whose parent is either not eligible for reunification or unavailable.

We’ll be providing updates on the situation tonight as the deadline nears.

 

Trump not giving up on Medicaid work requirements after court ruling

Secretary of Health and Human Services Alex Azar made some of the clearest comments yet on Thursday that his department will still approve Medicaid work requirements despite Kentucky’s being blocked by a federal judge last month.

Azar said the ruling was a “blow” to the administration’s efforts to encourage work among “able-bodied” adults in the Medicaid program, but said he is “undeterred” and proceeding forward.”

“We are fully committed to work requirements and community participation requirements in the Medicaid program,” Azar said at a speech at the Heritage Foundation on Thursday morning.

“We will continue to litigate, we will continue to approve plans, we are continuing to work with states, and we’ll drive forward.”

He added the administration would take what it learned from the court’s decision, even though it disagrees with it.

In June, U.S. District Judge James Boasberg ruled the Trump administration’s approval of Kentucky’s Medicaid work requirements “arbitrary and capricious.” The requirements are part of the state’s Kentucky HEALTH initiative.

What’s next: The administration announced last week it would reopen a 30-day comment period on the Kentucky waiver, a move that shows it’s trying to chart a way forward.

The administration has already approved requirements in Arkansas, Indiana and New Hampshire. Applications are pending in Arizona, Kansas, Maine, Mississippi, Ohio and Wisconsin.  

Read more here.

 

States sue Trump over association health plans.

A group of 11 states and Washington, D.C., are suing the Trump administration in an attempt to roll back a regulation that allowed for the expansion of certain health plans that skirt ObamaCare regulations.

The lawsuit, led by New York Attorney General Barbara Underwood (D) and Massachusetts Attorney General Maura Healey (D), alleges that the Department of Labor violated the Administrative Procedures Act when it wrote a rule expanding access to association health plans (AHPs).

AHPs have a long history of fraud, mismanagement, and abuse, the AGs said, with millions in unpaid claims for policyholders and providers, often leading to consumer bankruptcies.  

What the AGs want: The court to declare the rule unlawful, and to vacate it.

Key excerpt from the complaint: The rule “upends a decades-old understanding of a foundational employee benefits law for the purpose of exempting a significant portion of the health insurance market from the Affordable Care Act’s consumer protections.”

Read more on the lawsuit here.

 

Congressional watchdog finds Energy Department violated law with anti-ObamaCare tweet.

Remember Rick Perry’s ObamaCare tweet last year? You may not but it has the department in hot water. Turns out the tweet broke the law.

The report from the Government Accountability Office, an investigative arm of Congress, finds that the Department of Energy violated the law because its funding is not directed to be used for health-care messaging.

The tweet in question, from last July, linked to an anti-ObamaCare opinion piece by Energy Secretary Rick Perry, stating, “Time to discard the burdens and costs of Obamacare: @SecretaryPerry.”

The agency deleted the tweet later in the day.

“We find that Energy violated the purpose statute when it tweeted about the Secretary’s column because Energy did not show that its appropriation is available for the purpose of informing the public about health care legislation,” the GAO report states.   

Energy response: Actually we do work on health care. “The Department disagrees with the conclusion that DOE was in violation of the Purpose Statute,” a spokeswoman said. “DOE’s Office of General Counsel stated in its response letter to GAO that the OpEd and tweet covered issues well within the mission of the Department of Energy.”

Read more here.

 

House Dems pressure GOP on pre-existing conditions protections.

Dems are trying to keep up the pressure on pre-existing conditions ahead of the midterms, this time led by Rep. Jacky Rosen, who is taking on Sen. Dean Heller (R) for Senate in Nevada this year.

House Democrats have a resolution that would intervene to defend ObamaCare in a lawsuit filed by Texas and other conservative states.

Reality check: A group of state attorneys general has already moved to defend the law in court, but this resolution would also allow the House to step in.

Democrats think the politics of pre-existing conditions helps them in the midterms.

Read more here.

 

Priorities USA Action announced a $1.25 million ad buy against Rep. Martha McSally (R-Ariz.), focusing on her record on health care.

The ads will run statewide on Facebook, YouTube, Spotify, Pandora, Google, and on Fox News and The New York Times.

View an example of the ad here.

 

Modest premium increases hurt Dems’ midterm messaging

Health insurers are proposing relatively modest premium bumps for next year, despite doomsday predictions from Democrats that the Trump administration’s changes to ObamaCare would bring massive increases in 2019.

That could make it a challenge for Democrats looking to weaponize rising premiums heading into the midterm elections.

“It’s going to be very difficult to turn what’s happening with premiums into a talking point for Democratic candidates,” said Larry Levitt, senior vice president for health reform at the Kaiser Family Foundation. “These relatively modest increases in some cases seem to contradict the conventional wisdom that Republican efforts to undermine the law are driving premiums up. Both things are actually true.”

Why are premium increases so low? Partly, because premiums are already so high. Insurers overpriced their plans last year, anticipating that the Trump administration would make changes to ObamaCare. In an effort to protect their bottom lines, insurers opted to price high, rather than low.

Read more here.

 

What we’re reading

HHS Secretary Alex Azar bashes Obamacare exchanges, Medicaid expansion (Washington Examiner)

Powerful people in health care are finding a new landing pad: Google (Stat News)

A drug company tried to give away an overdose antidote to schools. But most of them declined the offer (Buzzfeed News).

 

State by state

Georgia market could stabilize with restoration of Obamacare payments (Atlanta Journal-Constitution)

Judge orders Wisconsin to cover transgender surgery for 2 Medicaid recipients (Milwaukee Journal-Sentinel)

 

From The Hill’s opinion page

Former RNC Chairman and Trump critic Michael Steele examines the prospects for President Trump’s drug pricing plan”