Overnight Health Care: Nevada union won’t endorse before caucuses after ‘Medicare for All’ scrap | McConnell tees up votes on two abortion bills | CDC confirms 15th US coronavirus case

Welcome to Thursday’s Overnight Health Care. 

The abortion debate is flaring up in Congress again, Bernie Sanders is trying to smooth over tensions with a powerful Nevada union, and Health Secretary Alex Azar thinks it’s too early to be concerned about an ObamaCare replacement plan.

We’ll start with some 2020 news…

 

Nevada’s Culinary Workers Union won’t endorse before primary

Nevada’s powerful Culinary Workers Union will not endorse a candidate in the presidential primary ahead of the state’s Feb. 22 caucuses, saying it will instead focus on turning out Democrats to vote President Trump out of office in 2020.

The decision to stay neutral in the crowded Democratic primary comes after the union recently distributed literature to its members warning that Sen. Bernie Sanders’s (I-Vt.) “Medicare for All” plan would “end culinary health care” by replacing private plans with government-run insurance.

Sanders’s online supporters aggressively went after the union for bashing his health care plan, angering its leaders.

But speaking at a press conference on Thursday, union secretary-treasurer Geoconda Argüello-Kline said the group would focus on promoting its goals of expanding access to health care for its workers and promoting immigration reform, rather than playing in presidential politics.

“We will endorse our goals,” Argüello-Kline said. “We’re not going to endorse a political candidate. We respect every single political candidate right now.”

Read more about the controversy here. 

 

Wednesday, February 26: America’s Opioid Epidemic: Lessons Learned & A Way Forward 

Join The Hill on Wednesday, February 26th in downtown Washington, D.C. as we host a conversation about expanding access to treatment and helping those battling opioid addiction begin the journey toward long-term recovery. We will be speaking with Nora Volkow, director of the National Institute on Drug Abuse, Rep. David Joyce (R-Ohio) and Rep. Paul Tonko (D-N.Y.). RSVP today!

 

McConnell tees up votes on two abortion bills

Get ready for the abortion debate to reignite when the Senate returns after next week’s recess. 

Senate Majority Leader Mitch McConnell (R-Ky.) set up two votes:

• The first is on a bill from Sen. Lindsey Graham (R-S.C.), which would ban abortions after 20 weeks with exceptions for the life of the mother and for victims of rape or incest. Doctors who violate the bill could face up to five years in prison.  
• The second bill, from Sen. Ben Sasse (R-Neb.), would penalize doctors who fail to “exercise the proper degree of care in the case of a child who survives an abortion or attempted abortion.”

The politics: Both bills would require 60 votes to overcome an initial procedural hurdle. With Republicans controlling 53 seats, neither are expected to get it, but the votes could force Democratic Senate candidates and White House hopefuls to go on record on the issue. Both bills failed in 2019 and 2018, but Republicans still used those votes to hit Democrats as “extreme” on abortion. 

From the Susan B. Anthony List, an anti-abortion group: “Democrats are proving to be completely out of step with their base on abortion, and they are feeling it,” said Marjorie Dannenfelser, president of the group. 

“It’s time they see that consensus is necessary to move forward on this debate in a way that honors American opinion. This is not only the right thing to do but the politically smart thing to do.” 

Read more here. 

 

CDC confirms 15th case of coronavirus 

The Centers for Disease Control and Prevention (CDC) has confirmed the 15th case of the coronavirus in the U.S. 

The patient is among a group of Americans who had been evacuated from Wuhan, China and quarantined at a military base in Texas. 

The CDC said the patient is the first person under quarantine at that location that has tested positive for the coronavirus. The patient is being isolated and receiving medical care at a nearby hospital.

Nearly all of the confirmed coronavirus cases in the U.S. have been individuals who had recently traveled in China. 

The U.S. has evacuated and quarantined more than 800 Americans from Wuhan since the outbreak started last month. 

Read more here. 

 

Democrats press Trump official for answers on ObamaCare replacement plan

Democrats are seething at President Trump’s top health official Thursday for not having a backup plan in case the Affordable Care Act (ACA) is overturned in a pending lawsuit supported by the Department of Justice (DOJ). 

Health and Human Services (HHS) Secretary Alex Azar told senators during a hearing Thursday a plan is not needed until the “final judgment” is made in the lawsuit. 

“I don’t know what you’re waiting for. If you have a better idea show us, but I have yet to see one plan that the administration has put forward,” Sen. Bob Menendez (D-N.J.) told Azar during a Senate Finance Committee hearing on the HHS budget request. 

“We would wait until there’s a final judgment in the final court of authority — in this case, it would obviously be the Supreme Court,” Azar responded.

The DOJ has refused to defend the ACA against a lawsuit, brought by attorneys general in Texas and other Republican-led states, that seeks to overturn the law that expanded health care to 20 million Americans.

A district court judge sided with the plaintiffs in 2018, ruling ObamaCare cannot stand without the individual mandate penalty, which was repealed by a tax-reform law passed by Congress in 2017.

After appeal, the 5th Circuit Court of Appeals agreed the individual mandate was unconstitutional but sent the case back to the lower court to determine which parts of the law could stand.

More on ObamaCare here.

 

Azar urges action on drug pricing 

When senators weren’t asking Azar about the ACA, they were asking about drug pricing. 

Mostly, senators who support a bill sponsored by Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.) used their time to subtly try to get their other colleagues to support it. 

Sen. Tom Carper (D-Del.) noted that some Republicans think the bill, which limits annual price increases drug companies take, is a form of “price setting.” 

“As a former CEO… of a major drug company, do you agree with these concerns?” Carper asked. 

Azar replied: “I fundamentally disagree with the notion that the inflation penalty provisions… are price controls.” 

“We want to get this or some other comparable bipartisan bill through,” Azar said, referring to the Grassley-Wyden bill. 

 

Some new figures from CBO on surprise billing

The competing surprise billing proposals going through Congress are being scrutinized down to the smallest changes in wording, which can have a big effect on the budget impact and for the various industries jockeying over legislation. 

The bill from the House Ways and Means Committee, which advanced on Wednesday, uses an outside arbiter to determine how much the insurer pays the doctor once the patient is taken out of the middle and protected from getting surprise bills. 

The latest: Right now the bill directs the arbiter to consider the median rate paid for a particular service. The Congressional Budget Office told a congressional office that if the arbiter could also looks at “commercially reasonable” rates, a phrase more favored by doctor and hospital groups, than the savings would fall from $18 billion to $5 billion over 10 years. 

Legislation from Sen. Bill Cassidy (R-La.) in the Senate also uses that phrase, but it has higher savings, of $17 billion, because it has an interim payment based on the median rate that doctors are paid in the meantime before having the option of entering arbitration. The CBO assumes many doctors would accept that payment and would therefore never enter arbitration in the first place.   

 

What we’re reading

When Your Doctor Is Also A Lobbyist: Inside The War Over Surprise Medical Bills (Kaiser Health News)

Why Bernie Sanders’s fight with a Nevada union really matters (Washington Post opinion) 

Americans Agree Health Care System Needs Fixing, New Survey Finds (WBUR) 

 

State by state

Florida Medicaid director says new rule would be ‘crippling’ (News 4 Jax)

No quick fix: Missouri finds managing pain without opioids isn’t fast or easy (KMOV)