Overnight Health Care: Official defends suspending insurer payments | What Kavanaugh’s nomination means for ObamaCare | Panel approves bill to halt employer mandate

Welcome to Thursday’s edition of Overnight Health Care.

The Trump administration says it has reunited all of the children under the age of five who were being held by the Department of Health and Human Services with their parents. But that’s only half of the total number of children eligible for being reunified who are in custody.

Also, we have the latest on Supreme Court nominee Brett Kavanaugh, including a look at the impact he could have on ObamaCare in the future.

But first, a top administration health official said ObamaCare payments to insurers had to be cut off, because the Centers for Medicare and Medicaid Services had not choice after a lower court ruling.

 

Verma defends canceling key ObamaCare payments

CMS Administrator Seema Verma is defending her move from over the weekend that set off a scramble among insurers and sparked new fears of rising premiums.

Verma told reporters at a policy breakfast on Thursday in Washington, D.C. that a court made her do it.

“We really are in a tough spot,” Verma said. “I think that there’s been a lot of discussion about whether the Trump administration is making a decision. We’re not making a decision. The court has told us what to do here … at the end of the day, we have to abide by the court’s ruling.”

Plenty of skeptics: But some legal experts disagree, and say CMS had other options beyond stopping all payments to comply with the ruling.

Insurers are pushing for the administration to quickly restart the payments, known as risk adjustment.

Verma said CMS is asking the court to reconsider, but until that happens, its hands are tied.

“We’ve been trying to figure out, is there a solution? We understand the impact to the market [but] we have to follow what the courts say,” Verma said.

More from Verma here.

 

Speaking of court cases…

At the same event, Verma fielded questions about why the administration has not stopped approving Medicaid waivers with work requirements. A federal judge in D.C. recently blocked Kentucky’s waiver, the first work requirements CMS ever approved.

Unlike the risk adjustment case, where Verma said the only option was to stop making the payments, she did not say CMS will stop approving waiver requests after the court ruling. Instead, Verma only said the Trump administration views state flexibility as important, and is committed to granting as much of it as possible.

CMS has approved waivers from four states–including Kentucky– that want to impose work requirements, premiums, and other types of coverage restrictions on Medicaid beneficiaries. Eleven other states are interested.

 

What does Kavanaugh’s nomination mean for ObamaCare?

We spoke to legal experts about what Kavanaugh’s nomination means for the health care law, in particular from one legal challenge.

Democrats are making the legal threat to ObamaCare a big part of their fight against President Trump’s Supreme Court nominee.

But legal experts are skeptical that the law is seriously at risk from the latest lawsuit, filed by Texas and 19 other GOP-led states.

• Ilya Somin, a libertarian law professor at George Mason University, said the latest lawsuit against the health law is “sufficiently outlandish that it’s highly unlikely to prevail.”
• Chris Walker, an Ohio State law professor and former law clerk for Justice Anthony Kennedy, said: “I doubt there are more than a couple votes on the court” against ObamaCare in the latest case.

Legal background: The latest case argues that all of ObamaCare should be invalidated because one provision, the mandate to have coverage, is unconstitutional. Experts say that arguments flies in the face of Supreme Court precedent on how much of a law to strike down when one part is overturned.

Read more here.

 

Trump administration says all eligible kids have been reunited with parents

According to HHS, all eligible children under 5 years old who were separated from their parents at a U.S. border crossing have been reunited, two days after a court-mandated deadline.

Federal officials identified 103 total kids in HHS custody who were taken from their families after their parents crossed into the country illegally. But only 57 were deemed eligible to be reunited with parents.

HHS said 46 other children were not eligible for reunification. Some of their parents haven’t cleared background checks, or they have criminal records, or they have been deported without their children.

Significance: HHS missed the deadline, and only 57 kids were reunited. Officials defended the speed of the reunification efforts, and said HHS is screening all the adults with DNA tests and background checks. But there’s another, bigger deadline coming up that could prove even more challenging.

The rest: The administration faces a July 26 deadline to reunite children ages 5 to 17. HHS wouldn’t give the most recent number of those children they have in custody, but the number is far greater than 103.

More details here.

 

Report shows 1.6 billion doses of opioids shipped to Missouri from 2012 to 2017

Sen. Claire McCaskill (D-Mo.) has been vocal on the opioid crisis for a while, and she has a new report showing a flood of opioid shipments to her state.

The report — a product of the senator’s ongoing investigation into opioid manufacturers and distributors — shows that three pharmaceutical distribution companies together shipped 1.6 billion doses of opioids to the state between 2012 and 2017, contributing to Missouri’s raging opioid epidemic.

“It’s staggering. Over six years we averaged 260 pills for every man, woman, and child in Missouri,” McCaskill said in a statement.

What to watch: McCaskill is facing a tough reelection race this year, and could make efforts to fight opioid abuse an issue.

Throwback: We wrote in April that McCaskill has sponsored a bill to give the Drug Enforcement Administration more power to seize suspicious opioid shipments. But the bill hasn’t gained traction among Republicans, and she thinks politics could be at play.

Read more here on her new report.

 

Planned Parenthood and the Susan B. Anthony List release dueling ads on SCOTUS nominee

Planned Parenthood and the Susan B. Anthony List are both out with digital ads targeting senators ahead of Brett Kavanaugh’s (yet to be scheduled) confirmation vote.

The details:

• Planned Parenthood’s six-figure digital ad buy will air in all 50 states through July, specifically focusing on “the danger Kavanaugh’s nomination poses to reproductive rights.” View the ad here.
• The SBA List released six digital ads Thursday targeting red state Democrats: Joe Manchin (W.Va.), Joe Donnelly (Ind.), Heidi Heitkamp (N.D.), Claire McCaskill (Mo.), Doug Jones (Ala.) and Bill Nelson (Fla.) All except Jones are running competitive reelection bids in states won by President Trump in 2016. Jones isn’t up for reelection until 2022, but is still seen as a key vote in the confirmation fight because he represents a deep red state. View the ad targeting Heidi Heitkamp here.

 

The House Ways and Means Committee turned its focus back to ObamaCare, passing two bills that would slowly chip away at it.

• One measure, sponsored by GOP Reps. Devin Nunes (Calif.) and Mike Kelly (Pa.), would temporarily repeal ObamaCare’s employer mandate and a tax on high cost employer-sponsored health plans.
• Another bill, sponsored by GOP Reps. Peter Roskam (Ill.) and Michael Burgess (Texas) would allow the use of ObamaCare’s tax credits for plans outside of the exchanges in the individual market. It would also allow anyone to purchase a catastrophic plan — plans that are cheaper but cover fewer services and are currently only available for those under 30.

What’s next: The bills could potentially get a vote in the House, where Republicans have a large majority. But don’t count on them coming up for a vote in the Senate in an election year.

 

What we’re reading

Dem senator: Kavanaugh would ‘turn back the clock’ on women’s health care (The Hill)

Poll finds strong support for Roe v. Wade (The Hill)

Bucking Trump, health insurers expand ObamaCare footprints (Forbes)

Democrats say Kavanaugh could help end ObamaCare, but court likely to deal with narrower issues (The Washington Post)

Medicaid website hides some ObamaCare information, group says (CNN.com)

 

State by state

Maine Gov. Paul LePage says he’d go to jail before he expands Medicaid (Associated Press)

Utah: No change to plans for Medicaid with work requirement (Associated Press)

 

Op-eds in The Hill

Trump signs GA Mission Act — this is a health care win for vets

Benefit of CVS/Aetna merger far outweigh the costs