Overnight Health Care: Kavanaugh questioned if Roe v. Wade was ‘settled law’ in leaked email | Senate to vote next week on opioid package | Officials seek to jail migrant children indefinitely | HHS chief, lawmakers meet over drug prices

Welcome to Thursday’s edition of Overnight Health Care.

It was another contentious day at Judge Brett Kavanaugh’s confirmation hearing, with abortion taking center stage. In the final day of questioning, Democrats pounced on leaked e-mails they said showed Kavanaugh’s views on Roe v. Wade.

 

Kavanaugh questioned if Roe v. Wade was ‘settled law’ in leaked email.

Democrats say new emails released Thursday are evidence that Judge Brett Kavanaugh’s Supreme Court nomination is a threat to abortion rights.

In a 2003 email, Kavanaugh questioned if Roe v. Wade was “settled” law.

Kavanaugh proposed deleting a line out of the draft of an opinion piece that said “it is widely accepted by legal scholars across the board that Roe v. Wade and its progeny are the settled law of the land.”

{mosads}Kavanaugh questioned if legal scholars did agree that Roe v. Wade, the landmark 1973 ruling that established the right to an abortion, was settled.

“I am not sure that all legal scholars refer to Roe as the settled law of the land at the Supreme Court level since Court can always overrule its precedent, and three current Justices on the Court would do so,” Kavanaugh wrote.

But those remarks might not be a gamechanger: Two swing votes, Sens. Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska), have not expressed any concern yet, though it is possible they could after more thoroughly reviewing the email.

In response, NARAL Pro-Choice America dropped another half a million on a TV and digital ad buy in Maine, where they’re pressuring Collins to vote against Kavanaugh’s confirmation.

That brings the total spent on that ad buy to $760,000. NARAL says the ads have been running since Friday and will continue through the week of the Senate floor vote on Kavanaugh’s confirmation.

“The release of the committee confidential documents proves what women have already known, Brett Kavanaugh does not think American women can determine what is best for our lives, our bodies and our health,” said NARAL President Ilyse Hogue.

“Senator Collins has promised not just Mainers, but all American women, she will stand with us on this crucial question of our freedom and equality. Unless she stands with her constituents and votes no, Senator Collins will be turning back the clock for generations.”

A tense day: Democrats, facing their last day to publicly question Trump’s nominee, upped their ante on Thursday, threatening to release confidential White House emails and accusing Supreme Court nominee Brett Kavanaugh of lying to senators.

The Judiciary Committee hearing went off the rails almost immediately when Sen. Cory Booker (D-N.J.) sparked a political firestorm by announcing that he was going to release “confidential” documents from Kavanaugh’s time as a White House lawyer.

Several Democrats then used a batch of emails publicly released on Thursday to imply that Kavanaugh had lied to the Judiciary Committee. 

More on that here.

Click here for more on the documents Booker released that had not been cleared for the public.

And check out The Hill’s live blog for the latest on today’s hearing.

 

Azar meets with GOP lawmakers on drug prices.

Secretary of Health and Human Services Alex Azar came to the hill Thursday to meet with GOP lawmakers to check in on drug prices. 

No big announcements yet: Rep. Tom Reed (R-N.Y.), who was also in the meeting, said that the group did not “directly” discuss specific legislation on drug prices but there was a “conversation” about areas where the administration could need additional authority from Congress. 

But expect more administration actions soon: Asked if he expected more administrative actions to be announced in the near future, Ways and Means Chairman Kevin Brady (R-Texas) said, “The answer is yes.” 

Keep watching rebates: Officials have also floated a move to eliminate or reform discounts known as rebates that drug companies pay to negotiators, in an effort to simplify the system and lower sticker prices.

Lawmakers discussed rebates with Azar on Thursday, though Reed said that discussion was limited given the ongoing regulatory process.

Read more here.

 

Trump administration seeks to jail migrant children with their parents.

The Trump administration is proposing to indefinitely jail migrant children with their families, a policy that would overturn 20 years of protections for immigrant children.

Administration officials on Thursday said the proposed change is necessary in order to prevent children from being separated from their families once they cross into the country illegally.

Under the Flores Settlement Agreement, which has governed the detention of migrant children since 1997, detaining children for more than 20 days is illegal. The proposed regulations would terminate that agreement.

The proposal has been in the works for months, as the Trump administration and congressional Republicans have sought ways to deal with the influx of families illegally crossing the country’s southern border.

Republicans have introduced numerous bills that would end the Flores protections, but despite requests from immigration officials, they have not been passed. 

The reasoning: Administration officials and congressional Republicans have cited the Flores agreement as one of the primary reasons for the “zero tolerance” policy of separating children from their families when they are detained at the border. The administration faced fierce blowback for the policy. By ending the Flores agreement, they no longer have a reason to separate families.

In addition, the administration has argued that the Flores protections incentivize parents to bring children when they try to illegally cross the border. Since children can only be detained 20 days, they are released into the country, with or without their parents.

Read more about the proposed policy change here.

 

Senate to vote next week on opioid package.

The Senate will vote next week on a package of bills aimed at curbing the nation’s opioid epidemic, Majority Leader Mitch McConnell (R-Ky.) announced Thursday.

McConnell’s spokesman said that Democrats had dropped their holds on the legislation. 

Why the hold up: Some Democrats had previously objected to a provision, calling it an earmark for a PhRMA-funded advocacy group.

What’s in the package: The sweeping package focuses on treatment and prevention as well as curbing the flow of illicit substances into the US. One of the bills to be voted on was authored by Sen. Rob Portman (R-Ohio) and advocated by President Trump on Twitter last month. The STOP Act aims to end the shipment of synthetic drugs like fentanyl to drug traffickers in the U.S.

Across the Capitol: The House passed its opioid package in June.

Read more here.

 

More on opioids….Blue Cross of Tennessee to stop covering OxyContin.

The biggest health insurer in one of the states hardest hit by the opioid epidemic is taking a significant new step against the crisis: It will stop covering OxyContin.

Blue Cross will instead offer coverage of two drugs it says are less likely to be abused, Xtampza and Morphabond, according to the Tennessean.

“We’re taking these additional steps because Tennessee deaths from prescription opioids have continued to rise, even as total prescriptions and dosage have decreased,” said Mary Danielson, a company spokeswoman. “As the state’s leading health insurer, BlueCross can make a meaningful difference in addressing the dangers of opioids. We believe it’s the right thing to do — for our members and for the state.”

Other steps include a seven-day limit on opioid prescriptions for people using the drugs for the first time and additional authorization requirements for higher doses of opioids.

Read more here.  

 

Thousands could lose Medicaid coverage in Arkansas under new work requirements.

The state of Arkansas says 4,574 Medicaid beneficiaries had not complied with work requirements for the months of June, July and August as of Monday.

While three months of noncompliance gets you booted from the Medicaid program, the deadline for beneficiaries to tell the state how they’re meeting the requirement for August wasn’t until Wednesday at 9 p.m.

That means that number could go up or down, but it likely won’t be a drastic change.

A spokeswoman said the state expects to release the final numbers around Sept. 13.

People who lose coverage will be locked out of the program until Jan. 1, when they get another three strikes for 2019.

The National Health Law Program is suing the Trump administration for approving the work requirements in Arkansas. That same group won a lawsuit against the administration earlier this summer blocking similar requirements from going into effect in Kentucky.

 

In case you missed it (like we did) the Senate passed a bill yesterday banning the use of ‘gag clauses’ in contracts with pharmacies.

Yesterday’s crazy news cycle buried this interesting news. Sen. Susan Collins’s (R-Maine) bill, which passed by unanimous consent, would ban pharmacy benefit managers from inserting “gag clauses” into its contracts with pharmacies.

Such clauses prevent pharmacies from telling customers they can save money on some prescriptions if they pay with cash instead of using their insurance. The House Energy & Commerce Committee will mark up Rep. Buddy Carter’s (R-Ga.) version of the bill Friday.

 

Progressive health care group targets vulnerable GOP candidates ahead of midterms.

Progressive campaign group Health Care Voter is launching a new seven-figure voter mobilization effort against House Republicans in over 20 races, including states like California, Colorado, Florida, Georgia, Iowa and Maine.

The campaign will include digital ads, college campus mobilization, and a 50 state voter guide. They are targeting Republican incumbents for their vote to repeal ObamaCare.

Targets: Some of the Republicans include Reps. Steve Knight (Calif.), Mike Coffman (Colo.), Vern Buchanan (Fla.), Karen Handel (Ga.), and Bruce Poliquin (Maine). Many of the races are labeled “toss up” by the Cook Political Report.

 

What we’re reading

Most insurers not nervous about ending ObamaCare mandate (Washington Examiner)

The opioid crisis hits home. Mine. (USA Today)

Avoidable sepsis infections send thousands of seniors to gruesome deaths (Kaiser Health News)

 

State by state

Tobacco firms throw additional $7.7 million in campaign against Medicaid expansion in Montana (MTN News)

Florida reaches deal on Medicaid mental health (WLRN)

Newly formed ‘Work, Not Obamacare PAC’ to fight Idaho Medicaid expansion (Idaho Statesman)

 

From The Hill’s opinion page

There aren’t enough doctors to go around

Medicare-for-all: Too costly and for too little care

 

The Hill event

Join us Wednesday, September 12 for “A Healthy Start: Infant and Early Childhood Nutrition,” featuring Reps. Nanette Barragán (D-Calif.) and Bobby Scott (D-Va.), and Administrator of the Food and Nutrition Service Brandon Lipps. Editor in Chief Bob Cusack will sit down with the headliners to discuss maternal, infant, and early childhood nutrition, and what steps can be taken to establish healthier eating patterns across all communities. RSVP Here.