Overnight Health Care — Presented By National Partnership for Women & Families — Senate sends opioid package to Trump’s desk | Drug companies fear Dem Congress | Premiums for employer plans rise

Welcome to Wednesday’s Overnight Health Care.

The pharmaceutical industry is worried about a Democratic takeover of the House, premiums for employer-sponsored health plans are rising, and another vulnerable Republican is trying to show he supports protections for people with pre-existing conditions.

Meanwhile, in the middle of a bitter partisan fight about the Supreme Court, there was a brief bright spot when the Senate passed bipartisan legislation to the opioid crisis, which is where we’ll start tonight…

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Senate sends opioid package to Trump’s desk

There was some bipartisanship in the Senate today amid all the fighting over Brett Kavanaugh.

The Senate passed an opioid bill by an overwhelming vote of 98-1. Sen. Mike Lee (R-Utah) was all alone in opposition.

What does the bill do? Some key provisions:

• Lifts some limits, which lawmakers called outdated, on Medicaid paying for care at addiction treatment facilities.
• Cracks down on illicit opioids being imported by mail from other countries and fueling the epidemic.
• Lifts limits on nurse practitioners and other providers being able to prescribe the addiction treatment drug buprenorphine.

The politics: In the House, GOP incumbents can tout it on the campaign trail. In the Senate, it’ll help Democratic incumbents.

For example, Sen. Joe Donnelly (D-Ind.), who faces a tough race this year, praised the bill from the Senate floor Wednesday and touted the inclusion of provisions he worked on.

A proposal that would do more (that doesn’t have much chance at the moment): Sen. Elizabeth Warren (D-Mass.) has a bill to provide $100 billion to fight the crisis over 10 years, saying a larger, more sustained investment is necessary.

Read more here.

 

 

Drug companies fear Democratic Congress

Fresh off a rare loss on the opioids bill, pharma insiders say the industry is prepping for a lot more if Democrats take the House.

Democratic lawmakers are giving industry reason to be concerned. They say Republicans have gone too easy on drug companies and are vowing that will change if they take power in November’s midterm elections.

They are promising investigations into rising drug prices and say they will push to allow importation of cheaper medicines from other countries and to allow Medicare to negotiate prices with pharmaceutical companies.

Key quote: “I think right out of the gate, we make a down payment on what we’re going to do about the costs of prescription drugs, and I would hope within the first 100 hours we would be able to put some constraints on big pharma,” Rep. Jan Schakowsky (Ill.), a top Democrat on the House Energy and Commerce Committee, told The Hill.

Drug prices have spiked in the last decade, and there’s bipartisan concern over the issue. But the parties are divided on the solutions.

Democrats want Medicare to negotiate prices and want to allow Americans to buy cheaper prescription drugs from abroad, policies that are staunchly opposed by pharmaceutical companies and Republicans.

Will that actually happen? If history is any guide, it’s not necessarily a slam dunk, especially if Republicans keep control of the Senate and Democrats only control the House. Even when Democrats held both chambers in 2007, they couldn’t muscle through a Medicare price negotiation bill. It passed the House, but failed in the Senate. One industry lobbyist predicted that Democrats will wage a battle of public perception. The industry will take a beating, but nothing as major as importation or price negotiation will pass.

Read more here.

 

In other pharma news…  A new pro-industry “dark money” group officially launched Wednesday. The Alliance to Protect Medical Innovation says the pipeline for new breakthrough medicine is under attack by insurance companies and pharmacy benefit managers.

The group’s first target: the John Arnold Foundation, which the Alliance says is waging a “crusade against the biopharmaceutical industry” by providing grants to a variety of organizations, including the advocacy group Patients for Affordable Drugs, and journalism outlets like ProPublica and Kaiser Health News.  

As a 501(c)(4) group, the Alliance is designated as a “social welfare organization.” It is allowed to engage in political activities and is not required to reveal its funding sources.

 

Planned Parenthood claims Brett Kavanaugh’s confirmation would put abortion access at risk for more than 25 million women.

The group made the claims in a new report released Wednesday with In Our Own Voice, a group that supports reproductive rights for black women. It argues that 20 states are at “high risk” for banning abortion if Kavanaugh is confirmed. The breakdown:

• Of these states, some, like Texas and Alabama, have abortion bans on the books that were established before the Supreme Court’s landmark Roe v. Wade ruling.
• Four of these states have “trigger laws” that would ban abortion if Roe v. Wade is overturned.
• Nine of the 20 states mentioned in the report have an “established history” of passing abortion restrictions and could be expected to ban abortion should the Supreme Court overturn Roe v. Wade, Planned Parenthood argues.

The states cited in the report are: Alabama, Arizona, Arkansas, Idaho, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, North Dakota, Ohio, Oklahoma, South Dakota, Tennessee, Texas, Utah, West Virginia and Wisconsin.

Context: Other abortion rights groups have reached similar conclusions, including Center for Reproductive Rights, which says 22 states could ban abortion if SCOTUS overturns Roe.

More context: Kavanaugh said he considers Roe v. Wade to be settled law, but that didn’t satisfy Planned Parenthood and other groups.

 

GOP lawmaker’s ad pledges support for pre-existing condition protections

Rep. Dana Rohrabacher (R-Calif.) on Wednesday released a reelection ad saying he wants to ensure protections for people with pre-existing conditions, making him the latest vulnerable Republican to highlight support for the ObamaCare provision.

In the digital ad, Rohrabacher said health care is a personal issue for him because his daughter was diagnosed with leukemia when she was eight years old.

“So for her and all our families, we must protect America’s healthcare system. That’s why I’m taking on both parties, and fighting for those with pre-existing conditions,” Rohrabacher says.

The rest of the story: Rohrabacher voted for the House GOP’s ObamaCare repeal and replacement bill, which would have allowed states to receive waivers allowing insurers to raise premiums for people with pre-existing conditions. He also joined with House Republicans in previous years to vote for full repeal of ObamaCare without a replacement.

His campaign did not say how he is taking on the Republican party. A spokesman pointed to an op-ed from last year where Rohrabacher said Medicare should bear all the costs of covering people with pre-existing conditions.

Read more on Rohrabacher’s ad here.

 

Survey: Premium increases for employer plans were moderate in 2018. But more plans come with a deductible.

From the Kaiser Family Foundation:

• Premiums for employer sponsored family plans increased by 5 percent in 2018 and 3 percent for single coverage plans.
• The average family premium has increased 55 percent since 2008, twice as fast as wages and three times faster than inflation.
• In 2018, 85 percent of people enrolled in employer health plans had a deductible, up from 81 percent last year, and 59 percent in 2008.
• The average deductible for a single plan was $1,573 in 2017, compared to $1,505 last year and $735 in 2008.

Read more here.

 

Democratic senators want to stop surprise medical bills.

New Hampshire’s senators on Wednesday introduced two bills to combat escalating out-of-pocket health care costs for uninsured patients, and to stop surprise medical bills. The bill from Sen. Jeanne Shaheen (D) would cap the amount that hospitals and physicians could charge uninsured patients and out-of-network patients who have individual market coverage.

Sen. Maggie Hassan (D) also announced that she will introduce companion legislation to help eliminate surprise medical bills. 

More info on the bills can be found here.

 

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FDA faces pressure on drugs for rare diseases

Sens. Rand Paul (R-Ky.) and Bob Casey (D-Pa.) are pressing the FDA to speed up the approval of drugs that treat rare diseases.

The issue was front and center at a Wednesday hearing of the Senate health subcommittee on children and families, reports The Hill’s James Wellemeyer.

Mark Dant, chair of the EveryLife Foundation for Rare Diseases, told senators that fewer than 400 of the over 7,000 rare diseases identified currently have FDA-approved treatments.

According to Dant, this situation leads many doctors to turn away patients with rare diseases and encourages some patients to take off-label drugs, which often come from foreign countries and without dosage instructions.

Mark Patterson, a professor of neurology, pediatrics, and medical genetics at the Mayo Clinic, called for more attention to the problem. He said that “collectively, [rare diseases] affect a very large [portion] of the population.”

Patterson wants FDA to “be required to accept the results of well-designed clinical trials … conducted outside of the U.S.” He believes doing so would expedite the approval process for drugs that treat rare diseases.

Michael Strupp, a professor of neurology at the University of Munich, called for changes to how FDA conducts trials when dealing with rare diseases. Currently, certain diseases affect so few people that even if every impacted individual were to participate in a trial, it would not lead statistically significant results.

“200 would be accepted, but if you only have 50 in the U.S., you cannot do a study” to meet FDA rules, Strupp said.

Toward the end of the hearing, Paul and Casey said they hoped to work together to amend the Orphan Drug Act, an 1983 law intended to expedite drugs for certain rare diseases.

 

What we’re reading:

Seema Verma pushes back on ObamaCare ‘sabotage’ charges (Washington Examiner)

It’s Baaaccck! Health Care Law Again Front and Center in Midterms (Roll Call)

In Australia, cervical cancer could soon be eliminated (The New York Times)

 

State by state:

ObamaCare prices in Nevada to be nearly unchanged (Washington Examiner)

Voters will determine Medicaid coverage for 90,000 Nebraskans (Lincoln Journal Star)  

 

From The Hill’s opinion page

Ricin attacks will continue

Strengthening and protecting Part D is an important challenge