Overnight Health Care — Presented by PCMA — FDA issues proposal to limit sales of flavored e-cigs | Trump health chief gets grilling | Divisions emerge over House drug pricing bills | Dems launch investigation into short-term health plans

Welcome to Wednesday’s Overnight Health Care.

The FDA released its long-awaited draft regulation on e-cigarettes, just a week after commissioner Scott Gottlieb announced his intended resignation. Meanwhile, HHS chief Alex Azar faced another grilling from House Dems, and the Energy and Commerce Committee is launching an investigation into short term insurance plans.   

We’ll start with the vaping announcement:

 

Outgoing FDA chief issues proposal to limit sales of flavored e-cigs

Outgoing Food and Drug Administration (FDA) chief Scott Gottlieb moved to restrict sales of some flavored e-cigarettes Wednesday as part of the agency’s efforts to combat teen vaping.

The proposed guidance would limit the sales of flavored e-cigarettes to vape shops that ban sales to minors, stores that have separate off-limits areas for adults and require heightened age verification for online sales.

That would essentially end sales of e-cigarettes at gas stations and convenience stores.

“Evidence shows that youth are especially attracted to flavored e-cigarette products, and that minors are able to access these products from both brick-and-mortar retailers, as well as online, despite federal restrictions on sales to anyone under 18,” Gottlieb said in a statement.

While the proposal doesn’t apply to menthol, mint and tobacco flavors, that could change if the FDA finds kids are using those flavors.

Context: The proposed guidance isn’t much different from what Gottlieb unveiled in November. It will undergo a 30-day comment period before being finalized. Gottlieb is also leaving the FDA next month, so finalizing the guidance will likely fall to his successor.

But public health groups think the proposal doesn’t go far enough.

“Only a full prohibition on all flavored tobacco products will help prevent new, young consumers from initiating use,” said Lisa Lacasse, president of the American Cancer Society Cancer Action Network.

Read more here.  

 

 

HHS Secretary Azar grilled over Title X, abortion and separated children

House Democrats on the Appropriations subpanel for Labor-HHS didn’t hold back when questioning Health Secretary Alex Azar over some of the agency’s controversial policies regarding women’s health and the children who were separated from their parents at the border.

Here are the highlights from today’s House Appropriations hearing on the 2020 budget request:

On the changes to the Title X rule, which would strip millions of dollars from Planned Parenthood and ban clinics from referring women for abortions:

“I want to be very clear that there was no consultation with the public health community, because it seems the administration didn’t care what the experts had to say about what impact this would have on women’s health,” said House Appropriations Chairwoman Nita Lowey (D-N.Y.), calling the administration’s move a “political decision.”

A key part of the rule would require a physical and financial separation between Title X services and abortions, effectively disqualifying Planned Parenthood and other clinics that provide abortions from the program.

“Your intention is to drive Planned Parenthood out of business,” Rep. Lois Frankel (D-Fla.) said to Azar.

Azar replied: “Not at all. Planned Parenthood may comply with these rules.”

He argued that the federal government, through Title X, is “inappropriately subsidizing” the “abortion enterprise.”

Republicans on the panel defended the rule as “valuing life.”
DeLauro countered that Republicans can’t “value life” while advocating for cuts to health programs and separating children at the border.

“We have to consider life issues across the board, and that extends to what we did at the border,” DeLauro said in her closing remarks.

On separated children:

Azar said unaccompanied minors in HHS care are there for an average of 71 days before being placed with sponsors.

There are currently 200 separated kids in HHS custody, but these are cases where the parents have felonies or are violent.

NIH cuts:

Democrats and Republicans on the panel agreed that cuts to the National Institutes of Health and the Centers for Disease Control and Prevention (CDC) are a non-starter. The panel has historically agreed to give those agencies funding increases.

“A cut of $5 billion would reverse this trend and send the wrong signal to young scientists,” said Rep. Tom Cole (R-Okla.), referring to President Trump’s 2020 budget.

 

Divisions emerge over House drug price bills.

Divisions are emerging in the House over what lawmakers hoped would be a bipartisan push to lower drug prices.

Drug pricing is a rare area where members of both parties think there is a chance for a deal this year. But as House Democrats took the first step on Wednesday to begin moving legislation forward, it was clear that even relatively small-scale drug pricing bills may not have a smooth path ahead.

Republicans on the House Energy and Commerce Committee raised objections to several of the bills at the hearing, accusing Democrats of refusing to negotiate with them on the legislation.

“We do want to lower the cost of prescription drugs, [but] we wish it were more inclusive,” said Rep. Greg Walden (Ore.), the top Republican on the committee, about the process.

The problem: Democrats pointed out that many of the bills, which are aimed at increasing competition from cheaper generic drugs, already have support from some Republican lawmakers.

The bills are likely to pass the Democratic-controlled House. But getting a significant number of House Republicans on board for a strong vote would raise pressure on the GOP-controlled Senate to act on the issue.

We’ve got more here.

 

Energy & Commerce Committee Democrats launch investigation into short-term health insurance plans.

Democrats say they’re concerned that companies selling the plans are refusing to cover certain health care services and are misleading potential consumers about what the plans offer.

“The Committee’s initial examination of these plans has yielded disturbing information about how insurance companies [short-term plans] discriminate against individuals with pre-existing conditions and put consumers at significant financial risk,” Chairman Frank Pallone (D-N.J.) and Reps. Diana DeGette (D-Colo.) and Anna Eshoo (D-Calif.) wrote in letters to the companies.

They lawmakers asked the companies to provide information about what percentage of applicants are denied coverage, how plans are marketed to consumers, and whether they do “post claims underwriting.”

The letters were sent to Agile Health Insurance, Anthem, Arkansas Blue Cross Blue Shield, Blue Cross Idaho, Cambia Health Solutions, eHealth, Everest, Health Insurance Innovations, Healthcare Solutions Team, Independence Holding Company, National General Accident and Health and UnitedHealth Group.

Read the letter to UHG here. 

 

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Senate Democrats want HHS to rescind approval of South Carolina adoption agency

A group of 40 Senate Democrats urged HHS Secretary Alex Azar to rescind a waiver that allows a South Carolina adoption agency to participate in a federally funded foster-care program, even though it will only work with Christian families.

The waiver exempts the agency from federal non-discrimination laws. In a letter, the Democrats said Azar should rescind the waiver and refrain from permitting any other similar measures “that sanction taxpayer-funded religious discrimination.”

The letter was spearheaded by Sens. Ron Wyden (D-Ore.), Dianne Feinstein (D-Calif.) and Bob Menendez (D-N.J.).

“With HHS’s stamp of approval, Miracle Hill Ministries and other South Carolina faith-based foster care agencies can now legally turn away qualified foster and adoptive parents just because they do not share the agency’s faith. This unprecedented action runs counter not only to the principles on which the United States was founded, but also to the goals of the foster care system,” the senators wrote.

 

What we’re reading

How Trump wants to whack Medicare and Medicaid spending (CNN.com)

Congress warns against Medicaid cuts: ‘You just wait for the firestorm’ (The New York Times)

Seema Verma: Medicaid reform rejected by Trump is ‘under review’ (Politico)

 

State by state

ObamaCare-protections bill revived in New Mexico (Associated Press)

A ‘Heartbeat’ abortion ban cleared the Ohio Senate. Here are the reasons for and against it. (Cincinnati Enquirer)

 

From The Hill’s opinion page

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