Overnight Health Care — Presented by PCMA — Sanders to roll out ‘Medicare for all’ bill | Dems target Juul over Altria ties | Measles cases spike nationwide

Welcome to Monday’s Overnight Health Care.

Plenty of news on deck today. Bernie Sanders is going to introduce the newest version of his Medicare for all bill this week, pharmacy middlemen will face a Senate panel tomorrow, Senate Democrats are increasing scrutiny of Juul, and measles cases spiked in the past week.

We’ll start with some news about Medicare for all:  

 

Sen. Bernie Sanders (I-Vt.) will roll out an updated version of his “Medicare for all” plan Wednesday on Capitol Hill.

Sanders, who is again seeking the Democratic nomination for president, will unveil the bill alongside Senate co-sponsors, some of whom are also candidates for president.

Sanders’s bill would largely eliminate private insurance and institute a single-payer system managed by the government. There are also some tweaks from the 2017 version, including coverage for home and community-based care and long-term care, such as nursing homes.

Why it matters: Obviously, Medicare for all isn’t going to pass this Congress. But the issue is playing a big role among the 2020 Democratic field of presidential candidates. Republicans have also seized on it to argue that Democrats want to eliminate private insurance.

A spokesperson for Sen. Cory Booker (D-N.J.), also a 2020 presidential candidate, said he would again sponsor the legislation, which he first backed in 2017.

But Sens. Kirsten Gillibrand (D-N.Y.), Kamala Harris (D-Calif.) and Elizabeth Warren (D-Mass.), all 2020 contenders who sponsored Sanders’ Medicare for All proposal in 2017, didn’t respond to requests for comment.

What to watch for: If those who backed the bill two years ago continue to do so, and if it picks up any more support. 16 senators backed the bill in 2017.

Read more on Sanders’ plans here.

 

 

Dems target Juul over Altria ties, advertising tactics

Senate Democrats are pressing e-cigarette manufacturer Juul for information about its advertising practices and recent partnership with Altria, amid what government officials have called an “epidemic” of youth vaping.

Eleven Democrats, led by Sens. Dick Durbin (Ill.) and Patty Murray (Wash.), sent a sharp letter Monday, accusing the company of being more interested in “padding its profit margin than protecting our nation’s children.”

The senators pressed Juul for information on its sales and ad spending, as well as information given to insurers and providers about whether Juul is effective at helping people quit smoking.

Altria backlash: The senators requested detailed information about Juul’s partnership with Altria, which makes Marlboro cigarettes, and how that will impact the company’s stated goal of reducing youth vaping. Altria invested $13 billion in Juul late last year for a 35 percent stake in the company. The senators said the deal erases “what little remaining credibility the company had when it claimed to care about public health.”

Following the money: The senators asked Juul to disclose any financial ties the company has to a collection of “conservative-leaning and anti-regulation organizations” that urged President Trump to intervene and stop FDA’s crackdown on vaping products.

Read more on the letter here.

 

Measles cases spike to 465 nationwide in past week

The number of measles cases in the country spiked by nearly 100 in the past week, reaching a high of 465, the Centers for Disease Control and Prevention (CDC) said Monday.

This is the second greatest number of cases reported in the U.S. since measles was eliminated in 2000, the agency said. The worst year for measles since then was 2014, when there were 667 cases.

Last week, the CDC confirmed 387 cases across 15 states, which was more than there were in all of 2018.

We’ve got more details on the spike here.

 

DOJ says it could take two years to identify thousands of children separated at border

The Trump administration said it could take up to two years to identify all the children separated from their parents under the administration’s “zero tolerance” policy.

The Department of Justice detailed the proposed timeline in a court filing late Friday. The DOJ had made progress reuniting many of the 2,700 children separated under the policy, but a federal court recently expanded the group to include thousands of children who were separated during an influx that began in 2017, before the “zero tolerance” policy was enacted.

The administration said there could be as many as 47,000 cases of unaccompanied children taken into government custody between July 1, 2017 and June 25, 2018.

DOJ officials said it would take at least a year, and as many as two years, to sort through all the children discharged by the Department of Health and Human Services’s refugee office during that period and identify all the children who were separated.

Commander Jonathan White of the U.S. Public Health Service, who is overseeing family reunification for HHS, said in an affidavit he is trying to streamline the process as best he can, but the sheer number of cases makes identification difficult and will take time.

More on the issue here.

 

Pharmacy middlemen under scrutiny

The Senate Finance Committee tomorrow morning will hear from executives of five of the top pharmacy benefit managers– including CVS Health, UnitedHealth’s OptumRx and Cigna’s Express Scripts– about the role they play in drug pricing.

Both Chairman Chuck Grassley (R-Iowa) and ranking member Ron Wyden (D-Ore.) have been critical of PBMs, which are often referred to as “middlemen.” PBMs administer prescription drug plans for large employers and are tasked with negotiating discounts on drugs with pharmaceutical firms and insurers.

Drug pricing is excessively complicated, and it’s hard to pin blame on one industry over the other. While Democrats and Republicans differ over some of the solutions to high drug costs, the one constant has been cross-industry finger pointing.

When drug company executives were grilled by the Finance Committee earlier this year, they said high prices were the fault of PBMs that pocket the discounts, instead of passing them on to patients. Tomorrow, expect the PBMs to blame the drug industry.  

 

Also on tap tomorrow:

The Senate Judiciary Committee will hold a hearing on the “Pain Capable Unborn Protection Act” at 10 a.m.

The House Education and Labor Committee will vote on a resolution blocking the Trump administration’s expansion of short-term plans at 10:15 a.m.

The House Ways and Means Committee will markup a prescription drug bill at 10:30 a.m.

Speaker Nancy Pelosi (D-Calif.), Ways and Means Chairman Richard Neal (D-Mass.) and Reps. Donna Shalala (D-Fla.) and Michael Burgess (R-Texas) will speak at the American Hospital Association’s annual meeting Tuesday. Check out the full schedule here.

 

SPONSORED CONTENT – PHARMACEUTICAL CARE MANAGEMENT ASSOCIATION

PBMs serve as the check against drugmakers’ pricing strategies by negotiating for consumers and clients to ensure prescription drugs are affordable. Learn how PBMs advocate for patients and payers at OnYourRxSide.org.

 

Mulvaney: Trump officials to release ObamaCare replacement plan ‘fairly shortly’

We’re back to waiting for a new ObamaCare replacement plan.

The administration will release a replacement plan “fairly shortly,” acting White House chief of staff Mick Mulvaney said Sunday.

Administration officials and White House aides, including Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma and Health and Human Services (HHS) Secretary Alex Azar, met for a Saturday summit at Camp David to discuss possible proposals.

“I do think you’ll see a plan here fairly shortly,” Mulvaney said on “Fox News Sunday.”

The big question: What will actually be in the plan? And it will it be an entirely new plan, or will it build on actions the administration has already taken, like expanding cheaper, skimpier health plans and taking actions to bring down drug costs?

The politics: Democrats are reacting with glee at the prospect of President Trump running on health care in 2020, an issue that Democrats think clearly breaks in their favor.

Read more here.

 

What we’re reading

Trump’s health care brain trust says no thanks (Politico)

Health care CEO pay tops $1 billion in 2018 so far (Axios)

Are prescription drug prices soaring? It’s complicated (Pittsburgh Post-Gazette)

 

State by state

Montana Medicaid expansion bill moves to state Senate floor (Associated Press)

Hunger and an ‘abandoned’ hospital: Puerto Rico waits as Washington bickers (New York Times)

Court challenge could halt Indiana’s Medicaid work requirements (NWI.com)

 

From The Hill’s op-ed page

Strong ‘Medicare for All’ legislation is like bargaining a strong union contract