Overnight Health Care: Walden won’t seek reelection | Senate Dems to vote this week to overturn Trump ObamaCare moves | Largest children’s migrant shelter to close | Vulnerable Republicans balk at drug pricing bill

Welcome to Monday’s Overnight Health Care. 

GOP Rep. Greg Walden (Ore.) is retiring, Kamala Harris spoke about her changing positions on “Medicare for All,” the country’s largest migrant children’s shelter is closing, and there’s drama in the Senate over ObamaCare and drug pricing.

We’ll start with today’s big Republican retirement news:

 

Oregon GOP Rep. Greg Walden won’t seek reelection

Big news for the health care sector: Walden, the top Republican on the Energy & Commerce Committee, will not seek reelection in 2020. 

In the last Congress, Walden was chairman of the full committee, which has immense power over health care issues in the House. 

{mosads}Even though he oversaw the GOP’s failed attempts to repeal and replace ObamaCare in 2017, he has prided himself on bipartisanship, and has been praised by Democrats as someone willing to work across the aisle on health issues. He was instrumental in the House’s 2018 passage of a bipartisan bill to combat the opioid epidemic and has worked to try to bring down prescription drug prices. 

“I will not seek re-election to the U.S. House of Representatives, nor election to any other office, but instead I will close the public service chapter of my life,” Walden said in a statement Monday.

Reaction… From Energy and Commerce Chairman Rep. Frank Pallone (D-N.J.): “When Greg became Chairman of the full Committee, he focused on the growing national opioid epidemic, and we worked closely together to pass the Support for Patients and Communities Act and to investigate opioid distributors and pill dumping in West Virginia. 

“I look forward to completing our bipartisan work over the next year and wish Greg nothing but the best in the future.”

The politics: Walden’s decision is yet another challenge for House Republicans. Walden is the 20th House Republican to decide to not seek reelection in 2020, compared with just seven Democrats.

Read more on Walden’s decision here.

 

Senate Democrats to vote this week to overturn Trump ObamaCare moves

Senate Democratic leaders said they will force a floor vote as early as Wednesday in an attempt to overturn a Trump administration rule that allows states to ignore parts of ObamaCare.

The resolution from Senate Minority Leader Charles Schumer (D-N.Y.) needs a simple majority to pass, meaning Democrats would need four GOP senators to vote against the Trump policy. It’s not likely to happen, but the vote is a symbolic attempt to put vulnerable GOP senators in a tough spot.

The policy: Senate Democrats are forcing a vote to overturn an administration guidance that lets states apply for waivers so they can prioritize cheaper, leaner plans than the ones offered on the ObamaCare exchanges. Basically, it would let states do an end run around the law. The plans don’t need to cover some of ObamaCare’s “essential” benefits such as mental-health services and prenatal care, and they can refuse to cover people with preexisting conditions. The Trump administration has made it a point to tout state flexibility from ObamaCare, but so far, there haven’t been any states to apply. 

The politics: Just because no state has applied, doesn’t mean Democrats will give Trump a pass. In this case, it really is the thought that counts. Democrats see health care and protecting people with preexisting conditions as one of their biggest advantages heading into 2020 and want to put vulnerable Republicans like Martha McSally (Ariz.) and Cory Gardner (Colo.) on record.

“It is preposterous that the Trump administration claims to care about preserving pre-existing condition protections for millions of Americans while simultaneously peddling shoddy, substandard junk plans that undermine and weaken those very protections,” Schumer said.  

Read more on the vote here.

 

Harris: ‘I knew I’d be called a flip-flopper’ on ‘Medicare for All’ 

Sen. Kamala Harris (D-Calif.) is addressing the sometimes winding road she has taken on health care in the presidential race. 

“I said to my team, ‘I know we’re gonna take a political hit for it,'” Harris said in an interview with “Axios on HBO” that aired Sunday. “I knew that. I knew we were. I knew I’d be called a flip-flopper for that.”

Harris said her health proposal was in response to voters who told her they did not want to lose the choice of having a private plan.

“I heard from people, ‘Kamala, don’t take away my choice if I want a private plan. Please don’t take away my choice.’ And I said, you know what? That is fair,” Harris added.

Background: She originally said in January, “Let’s eliminate all that,” in reference to private insurance. In July, she released her own plan that maintained some role for private insurance and would allow privately administered Medicare plans under strict rules.

Big picture: Harris has positioned herself in between staunch Medicare for All supporters like Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.) and those who want an optional government-run plan, like South Bend, Ind., Mayor Pete Buttigieg and former Vice President Joe Biden.

Read more on Harris here. 

 

Largest migrant children’s shelter to close by end of November

The controversial Homestead Shelter, the only for-profit migrant children’s shelter in the country, will close.

The private military contractor which runs Homestead will not have its contract renewed, the administration confirmed Monday.

The contract with Caliburn International, which operates the massive Homestead Shelter in Florida, will end Nov. 30, and the facility will be essentially shuttered. However, the Department of Health and Human Services (HHS) said the shelter is being placed on “warm status,” which means the agency will retain access to the Homestead site and could reopen it for temporary use in the future in the event of an increase in unaccompanied child referrals or an emergency situation.

“In our ongoing efforts to ensure fiscal prudence, following a sustained decrease in referrals, HHS operations at the Homestead Temporary Influx facility will be transitioned into warm status effective immediately,” the agency said in a statement to The Hill. 

Caliburn referred requests to comment to HHS. The company has come under fire from activists and lawmakers who objected to a for-profit, private prison contractor running a children’s shelter at taxpayer expense. Congressional Democrats have also criticized the company for hiring former Trump White House chief of staff John Kelly to serve on its board of directors.

Read more here.

 

Missouri to begin hearing on state’s last abortion clinic

A hearing over Missouri’s last standing abortion clinic will begin Monday to determine whether it can keep its license to provide abortions.

Administrative Hearing Commissioner Sreenivasa Rao Dandamudi will preside over the hearing as an “independent trial judge,” the Associated Press reported, citing a commission official.

Missouri would become the first state since 1974, the year after the Roe v. Wade decision, to not have a functioning abortion clinic, if the clinic is shut down. 

The Planned Parenthood of the St. Louis region had its license officially expire at the end of May. A court ordered the clinic to continue providing abortions until the dispute with the state health department is resolved. 

What’s next: The hearings will take five days and will include testimony from state health officials and Planned Parenthood employees.  

Read more on the hearing here.

 

Vulnerable Republicans balk at Trump-backed drug pricing bill

Sen. Chuck Grassley (R-Iowa) is pitching his drug pricing bill as a good way for Republicans to keep control of the Senate next year. 

But many vulnerable Senate Republicans don’t seem to agree as of yet. 

GOP Sens. Thom Tillis (N.C.), Martha McSally (Ariz.), Cory Gardner (Colo.) and Joni Ernst (Iowa), who all face potentially tough races next year, have either expressed concerns about the legislation or declined to back it. Sen. Susan Collins (Maine) is the lone vulnerable Republican to endorse the measure.

The calculation: On the one hand, the bill has the support of President Trump, and lowering drug prices is a popular issue with voters. But on the other hand, supporting the bill breaks with GOP orthodoxy and invites a backlash from both conservatives and the pharmaceutical industry.

The most controversial provision for Republicans requires drug companies to pay money back to Medicare if their prices rise faster than inflation, something some Republicans view as too close to a “price control.”

Read more here. 

 

House moving PBM transparency bill

The House on Monday night is expected to pass a bipartisan bill to require pharmacy benefit managers to post the total rebates that drug companies pay to them on a public website to help increase transparency around PBMs. 

Context: The passage of this bipartisan bill, shows that the House is moving forward on at least some small, noncontroversial measures at the same time that Democrats push forward on their sweeping, signature drug pricing legislation. 

The moderate Blue Dog Coalition endorsed this bill and had called for a vote on it and other measures. 

Swing-district Democratic Reps. Abigail Spanberger (D-Va.) and Elissa Slotkin (D-Mich.) are sponsors. The lead Republican is Rep. Jodey Arrington (R-Texas).  

 

Coming up this week: 

The Senate Finance Committee will hold a hearing on compliance with Medicaid eligibility requirements, Wednesday at 2 pm. 

The Senate health committee will markup several bills Thursday at 10 a.m.

 

What we’re reading

2020 ObamaCare premiums are on track for smallest increases ever (Vox.com) 

Democrats’ new logic on drug pricing: Developing slightly fewer medicines is OK if it means lower prices (Stat News) 

Elizabeth Warren’s ambiguity on health care comes with some side effects (NPR) 

 

State by state

States try a gentler approach to getting Medicaid enrollees to work (Kaiser Health News)

Medicaid patients sick and stranded after Florida state-provided rides fail to show  (WFLA) 

Farmworkers face daunting health risks in California’s wildfires (Kaiser Health News) 

 

From The Hill’s opinion page:

Another Chinese threat to our national security: Prescription drugs