Overnight Health Care — Presented by Johnson & Johnson — Virginia moves to suspend Medicaid work rules | Powerful House panel sets ‘Medicare for All’ hearing | Hospitals sue over Trump price rule | FDA official grilled on vaping policy

Welcome to Wednesday’s Overnight Health Care.

Hospitals are taking the Trump administration to court, Virginia plans to suspend Medicaid work requirements, the House Energy and Commerce Committee is holding a “Medicare for All” hearing, FDA’s tobacco chief faced questions in the House, and every state now has reported a vaping-related injury.

We’ll start with Medicaid news

 

Virginia moves to suspend Medicaid work requirements

In the latest example of “elections have consequences,” Virginia is moving to drop work requirements from its Medicaid program after Democrats took full control of the state legislature.

Gov. Ralph Northam (D) said in a statement that he has instructed the state’s Medicaid director to “pause” negotiations with the Trump administration about how to implement the requirements that certain “able-bodied” Medicaid recipients need to work and pay premiums.

“Virginians made it clear they want more access to health care, not less,” he said in the statement. “Given the changed make-up of the General Assembly and based on conversations with new leadership, it is unlikely Virginia will move forward with funding a program that could cause tens of thousands of Virginians to lose health care coverage.”

The backstory: Virginia was one of several states that initially rejected Medicaid expansion under ObamaCare, but Democrats nearly flipped the state House in 2017 after running on expansion. So several Republicans were looking for a compromise: work requirements. 

The new reality: In last month’s elections, Democrats took control of the General Assembly for the first time in 26 years, making it unlikely the state would keep moving forward on work requirements. Aside from politics, Northam cited the likelihood of spending money defending the state against the lawsuits that have been filed against other states with work requirements. 

More on Northam’s announcement here.

 

 

FDA official grilled on vaping policy 

A top Food and Drug Administration (FDA) official was hammered by members of Congress Wednesday for not answering questions about the agency’s plan to curb youth vaping rates. 

Mitch Zeller, director of the Center for Tobacco Products, would not say whether the FDA is still considering a proposal to clear the market of flavored e-cigarette products it says are appealing to kids. 

“There has been no final decision made on this policy. Because there’s ongoing discussions that are taking place I’m not going to be able to get into the substance of what was in that document,” Zeller said about guidance the FDA sent to the White House in October. 

That response wasn’t sufficient for Democratic members of the House Oversight Committee, who have grown frustrated with the administration’s slow pace. 

“I suggest you go back to the FDA and you tell them the American public is up in arms about this youth e-cigarette epidemic,” said Rep. Raja Krishnamoorthi (D-Ill.), chairman of the Oversight Subcommittee on Economic and Consumer Policy. 

“It’s time to get their act together and put this flavor ban together immediately, without delay, before another child gets hooked to these e-cigarettes.” 

President Trump and his top health officials said in September the administration would soon issue guidance clearing the market of flavored e-cigarettes. 

The FDA sent that guidance in October to the White House regulatory office, which finished its review last month. But the administration hasn’t given any indication of whether it will move forward with a full flavor ban or pursue a different policy. 

 

Powerful House panel to hold ‘Medicare for All’ hearing next week

Get ready for a fight over Medicare for All in the Energy and Commerce Committee next week. 

The House Energy and Commerce Health Subcommittee will hold a hearing next Tuesday on the Medicare for All bill introduced by Reps. Pramila Jayapal (D-Wash.) and Debbie Dingell (D-Mich.), along with six other bills, including scaled-back “public option” proposals. 

Big picture: This is a step forward for Medicare for All in getting a hearing in a key committee. But that doesn’t mean leadership supports the idea or that it will get a vote in this Congress. 

Speaker Nancy Pelosi (D-Calif.), while giving her support to airing ideas at a hearing, has been raising increasingly explicit warnings against the policy dominating her party’s presidential race, warning of its cost and that people do not want to lose their private insurance. 

“I’m not a big fan of Medicare for All,” she said last month.  

Read more here. 

 

Hospital groups file lawsuit to stop Trump price transparency rule

Hospitals are stepping up their battle against the Trump administration over its transparency rules. 

Hospital groups on Wednesday filed a lawsuit to stop the Trump administration’s price transparency rule that requires hospitals to disclose negotiated rates with insurers.

“Instead of giving patients relevant information about costs, this rule will lead to widespread confusion and even more consolidation in the commercial health insurance industry,” said Rick Pollack, president and CEO of the American Hospital Association. “We stand ready to work with CMS and other stakeholders to advance real solutions for patients.”

Fight brewing: The Trump administration is not backing down and appears eager to take on hospitals. 

“Hospitals should be ashamed that they aren’t willing to provide American patients the cost of a service before they purchase it,” HHS spokeswoman Caitlin Oakley said.

Earlier on Wednesday, CMS Administrator Seema Verma published an op-ed in the Chicago Tribune, taking hospitals to task for a lack of transparency. 

Read more here.

 

Trump targets drug protections to save trade deal

The Trump administration is reportedly considering easing patent protections for brand-name drugs in order to secure Democratic support to pass the new North American trade deal through Congress.

If approved, the change would be a major shift in Republican priorities and a significant blow to the pharmaceutical industry, which opposes the move.

But the politics around drug pricing have changed, and President Trump is looking for a deal. He has also made lowering drug prices a key priority for his presidency.

The current language in the U.S.-Mexico-Canada Agreement (USMCA) gives branded biologics — drugs that are made from living organisms rather than synthetic chemicals — 10 years of protection from cheaper alternatives.

Congressional Democrats seized on this language and insisted they would not vote for the deal unless it was changed. Now, the administration is reportedly considering scaling back or even eliminating the protections outright to allow cheaper, generic versions of biologic drugs to come to the market quicker.

Changing patent protections, though, is opposed by powerful pharmaceutical industry interests, and it’s not clear if drug protections alone will be enough to get reluctant Democrats to push the trade deal over the finish line.

Read more here.

 

SPONSORED CONTENT – JOHNSON & JOHNSON

We’re helping to solve America’s urgent health issues by developing a vaccine to prevent HIV, fighting cancer, relieving depression and making personalized joint replacements. Read our latest Health for Humanity Report.

 

Alaska reports first vaping-related injury

An Alaska teen has been hospitalized for a vaping-related injury, the state announced Wednesday. Every state in the country has now reported instances of vaping-related injuries.

The state’s Department of Health and Social Services announced on Wednesday that the teen from Southeast Alaska is hospitalized and improving. The patient reported regularly vaping nicotine and THC products, it said. 

The department added that it had investigated nine suspected cases of vaping-related injuries over the past several months but said this is the first that meets the Centers for Disease Control and Prevention (CDC) requirements to be classified as such a case. 

The CDC still hasn’t identified a specific product or ingredient that is making people sick. The only thing in common between all cases is that patients had used e-cigarette products. 

Most of the patients had vaped THC, the psychoactive ingredient in marijuana, before becoming ill. THC was present in most of the samples collected, and many patients had purchased those products off the street.

But it’s not clear if it’s the THC or any number of chemicals and substances that are found in vaping liquids are causing the lung illnesses.

Read more here.

 

What we’re reading

Why health insurance in rural America is suddenly getting cheaper under ObamaCare (Vox.com)

A clinical trial for Huntington’s opens the door to hope for some patients. Only so many can get in (Stat News) 

Candidates are betting big on health. Is that what voters really want? (Kaiser Health News)

 

State by state

Wyoming governor promises Medicaid expansion will get ‘fair hearing’ (Associated Press) 

Minnesota suing Juul for ‘targeting youth’ in e-cig marketing (Minnesota Public Radio)

Bankruptcy judge in New York considers $1.3M bonus for Purdue Pharma CEO (NBC New York) 

 

From The Hill’s opinion page

American health care has a new third rail