Overnight Health Care — Presented by the National Taxpayers Union — Trump officials approve work requirements in Michigan, Maine | How Dems in one state are moving to protect ObamaCare

Welcome to Friday’s Overnight Health Care.

A quick programming note: We will be taking a break next week. The newsletter will be back Jan. 2. Happy holidays!

As for today, Washington is focused on the shutdown fight but there’s also important health care news….

Trump administration approves work requirements in Maine, Michigan

The Trump administration handed victories to two outgoing Republican governors Friday when the Centers for Medicare and Medicaid Services approved Medicaid work requirements in Maine and Michigan.

That means the administration has now approved work requirements for seven states, including Indiana, Arkansas and Wisconsin.

“The CMS sleigh has made deliveries to Kansas, Rhode Island, Michigan, & Maine this week to drop off signed #Medicaid waivers. Christmas came early for these Governors & we are proud to support local innovation all across this great country!” CMS administrator  Seema Verma tweeted Friday.

Why it matters: Maine and Michigan elected Democratic governors in November who oppose work requirements. They take office in January, but it’s unclear what, if anything, they can do about them.

Read more here.

Pennsylvania state Senate Democrats move to protect ObamaCare after court ruling

One question after a federal judge struck down the Affordable Care Act last week is whether states will take action to fight back themselves.

Turns out at least Pennsylvania Democrats are. State Senate Democrats will introduce bills to codify the health law’s essential health benefits, on what an insurance plan must cover, and the ban on discriminating based on pre-existing conditions, according to the Pittsburgh Post-Gazette.

“People are certainly concerned. The ruling has frightened some people,” said state Sen. Judy Schwank (D) according to the Post-Gazette.

Democrats in Congress are so far not calling for legislative action beyond formally intervening in the lawsuit to argue in favor of the law. Many legal experts expect the ruling to be reversed on appeal.

Read more here from the Post-Gazette.

Individual mandate not all that big a deal after all?

Democrats pounded the drum with warnings not to repeal the individual mandate, warning of spiking premiums and fewer people enrolling.

But after the latest sign-up numbers came in just modestly down in the first year without a mandate, maybe it seems the mandate was not all that important?

“The law originally took a carrot-and-stick approach, and it’s pretty clear the carrots had a lot more power than the stick,” Larry Levitt, a health policy expert at the Kaiser Family Foundation told the Associated Press.

Caveat: It’s possible some effects of repealing the mandate already showed up in premiums last year, because insurers anticipated that the mandate would be gone.

Read more here, from the Associated Press.

What we’re reading

Why the spotlight on generic drug prices is getting brighter (Axios)

Wisconsin Republican walks back comments on Medicaid expansion (Associated Press)

State by state  

Obamacare sign-ups hit record In Oklahoma, but cuts in outreach could affect rural areas (KGOU)

Montana governor confident about Medicaid fight ahead (Associated Press)