Overnight Health Care: House GOP talking employer mandate repeal | Trump officials face decision on lifetime Medicaid limits | Trump fires first salvo on drug prices

by Nathaniel Weixel - 02/13/18 6:04 PM ET

House GOP discussing repeal of ObamaCare employer mandate

House Republicans are in discussions about repealing or delaying ObamaCare’s employer mandate to offer health insurance, House Ways and Means Chairman Kevin Brady (R-Texas) said Tuesday.

Brady told reporters that he has discussed the idea with Secretary of Health and Human Services Alex Azar, as well as other members of Ways and Means.

“We’ve discussed that with him as well as committee members, so yeah, there is that discussion, and I’d like to see us make progress there,” Brady said.

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He said he hopes relief from the mandate, which imposes a financial penalty on businesses with 50 or more employees that do not offer health coverage for their workers, would be retroactive to prevent employers for being penalized for not offering coverage back to 2015, when the mandate took effect.

The employer mandate is generally not seen as a core part of ObamaCare. But it has drawn opposition from business groups who say it is a burden.

With more sweeping ObamaCare repeal efforts appearing unrealistic at the moment, Republicans are shifting to chipping away at certain parts of the law.

Read more here.

Ryan calls for ‘incremental’ health reforms after failure of ObamaCare repeal

Speaker Paul Ryan (R-Wis.) is calling for “incremental” health-care reform after the Senate failed to pass an ObamaCare replacement bill last year.

Asked on Fox Business on Tuesday if lawmakers will try again to pass an ObamaCare repeal bill this year, Ryan pointed to incremental changes.

“Well, I think there are a lot of things we can do kind of incrementally,” Ryan said.

The comments are an acknowledgement that there is no apparent path forward for a large-scale ObamaCare replacement or entitlement reform bill this year in the Senate, where Republicans now have a one-seat majority.

Ryan noted that the opposition of Sen. John McCain (R-Ariz.) is what prevented the Senate from passing a pared-down ObamaCare repeal bill.

“What we tried to do was do it all in the House bill with repeal and replace,” Ryan said. “Like I said, we passed it. And that bill — one guy in the Senate did this instead of that and that went down. That would have been the biggest entitlement reform bill ever passed by Congress.”

As examples of previous incremental steps, Ryan pointed to repealing the ObamaCare individual mandate in the tax bill, as well as charging wealthier seniors higher Medicare premiums and repealing the Medicare cost-cutting board known as the Independent Payment Advisory Board in the budget deal last week.

Read more here.

Trump officials face decision on lifetime limits for Medicaid

The Trump administration is facing a crucial test of how much flexibility they are willing to give states to remake their Medicaid programs.

Federal officials have already given the green light to two states to impose work requirements on Medicaid recipients, and at least eight other states are hoping to follow.

But a handful of other states want to go even further by putting a lifetime cap on how long people can be enrolled in the Medicaid program.

No state has ever put a limit on how long a person can receive Medicaid benefits. But given that the Trump administration has already shown a willingness to approve conservative policies like work requirements, premiums and lockout periods for Medicaid, many experts and advocates think lifetime limits could also win approval.

Critics of lifetime limits say they would fundamentally shift Medicaid from a health care safety net program for the poor and sick to a welfare program.

“It’s clear that [the administration] view[s] Medicaid not as a health insurance program. They are hopeful to get as many people off the program and off public assistance as possible,” said Jessica Schubel, a senior policy analyst at the Center on Budget and Policy Priorities.

Read more here.

Trump fires first salvo on drug prices

President Trump is beginning to move on high drug prices, unveiling a series of modest proposals in his budget request released Monday.

It’s the first time Trump has issued major proposals to lower drug prices since coming to the White House, despite criticizing pharmaceutical companies last year and accusing them of “getting away with murder.”

Advocates for lowering drug costs greeted the proposals on Monday as a step in the right direction, but said they are not nearly enough.

David Mitchell, founder of the advocacy group Patients for Affordable Drugs, said the proposals are “tinkering around the edges” of the issue but do not get at the “root cause, which is the drug companies charge too much money.”

The proposals in Trump’s budget include capping out-of-pocket drug costs for Medicare enrollees, allowing up to five states to join together to negotiate drug prices in Medicaid, limiting the growth rate of certain Medicare drug payments to inflation and requiring insurers to pass drug discounts on to consumers.

Notably, the proposals do not include more sweeping changes that Trump has supported in the past, such as Medicare negotiating drug prices or allowing the importation of drugs from abroad.

Read more here.

Planned Parenthood announces nationwide push for abortion, birth control legislation

Planned Parenthood on Tuesday announced a nationwide initiative to expand access to abortion, birth control and reproductive health care.

Planned Parenthood, its affiliates, state lawmakers and other partners will roll out legislation in more than a dozen states this week that it says will expand access to sexual and reproductive care, with a plan to advance initiatives in all 50 states by the end of the year.

Planned Parenthood framed the new push as a rebuttal to the Trump administration’s “attacks” on women’s health care.

Planned Parenthood and its partners are set to roll out and advocate for bills they argue would protect birth control coverage, expand access to abortion and make sex education more inclusive.

The group is pushing for the passage of a bill in Maine that would require all nurse practitioners to provide the abortion pill to patients upon request. And in Missouri, a bill supported by Planned Parenthood would repeal the state’s 72-hour waiting period for abortions.

Read more here.

McCaskill report: Opioid manufacturers gave millions to advocacy groups

A new report from Sen. Claire McCaskill (D-Mo.) found that five opioid manufacturers paid nearly $9 million to 14 outside groups between 2012 and 2017, alleging that the advocacy groups often “amplified messages favorable to increased opioid use.”

The groups — many of which work on chronic pain and other opioid-related issues — lobbied to defeat prescriber limits on opioids and many criticized facets of 2016 guidelines that limited the prescribing of painkillers from the Centers for Disease Control and Prevention (CDC), according to the report.

Additionally, the report noted a “lack of transparency” around the donors who give to the advocacy groups. While the groups aren’t required to disclose their donors publicly, McCaskill said that should be changed.

Read more here.

What we’re reading

Opioid crisis cost US more than $1 trillion since 2001 (Washington Examiner)

Administration imposes sweeping limits on federal actions against companies (The New York Times)

Sneeze machine study takes a deep dive into how flu spreads (NBC News)

State by state

California’s regulators to investigate Aetna’s medical coverage decisions (Kaiser Health News)

NC treasurer to UNC Health Care: Put up $1 billion to guarantee cost savings (Charlotte Observer)

Doctors in Maine say halt in OxyContin marketing comes ’20 years late’ (NPR)

From The Hill’s opinion pages:

Congress just took action on technology enabled Medicare reforms

State lawmakers have a responsibility to reform Medicaid