Welcome to Overnight Health Care, Thursday edition, where everyone is captivated by the immigration debate in Washington.
Follow The Hill’s live blog on the immigration drama in Congress. The quick skinny: A hardline immigration bill failed in the House; meanwhile, House GOP leadership postponed a vote on a compromise bill.
Also, the controversy over Trump’s policy of separating children from families caught crossing the border illegally isn’t over yet. Trump signed an executive order Wednesday stopping the practice, but there are worries about the potential long-term health impacts for children who have already been separated.
On Thursday, Democrats and medical professionals called for children separated from their families at the border to be immediately reunited to minimize any long-term harm to their mental and physical health.
“The executive order President Trump signed yesterday does not resolve this crisis that he created,” said Democratic Whip Steny Hoyer (Md.) at a press conference with representatives of health groups.
Why it matters: Trump’s executive order mandates that families crossing the border be detained together, but does not address the 2,300 children who have already been separated from their families. Health groups say the children need to be reunited with their families ASAP to minimize any impacts to their mental and physical health.
Key quote: “These children have been needlessly traumatized and must be reunited with their parents or other family members as quickly as possible,” said Arthur Evans, CEO of the American Psychological Association.
Potential health problems include Post Traumatic Stress Disorder, substance use, aggressive behavior, decline in educational achievement, and even heart disease, diabetes and cancer later in life.
The top Democrat on the House Energy and Commerce Committee wants the government’s watchdog to audit efforts by HHS and DHS to reunite children separated from their families.
Key quote: “To bring accountability and ensure these children are properly accounted for and ultimately reunited with their families, Congress needs an immediate assessment of the systems or processes by which ORR [HHS’s Office of Refugee Resettlement] and DHS are tracking each minor in their care, as well as their respective parents or guardians from whom they were separated,” Rep. Frank Pallone Jr. (D-N.J.) wrote in a letter to the Government Accountability Office sent Thursday.
White House wants to reorganize the federal government
The White House on Thursday released a sweeping plan to reorganize the federal government, but its main proposals face a chilly reception in Congress.
The main proposals:
- Move the food stamp program, officially known as SNAP, out of the Department of Agriculture and into the Department of Health and Human Services. That department would then be renamed the Department of Health and Public Welfare.
- A new Council on Public Assistance would then oversee programs gathered in one place, including food stamps and Medicaid, and have the power to impose uniform work requirements in those programs, a move strongly opposed by Democrats.
- Privatize the United States Postal Service.
- Merge the Department of Agriculture’s food safety regulators with those in the Food and Drug Administration.
The catch: Most of the proposals would require action from Congress.
Dems panned the proposals: “Democrats and Republicans in Congress have rejected President Trump’s proposals to drastically gut investments in education, health care, and workers — and he should expect the same result for this latest attempt to make government work worse for the people it serves,” said Sen. Patty Murray (D-Wash.), the top Democrat on the Senate Health, Education, Labor, and Pensions Committee.
Planned Parenthood fights changes to family planning program in court
A federal district court in D.C, heard arguments Thursday in Planned Parenthood’s case against the Trump administration. Earlier this year, the Trump administration made several changes to the Title X Family Planning Program that Planned Parenthood argues puts them at a disadvantage for receiving funding. Planned Parenthood and the American Civil Liberties Union argue the changes are illegal and should be thrown out. Here’s the gist:
- Planned Parenthood takes issue with a new scoring mechanism laid out in the funding opportunity announcement (known as an FOA, a document that describes HHS’ priorities for the program this year).
- Planned Parenthood also says it is disadvantaged by the FOA’s emphasis on abstinence and suggestion that providers offer primary health care services on site, or through nearby providers with referrals.
- An independent panel reviews the applications from providers for HHS, scoring each applicant on how it meets program priorities laid out in the FOA.
- Planned Parenthood argues the new requirements, and the scoring mechanism, are unlawful because HHS did not go through a notice and comment period.
- HHS argues these aren’t requirements at all, but suggestions. It also notes that the Deputy Assistant Secretary at HHS has the final say in which organization gets grants. She does not have to follow the panel’s recommendations.
- HHS also argues it doesn’t need to go through a notice and comment period, because FOAs typically don’t. The bar for what requires a notice and comment period is high, an HHS lawyer argued. The changes in grants are discretionary and procedural, and the changes are suggestions, not requirements.
What next: Planned Parenthood is asking the judge to order HHS to give current grantees continuation funding until the agency can issue another FOA. HHS is asking the judge to dismiss the suit.
Insulin prices have skyrocketed, sparking outrage from diabetes advocates.
They’re calling for greater transparency and federal oversight of the market for a drug that helps more than 7 million Americans.
Three companies — Eli Lilly, Sanofi and Novo Nordisk — control 99 percent of the world’s insulin, and advocates have been asking them to explain their pricing. According to the American Diabetes Association, the average price of insulin nearly tripled between 2002 and 2013.
Case in point: The price for a vial of one the most popular insulin brands, Humalog, increased from $21 in 1996, to $35 in 2001, to $234 in 2015, to $275 in 2017. There are no generic forms of insulin on the market, but there are some cheaper “biosimilar” versions.
One of the country’s largest insurers, Cigna, aims to reduce drug overdoses by 25 percent in key areas.
Where the effort will be focused: Connecticut, Maryland, New Jersey and Virginia — as well as the metropolitan areas of Chicago, New York, Philadelphia and Washington, D.C.
How it works: Cigna plans to use predictive analytics to identify customers who are at the highest risk for an opioid overdose and develop partnerships in those areas to help combat the opioid epidemic, Dr. Doug Nemecek, the company’s chief medical officer for behavioral health, told The Hill.
When the insurer identifies a person at risk of an overdose, the company’s licensed clinicians reach out. Then, they can provide education on overdose risk factors, perform assessments on their health, identify any risks for mental health and substance use disorders that might require additional care, make referrals and more.
***
Sponsored Content –Association of American Medical Colleges
While all doctors are trained to treat pain and addiction, specialists in these fields are critical to address this issue in urban and rural communities alike. The bipartisan “Opioid Workforce Act of 2018” would provide federal support to train more doctors in addiction medicine, addiction psychiatry, and pain management. We urge Congress to include this legislation in any final package to combat the opioid epidemic. www.aamc.org/opioidresponse
***
What we’re reading:
A look inside the places where infant and child migrants are held (CNN)
Meet the anti-abortion Trump appointee taking care of separated kids (Politico)
The health care industry needs workers. So it’s turning to former factory and retail workers (CNNMoney)
State by state
States brace for dramatic overhaul to federal foster care funding (The Hill)
Oscar Health to expand individual insurance to more states (Reuters)
Abrams pushing health care as a key issue in her campaign for Georgia governor (Georgiahealthnews.com)
From The Hill’s opinion pages
With so much trauma, let’s make mental health America’s No. 1 issue
Justice Department made terrible move with ObamaCare mandate
The Hill presents:
Join us Tuesday, June 26 for “Mergers and Innovation: Measuring Performance and Patient Care,” featuring HHS Deputy Secretary Eric Hargan, Sen. Bill Cassidy (R-La.) and Rep. Gene Green (D-Texas). Topics of discussion include how the landscape of health care delivery in the United States is undergoing a dramatic shift, its implications for health care industry stakeholders and patients and also the role of Congress in ensuring all Americans have access to quality care. RSVP Here.