Overnight Health Care — Presented by Purdue Pharma — Trump insists GOP will ‘totally’ protect people with pre-existing conditions | Landmark opioid bill signed into law | Report finds agencies blindsided by ‘zero tolerance’ policy

by Nathaniel Weixel, Jessie Hellmann and Peter Sullivan - 10/24/18 8:26 PM ET

Welcome to Wednesday’s edition of Overnight Health Care.

President Trump and Republicans are trying to make their closing arguments ahead of the midterms, insisting they support pre-existing condition protections. Meanwhile, a Democratic analysis shows who could be harmed if the administration-backed lawsuit against ObamaCare succeeds.

President Trump also signed a landmark opioids bill into law today, and he’s expected to make a major announcement tomorrow at the Department of Health and Human Services. It’s a bit of a mystery… the announcement could be related to opioids or drug pricing.

Let’s start with the fight over pre-existing conditions…

Trump insists GOP will ‘totally’ protect pre-existing conditions, despite ObamaCare repeal efforts.

Trump is stepping up his efforts to try blunt Democratic attacks on pre-existing conditions, despite his support for ObamaCare repeal.

“Republicans will totally protect people with Pre-Existing Conditions, Democrats will not! Vote Republican,” Trump tweeted Wednesday.

But: Trump last year supported GOP-authored ObamaCare repeal bills that would have weakened protections for pre-existing conditions. The bill from House Republicans, for example, allowed states to get waivers that would allow insurers to spike premiums for people with pre-existing conditions.

The Trump administration is also supporting a lawsuit currently in federal court seeking to overturn ObamaCare’s protections for people with pre-existing conditions.

Political context: Democrats are pounding Republicans with ads across the country highlighting the effect of GOP ObamaCare repeal votes on pre-existing conditions. Republicans are scrambling to counter those attacks.

Read more here.

Meanwhile, a new analysis shows over 15 million people could be at risk if the lawsuit succeeds.

More than 15 million people could either lose their health coverage or face premium increases as a result of their pre-existing conditions, gender or age, according to a new report released by congressional Democrats on Wednesday.

The report, released by Democratic staff on the House Oversight Committee, serves as a counterpoint to claims by Republicans ahead of the midterms that they will protect people with pre-existing conditions.

The report only examined people who purchase insurance through the individual market. It found that if the lawsuit is successful, just over 10 million people may lose federal protections against coverage denials or premium increases.

Who else could be hurt: Of those 10 million, just over 4.8 million have pre-existing health conditions severe enough that insurers may deny them coverage altogether, the report said. In addition, more than 9 million women could face coverage denials or premium increases because of their gender.

More numbers: A separate report conducted by the consulting firm Avalere found over 100 million people could face higher premiums or significant out-of-pocket costs if ObamaCare is repealed or its pre-existing conditions protections are eliminated.

Why the difference: Unlike the congressional study, the one from Avalere looked at everyone with commercial insurance, including employer-sponsored coverage. Prior to ObamaCare, employers could refuse to cover pre-existing conditions for up to a year-long “waiting period” if employees failed to maintain continuous coverage, a practice that could return if the law’s protections are repealed.

Read more here.

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Watch out tomorrow: Trump speech and an announcement…

President Trump will give a speech Thursday at HHS headquarters, which sources say is expected to focus on drug pricing.

The suspense: There is expected to be an announcement of some kind, though it is not clear what it will be.

Fighting high drug prices has been a focus for Trump, who has railed against drug companies for their high prices.

His administration rolled out a series of actions on the topic, including a move earlier this month to force pharmaceutical companies to disclose prices for their drugs in TV ads.

Democrats praised that move, but have also called for stronger action on the topic, such as allowing Medicare to negotiate drug prices.

Read more here.

Trump signs sweeping bill aimed at tackling opioid crisis

President Trump on Wednesday signed sweeping legislation meant to curb the nation’s opioid epidemic.

The bipartisan bill, which passed Congress earlier this month, includes dozens of treatment, prevention and enforcement provisions authored by hundreds of lawmakers representing states ravaged by the epidemic.

“Together we are going to end the scourge of drug addiction in America,” Trump said during a ceremony at the White House.

“We are either going to end it or we are going to make an extremely big dent in this terrible, terrible problem.”

Context: Mostly everyone supports the bill, but wishes it went further in addressing the epidemic that killed 49,000 people last year. The main criticism is it doesn’t dedicate enough funding to the problem. The bill Trump signed Thursday cost around $8.5 billion, but that money was already authorized by Congress earlier this year.

Many advocates like a bill authored by Sen. Elizabeth Warren (D-Mass.) and Rep. Elijah Cummings (D-Md.) that would provide $100 billion in funding over 10 years to address the crisis.

From Sen. Patty Murray (D-Wash.), the ranking Democrat on the Senate health committee:

“We must remember this crisis is far from over. We need to build on our work in this important legislation, which is why Democrats are going to keep fighting for more action and greater investments to provide our communities with the resources they need to address the root causes and ripple effects of this heartbreaking epidemic.”

Republicans also agree there’s more work to be done. From Energy & Commerce Committee Chairman Greg Walden (R-Ore.)

“Rarely can we say that legislation will save lives, but there is no doubt that H.R. 6 will do just that. While there is more work to be done, we are proud of the important step forward our nation is taking today.”

Read more here.

How the administration’s “zero tolerance” policy blindsided agencies.

Key government agencies were blindsided by the Trump administration’s “zero tolerance” policy and had no plan in place to deal with the thousands of children who were separated from their parents, according to government investigators.

Both the Department of Health and Human Services (HHS) and the Department of Homeland Security (DHS) were caught off guard when Attorney General Jeff Sessions released the “zero tolerance” memo in April.

The agencies had no idea the memo was coming, and as a result did not take specific steps to plan for the separation of parents and children or potential increase in the number of children who would be held by HHS’s Office of Refugee Resettlement.

More than 2,600 children were separated from their parents over the course of just three months before a massive backlash led the administration to cancel its policy.