Health Care

Overnight Health Care: Supreme Court strikes down Louisiana abortion law | Governors rethink opening bars, restaurants amid COVID-19 spike | WHO director warns pandemic ‘speeding up’

by Nathaniel Weixel, Jessie Hellmann and Peter Sullivan 06/29/20 06:16 PM ET

Welcome to Monday’s Overnight Health Care.

The number of coronavirus cases in the U.S. is not improving as the death toll surges towards 126,000. More states are pausing reopening measures, most notably bars. Gilead finally put a price tag on remdesivir, but drug pricing legislation in Congress is falling apart.

We’ll start with non-virus news, at the Supreme Court:

Supreme Court strikes down Louisiana abortion restrictions

The Supreme Court on Monday struck down a Louisiana abortion law, handing a win to abortion rights advocates who feared the conservative court would break with past rulings to rein in protections that emerged from the landmark decision in Roe v. Wade.

The justices voted 5-4 to invalidate Louisiana’s admitting-privilege law in the first major abortion ruling of the Trump era, which came after the court struck down a nearly identical Texas restriction four years ago.

Why it matters: The plaintiffs in the case argued the requirements would not improve a woman’s health or safety and would result in the closure of nearly every abortion clinic in Louisiana. The law required physicians who perform abortions to hold “active admitting privileges” at a hospital within 30 miles of their facility.

Narrow concurrence: Chief Justice John Roberts joined the court’s four liberals in ruling against Louisiana. In a concurring opinion, Roberts said his vote was guided by deference to prior rulings, particularly the court’s 2016 decision in Whole Woman’s Health v. Hellerstedt, which struck down a nearly identical Texas law. Roberts dissented in that case, which teed up his vote in the Louisiana case as a crucial assessment of his image as an “institutionalist” justice dedicated to honoring prior Supreme Court opinions, especially recent ones.

Read more here.

Governors rethink opening bars, restaurants amid spike in COVID-19 cases

State and local officials are facing pressure to keep bars and indoor dining closed as the U.S. reckons with another upswing in COVID-19 infections weeks after lockdown measures were lifted.

Indoor venues where people eat, drink and socialize have become a source of COVID-19 spread in several states where cases are rising, forcing leaders to reevaluate their decisions to allow bars and indoor restaurants to reopen during a pandemic. Meanwhile, governors that have not yet allowed those facilities to reopen said they will reconsider their plans to do so.

“I think across all these states, we just can’t have bars — I’m not sure that we can even run restaurants where people are sitting indoors, nightclubs — anything that gathers people indoors I think at this moment is way too risky and has to be dialed back,” said Ashish Jha, professor of global health at the Harvard T.H. Chan School of Public Health, on NBC’s “Today” on Monday.

Context: Governors in Texas, California and Florida mandated bar closures this weekend, and other governors are likely weighing whether they will do the same. Bars and indoor restaurants still remain open in much of the country, including in other states seeing rises in cases, like Arizona, Georgia, Louisiana, South Carolina, Nevada and most counties in Pennsylvania.

WHO director warns pandemic ‘speeding up’

More than 10 million people across the globe have tested positive for the coronavirus, WHO Director-General Tedros Adhanom Ghebreyesus said Monday, nearly 180,000 of whom tested positive in the last 24 hours.

Almost half a million people have died worldwide.

“The reality is this is not close to being over,” Tedros told reporters. “Globally, the pandemic is actually speeding up.”

About half the cases, and nearly half the deaths across the globe, have come in the Americas. The United States, which accounts for about 4 percent of the global population, has nearly a quarter of the total confirmed cases, 2.4 million.

States reported more than 44,000 new cases on Sunday, the WHO said in their daily situation report on Monday, higher than any nation on earth. Brazil reported 46,000 new infections on Saturday, and almost 39,000 new infections on Sunday.

Read more here.

House fires back at Trump by passing ObamaCare expansion

The House on Monday passed a bill to expand the Affordable Care Act as Democrats seek to hammer President Trump and Republicans on health care heading into the November elections.

The legislation, which passed in a largely party-line vote of 234 to 179, would increase the 2010 health law’s subsidies that help people afford their premiums and add more federal funding for Medicaid expansion.

Democrats timed the vote to contrast with the Trump administration’s legal brief filed with the Supreme Court last week calling for the ACA to be struck down, a move Democrats said would be even more harmful during the coronavirus pandemic.

The measure steers clear of the internal Democratic debate over “Medicare for All” and does not include any kind of government-run health insurance program, often called a “public option.”

Caveat: The bill is not expected to go anywhere in the GOP-controlled Senate given Republican opposition to the ACA, also known as ObamaCare.

Read more here.

Trouble in drug-pricing land

Sen. Ron Wyden (Ore.), the top Democrat on the Senate Finance Committee, will not co-sponsor an updated version of what had been a bipartisan measure to lower drug prices, as his partnership with Sen. Chuck Grassley (R-Iowa) on the issue appeared to fall apart on Monday.

Wyden last year introduced a bipartisan bill to lower drug prices that he negotiated with Grassley, the chairman of the Senate Finance Committee. Grassley is now preparing to introduce an updated version of the bill with relatively minor changes, but Wyden is dropping off as a co-sponsor.

Not a great sign for drug pricing chances: The move set off a round of finger-pointing on Monday, as the already long odds for a bipartisan breakthrough on drug prices this year appeared to get even longer.

The competing sides: Grassley said Democrats, led by Senate Minority Leader Charles Schumer (D-N.Y.), were walking away from the negotiations to preserve drug pricing as a campaign issue, while Wyden said Republicans were never really at the table to begin with given that Senate Majority Leader Mitch McConnell (R-Ky.) does not support the bill.

Read more here.

In other drug-pricing news

Gilead will start charging U.S. patients for the experimental drug remdesivir, the company and the Trump administration announced Monday.

A five-day course of remdesivir will cost the U.S. government and other developed countries $2,340 per patient.

Private insurers, but also Medicare and Medicaid, will pay a markup: $3,120 for a five-day course of the drug, and $5,700 for the longer 10-day course. The company intends to begin charging for the drug in July.

The federal government will get a cheaper price than private insurers, CEO Daniel O’Day wrote, because “of the way the U.S. system is set up and the discounts that government health care programs expect.” The U.S. is the only country where Gilead will charge two different prices.

Remdesivir has shown promise in helping hospitalized COVID-19 patients recover faster, but the benefits have been fairly modest, and there was no impact on mortality. Still, it is the only therapy authorized by the Food and Drug Administration to treat COVID patients.

Pushback: The price point was immediately criticized by advocacy groups and Democratic lawmakers as far too high, given the major level of taxpayer support for developing the drug.

The Department of Health and Human Services acquired 500,000 additional doses of the drug and will distribute them through September to state health departments based on the number of hospitalized patients with COVID-19, the agency said.