Overnight Health Care: GOP in retreat on ObamaCare | Drug pricing fight heads to the states | PhRMA spends record amount on lobbying

View in your browser     Welcome to the Friday edition of Overnight Health Care. While Congress may be out of town today, we're still here to bring you the latest health news. Lobbying disclosures are due by midnight, which we means we get to find out how much health companies spent courting members of Congress and the administration. Many companies are late filers, so we may have to update you Monday. But we'll tell you what we do know so far. Hint: PhRMA spent a lot.   But first: Republicans are backing off ObamaCare as a campaign issue ObamaCare repeal dominated the agenda last year, but now Republicans are backing off as they campaign in 2018. That's certainly a shift from 2010 and 2014, when repeal was a rallying cry for Republicans in the midterms. "I am focused on improving healthcare in any way we can; I'm not looking to tilt at windmills," said Rep. Tom MacArthur (R-N.J.), who played a key role in last year's repeal push. "I don't think it's seen as a winning issue," said GOP strategist Ford O'Connell. "It's also an issue that tends to fire up the Democratic base more so than the Republican base." What's changed? Some Republicans blamed the Senate for its failure to pass repeal, saying that had taken away the issue. The House GOP did its job, and now some GOP supporters of repeal say the House is paying for the Senate's sins. Democrats, though, point to the health law's rising popularity in polls. Read more here.   Trendy in the states: Drug pricing. Congress has railed against pharmaceutical executives for jacking up the prices of some medicines. But lawmakers haven't passed sweeping legislation to address the issue. That's led many states to tackle the industry on their own. Legislatures across the country have considered a slew of bills aimed at decreasing the cost of drugs, increasing price transparency and cracking down on controversial industry practices. On the federal front: Trump is expected to give a speech on prescription drug prices Thursday, but the White House has indicated the speech will mostly be a call for new ideas to address drug prices. Read more here.   PhRMA spends record amount on lobbying amid drug pricing fights. The largest drug lobby group in America beat its own record for the most spent on lobbying in a single quarter. PhRMA spent $10 million in the first quarter of this year as it looked to stop a bipartisan drug pricing measure from becoming law. That's a $2 million increase compared to the same time last year, and a $4 million increase over the fourth quarter, which was the end of last year. A win: The group's effort to fight the CREATES Act, intended to increase competition among generic and branded drug manufacturers, paid off. The measure did not make it into Congress's February spending bill. A loss: PhRMA was unable to stop a provision that raised the share of costs that drug companies have to pick up as part of closing the "donut hole," a gap in drug coverage for Medicare Part D beneficiaries. The bottom line: PhRMA is one of the most powerful lobbying groups in Washington, and they can, and do, use their clout to block bills that could hurt their bottom lines. Read more here.   Also from the lobbying reports: The American Hospital Association spent $5 million on lobbying, an increase of about half a million compared to last quarter. The American Medical Association spent $6.6 million, down by a couple hundred thousand compared to this time last year. AARP kept its spending relatively level compared to Q1 of 2017, spending $2.1 million. America's Health Insurance Plans (AHIP), the largest trade group of insurance companies, spent $2.3 million, an increase of about $600,000 over last year's first quarter.     The fifth of The Hill's Close to Home series on opioids, presented by Partnership for Safe Medicines, talked to Rep. Donald Norcross (D-N.J.) about his grandmother and brother-in-law's addiction to alcohol and how the epidemic is hurting rural communities in his district. Norcross' grandmother was loving and caring, donating on all four of her grandsons whenever they visited. But the Norcross brothers didn't get to visit when she was in "one of those moods." He eventually learned his grandmother had been addicted to alcohol. Norcross's grandmother wasn't his only family member who struggled with an alcohol addiction. As an adult, he watched as his brother-in-law, whom he attended high school with, struggled with an alcohol addiction until having, what Norcross called, "a moment of clarity." That moment came when Norcross's brother-in-law was in the hospital, a result of nearly 20 years of excessive drinking. His skin tone had yellowed, and his stomach was distended, Norcross recalled. Of note: Personal experiences, such as these, have helped shaped Norcross's views as he works on issues touching on addiction in Congress, where he serves as a vice chairman of the House Bipartisan Heroin Task Force. Perspective: The country is grappling with how to solve the opioid epidemic, a task that isn't easy. Yet, thousands of people are also dying per year from misusing alcohol and other drugs. Read more here.     What we're watching next week: Ronny Jackson, Trump's pick to lead the VA, testifies at his confirmation hearing in the Senate Veterans' Affairs Committee on Wednesday. Jackson is relatively unknown in Washington, and is facing questions from senators of both parties about his experience. Democrats are also concerned about his commitment to fight privatization efforts at the agency. Jackson has been trying to convince members of his ability to run the massive agency, but it remains to be seen if they will be convinced.   Combating the opioid epidemic is once again on the agenda in the House and Senate. In the House: An Energy and Commerce subcommittee will get to work Wednesday afternoon marking up a series of bills intended to combat the opioid epidemic. Chairman Greg Walden (R-Ore.) is pushing ahead with his target of bringing a bill to the House floor by Memorial Day weekend. Of note: The panel's ranking member, Rep. Frank Pallone Jr. (D-N.J.), registered concern at an April 11 hearing with how fast the committee was moving on its opioid legislation. Key quote: "While I support addressing this crisis through a bipartisan process, I am concerned that the sheer quantity of bills before the Committee today and the Chairman's extremely ambitious timeframe will not leave us much time to get these policies right." In the Senate: The HELP Committee will mark up its bill on Tuesday. It includes measures attempting to make it easier to prescribe smaller packs of opioids for limited durations, spur the development of nonaddictive painkillers and bolster the detection of illegal drugs at the border. Also look for: Whether a manager's amendment will include a maternity mortality bill many have been pushing to add to the opioid package.   Friday roundup: Indiana's "selective abortion" law is unconstitutional.  A federal appeals court struck down a law signed in 2016 by then-Gov. Mike Pence that banned women from having abortions based on the gender, race or disability of the fetus. According to the 7th U.S. Circuit Court of Appeals in Chicago, the law imposes an "undue burden" on a woman's right to get an abortion. A new report finds that opioid prescriptions have declined by 29 percent since 2011. The study from the Iqvia Institute for Human Data Science finds that opioid prescriptions peaked in 2011 after rising throughout the previous decade to an average of 72 pills per adult American. Since then, opioid prescriptions have dropped to 52 pills per adult, still well above the level in the early 2000s. The decline accelerated in 2017, dropping about 10 percent that year, the study finds. New data from the CDC showed a 21 percent increase in new cases of hepatitis C in the U.S., which some experts have attributed to the opioid epidemic. Advocates argue this proves Congress needs to appropriate more funds to combat the rise of new infections.   What we're reading How stakeholders in the short-term medical market are gearing up to attract more customers (Modern Healthcare) How Medicare's conflicting hospitalization rules cost me thousands of dollars (NPR) An ER that treats you like a VIP (The New York Times)   State by state Tennessee passes bill to impose Medicaid work requirements (Associated Press) Idaho Medicaid expansion initiative down to the wire (Spokesman-Review) California leads nation In pushing back against Trump administration health policies (Kaiser Health News)     Send tips and comments to Jessie Hellmann, jhellmann@thehill.com; Peter Sullivan, psullivan@thehill.com; Rachel Roubein, rroubein@thehill.com; and Nathaniel Weixel, nweixel@thehill.com. Follow us on Twitter: @thehill, @jessiehellmann, @PeterSullivan4, @rachel_roubein, and @NateWeixel.         Did a friend forward you this email? Sign up for Healthcare Newsletters     Forward Healthcare Newsletters       Privacy Policy  |  Manage Subscriptions  |  Unsubscribe  |  Email to a friend  |  Sign Up for Other Newsletters   The Hill 1625 K Street, NW 9th Floor, Washington DC 20006 ©2016 Capitol Hill Publishing Corp., a subsidiary of News Communications, Inc.