| Happy Tuesday and welcome to Overnight Health Care. If you've had enough of all the Roseanne Barr coverage today, you are in luck. There's plenty of big health care news ahead. First off, the Supreme Court rejected a challenge to an Arkansas law that restricts medication-induced abortions. This means that, for now at least, the law will go into effect, and potentially lead to the closure of two of the state's three abortion clinics. What the law does: The law, passed in 2015, requires doctors who provide medication abortions to have a contract with a second doctor who has hospital admitting privileges. The issue: Planned Parenthood, which sued over the law, argues its true purpose is to make it more difficult to access medication abortions. Supports say it's for safety purposes, in case there are complications with the procedure. What's next: Planned Parenthood said it would notify its patients that they can receive the procedure in the state, but that it would "move swiftly" for emergency relief in the district court. Stay tuned... We have more here. A fourth federal judge has ruled against the Trump administration's cuts to the Teen Pregnancy Prevention Program. Judge John Coughenour, a Reagan appointee in Washington state, ruled Tuesday afternoon that the administration unlawfully ended grants two years early for the King County Health Department in Seattle, which participated in the Teen Pregnancy Prevention (TPP) Program. Context: The Department of Health and Human Services last year sent notices to 81 TPP grantees, informing them that their five-year grants would end two years earlier than originally planned, arguing the program was effective. Tuesday's ruling means HHS will have to process King County's application for the final two years of funding. Why this matters: Federal judges have now ruled in four different cases involving nine TPP grantees that the administration's actions were unlawful. Now we're waiting to see how a class action lawsuit brought by the remaining grantees against the Trump administration plays out. That four judges ruled against the administration so far is a good sign for grantees. Read more here. Staffing changes at HHS Diane Foley has been named deputy assistant secretary for population affairs at HHS, which oversees the Title X family planning program. Foley replaces Teresa Manning, who abruptly resigned in January. Why it matters: The administration is trying to shepherd through changes to Title X that would drastically reshape the program. A proposed regulation unveiled last week would ban providers from participating in the program if they refer patients for abortions or share space with abortion providers. Foley's background shows she's in step with the administration on issues of abortion and abstinence. She was the CEO and president of Life Network, which runs two pregnancy resource centers in Colorado Springs, Colo. From HHS: "Dr. Foley has a long and distinguished career working in the healthcare and the public health arenas." Puerto Rico death toll is 70 times higher than the official government estimate, study says. The study, published Tuesday in The New England Journal of Medicine, estimates that nearly 5,000 people died in Puerto Rico due to Hurricane Maria, many from delayed medical care. The Puerto Rican government's estimate: 64. How the study was conducted: Researchers from the Harvard School of Public Health and other institutions visited 3,299 households in Puerto Rico and asked about all deaths and their causes of death from when Hurricane Maria made landfall on Sept. 20 to the final day of December 2017. How the conclusion was reached: The study found that the mortality rate increased by 62 percent in the final months of 2017 when compared to the same time period in 2016. In total, the researchers calculated that 4,645 more people died in the final months of 2017 than in the same time frame a year prior.
Why it matters: The researchers said their study was imprecise, but the findings are important. Numerous reports have long indicated that the death count from Hurricane Maria was much higher than reported by the government. Read more here. Cassidy plans price-transparency bill Sen. Bill Cassidy (R-La.) still wants to repeal and replace ObamaCare, but he's also putting out some other ideas that have the chance to get some bipartisan support. - One idea: Mandating price transparency. Cassidy said on Fox News Radio that he hopes to soon introduce legislation to do that, so "if somebody gets an X-ray order for their child's belly, they will know the cost of that before they go in to get it done and they can price shop."
- A second bill would ban "gag clauses" that prevent pharmacists from telling patients when it would be cheaper to pay cash as opposed to using insurance. The Trump administration has backed this idea.
Cassidy acknowledged there could be industry opposition. "There's always going to be pushback when people are making lots of money because the American citizen doesn't know what's going on," he said. We have more on his proposals here. And you can read the full white paper here. Virginia's on the cusp of Medicaid expansion.
The GOP-controlled General Assembly is poised to adopt a budget tomorrow that will include some form of Medicaid expansion, a long sought-after victory for Democrats and expansion proponents. An estimated 400,000 people in the state are expected to gain coverage. Democrats in the state fought to try to expand Medicaid for years under former Gov. Tim Kaine, but Republicans have always had enough of a majority to block Democratic efforts. But now, the Senate has at least 21 Republicans willing to accept federal funding under ObamaCare to expand coverage. Insurers cite Trump policies as reason for rising premiums. The repeal of the individual mandate and actions from the Trump administration could result in premium increases of up to 15.7 percent in the individual market for the 2019 plan year, according to a brief by the insurance lobby AHIP. Insurer arguments: - The elimination of the individual mandate could increase premiums by 9 percent to 10 percent.
- Plans to expand access to short-term insurance plans that cover fewer services could increase premiums by 0.7 percent to 1.7 percent.
- Plans to allow more small businesses to band together to buy insurance (association health plans) could result in premium increases of 2.7 percent to 4 percent
Context: The arguments aren't new. Health costs are rising, as are premiums, and individual insurance companies have placed much of the blame on the Trump administration. Why it's important: As insurers set rates for the upcoming plan year, AHIP wants to remind members of Congress and the administration about what could come if they don't act. In case you missed it over the weekend The abortion wars are flaring for midterm election campaigns, and both sides think they have the upper hand. Trump's new pick for the VA is boosting hopes for reform. What we're reading To lower your Medicare drug costs, ask your pharmacist for the cash price (NPR) Meet the six Trump administration officials who will oversee the next moves on drug pricing (Stat News) Former drug industry lobbyist helps steer Trump drug plan (Politico) State by state Arkansas readies for first in nation Medicaid work requirement rollout (KUAR) Wisconsin ObamaCare helpers seek local money to offset federal funding decline (Wisconsin State Journal) From the Hill's opinion page: Alyssa Milano says if you care about mental health, then make sure you vote. A doctor says the medical and scientific communities stand for abortion access. | 
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