| Welcome to Wednesday's Overnight Health Care. We're celebrating that the AP has reaffirmed what we've known all along: "health care" is two words. Congress is still out of town on recess, but that hasn't stopped states from making news on Medicaid. President Trump signed the Right to Try bill, and also made some vague promises about drug prices. We'll start in the states, specifically Virginia, which made major headway on Medicaid expansion Wednesday afternoon. Big day for Medicaid expansion In Virginia: The state Senate narrowly passed a budget that included Medicaid expansion by a 23-17 vote. The House of Delegates, which already passed a budget with Medicaid expansion earlier this year, will have to vote again before the bill can be signed by Gov. Ralph Northam. This is a major victory for expansion backers who have been pushing for years in the state and finally got a boost from Democratic gains in last year's elections in the state. Northam has made Medicaid expansion a major priority of his administration, and when he signs the bill, Virginia will become the 33rd state, along with D.C., to expand coverage. The move means 400,000 people are set to get health insurance. Key quote: "We have the ability to move something through that's very sure in these uncertain times," Sen. Emmett Hanger, Jr., (R), the sponsor of the Medicaid expansion compromise bill, said during the floor debate. "We can develop a uniquely Virginia plan. While it draws from the experience of many states that have been out there before us, it will serve our citizens." Carrot and stick: The vote comes with a major tradeoff for Democrats. The plan will also require Virginia to request a waiver from CMS to impose work requirements as well as premiums on beneficiaries above the poverty level. Read more here. In Utah: A Medicaid expansion measure qualified for the ballot in November. Expansion would extend coverage to about 150,000 people in the state. "Thousands of Utahns have added their signatures to the campaign, declaring it's time that our most vulnerable families have access to high-quality and affordable health care through Medicaid," said Frederick Isasi, executive director of the liberal advocacy group Families USA. Utah organizers collected 147,280 signatures for the initiative. The ballot measure is competing with a plan backed by Utah Gov. Gary Herbert (R) to expand Medicaid only in part. Known as a "partial expansion," that plan would expand Medicaid up to 100 percent of the federal poverty line, less far than the traditional expansion of up to 138 percent. The partial expansion plan would need approval from the Trump administration, though, which has never approved such an idea and could be reluctant to approve any expansion of Medicaid. Read more here. What to watch next: Utah's measure will be on the ballot in November, along with an expansion measure in Idaho. And Maine is still facing a battle over the expansion its voters passed but that Republican Gov. Paul LePage has so far refused to implement. Trump signs 'right to try' bill in an effort to make it easier for terminally ill patients to access experimental drugs not yet approved by the drug administration. In a bill signing ceremony, surrounded by terminally ill patients and their families, Trump said the new law would give patients who have exacerbated all other options a "fighting chance." From the president: "We're going to be saving tremendous numbers of lives. And it's so great that you're up here with us and that we're all on this front line together." Context: Democrats and public health groups say the bill could be harmful to patients. Republicans say patients should have every option available to them within reason. Notable: Trump thanked Sen. Joe Donnelly (D-Ind), one of only two Democratic sponsors of the bill, for his efforts, despite calling him a "really incredible swamp person" earlier this month. Donnelly, who is facing a tough reelection bid in a state won by Trump in 2016, touted Trump's remarks in a press release shortly after. Sen. Joe Manchin (R-W. Va.), the other Democratic co-sponsor of the bill, was in West Virginia and didn't come to the ceremony. We have more here. No one is quite sure what he's talking about, but Trump says drug companies are going to 'voluntarily' slash prescription drug costs in the coming weeks. In off-the-cuff comments made during today's ceremony, Trump said: "I think we're going to have some of the big drug companies, in two weeks, they're going to announce because of what we did, they're going to announce voluntary massive drops in prices." Context: The administration announced a plan earlier this month to lower drug costs, mostly through regulatory action, but drug companies have viewed the proposal favorably. It's not clear if this is related. We explain here. A pharmaceutical company issued a voluntary recall for nearly 170,000 birth control packs after it was revealed that a packaging error could cause unintended pregnancies. The pills in the recalled packs were placed in the wrong order, with the four placebos in the beginning. Pills taken out of sequences could result in unintended pregnancies, said Allergan, the maker of Taytulla. "As a result of this packaging error, oral contraceptive capsules, that are taken out of sequence, may place the user at risk for contraceptive failure and unintended pregnancy," Allergan said in a statement on Tuesday. Read more here. Louisiana's Democratic governor John Bel Edwards signed what could be the nation's strictest abortion ban. But there's a catch: The law will only take effect if a similar law in Mississippi is upheld by a federal court, according to the Associated Press. The Louisiana measure would carry a prison sentence of up to two years someone who performs an abortion after 15 weeks. If the laws in Louisiana and Mississippi take effect, it will be the earliest abortion bans in the country. Read more here. What we're reading Domestic violence's overlooked damage: Concussion and brain injury (NPR) Trump's new insurance rules are panned by nearly every health group that submitted formal comments (Los Angeles Times) Trump wants Medicaid to push for lower drug prices – But will patients be hurt? (Stateline) State by state Kentucky governor teams up with nonprofit to help people keep their Medicaid (Louisville Courier Journal) Kansas Medicaid woes prolong wait for autistic kids needing therapy (KCUR) From the Hill's opinion page: If we want to combat Ebola, the time to act is now Bipartisan support for medical research is good news for all Prices that insurers pay can help end hospital price gouging | 
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