Overnight Health Care — Sponsored by PCMA — DOJ move against ObamaCare sets off frenzy | Maine governor appeals Medicaid expansion order | Lawmakers target drug 'middlemen' over costs

Sponsored by Pharmaceutical Care Management Association | View in Browser     Welcome to Overnight Health Care, sponsored by the Pharmaceutical Care Management Association.   We're happy it's Friday, but we're not heading out for the weekend without first bringing you up to date on the fallout and reactions to the latest ObamaCare legal battle. The Trump administration on Thursday night declined to defend ObamaCare against a lawsuit from Texas and 19 other GOP-led states that argue the law is unconstitutional. The conventional wisdom is still that the suit has little chance of success, but it set off a flurry of reactions and activity.   Dems blasted the Trump administration move as a 'stunning attack on the rule of law' "The Justice Department's refusal to defend the Affordable Care Act (ObamaCare) in federal court is a stunning attack on the rule of law, the stability of our health care system, and Americans' access to affordable health care," said Reps. Bobby Scott (Va.), Frank Pallone Jr. (N.J.) and Richard Neal (Mass.), the top three Democrats on the House health-care committees. Political strategy: Democrats are seeking to tie the Justice Department's actions into their argument that the Trump administration is "sabotaging" health care and driving up premiums, a key midterm message. "The administration's attempt to eliminate protections for the 130 million Americans with pre-existing conditions is just the latest -- and potentially the most damaging -- example of the coordinated effort by congressional Republicans and the Trump administration to sabotage the Affordable Care Act, driving up uninsured rates and out-of-pocket costs for Americans," the Democrats said. More on their reaction here.         SPONSORED CONTENT   Pharmaceutical Care Management Association Where PBM tools are used, a new report shows net spending – including the combined impact of drug prices, generic vs. brand drug use, and the overall number of prescriptions – declined by 2.1% last year. Spending increased in 2017 through channels not managed by PBMs. Learn how PBMs are part of the solution to reducing Rx costs at DrugBenefitSolutions.com.       Health insurers also opposed the conservative states' lawsuit Health insurers are desperate to finally get some certainty in the ObamaCare markets, and this lawsuit does not help them on that front. Experts warned insurers could raise premiums due to the added uncertainty. What the health insurance lobby, America's Health Insurance Plans, is saying: "Zeroing out the individual mandate penalty should not result in striking important consumer protections, such as guaranteed issue and community rating rules that help those with pre-existing conditions," the insurers said. "Removing those provisions will result in renewed uncertainty in the individual market, create a patchwork of requirements in the states, cause rates to go even higher for older Americans and sicker patients, and make it challenging to introduce products and rates for 2019. Instead, we should focus on advancing proven solutions that ensure affordability for all consumers."   On a different front, there could be some bipartisanship on one health area: targeting drug price 'middlemen' With public outrage growing over the rising costs of prescription drugs, Congress is targeting the middlemen they say are to blame. Specifically, lawmakers are moving to ban "gag clauses" that prohibit pharmacies from telling customers they can save money on a drug if they pay with cash instead of using their health insurance. These clauses are sometimes included in contracts between pharmacies and pharmacy benefit managers -- the middlemen who act as negotiators between drug companies and insurers. Legislative action to watch: A bill from Sen. Susan Collins (R-Maine) to ban gag clauses is expected to come up for a committee vote on June 20. Rep. Buddy Carter (R-Ga.) also has a bill in the House. Read more here.     Maine governor appeals court order mandating Medicaid expansion Maine Gov. Paul LePage is keeping up his resistance to Medicaid expansion even after a court ordered his administration to comply. He is now appealing the decision. Background from earlier this week: Michaela Murphy, a Maine Superior Court justice, ruled Monday afternoon that the state must submit a plan to the federal government by June 11 detailing how it plans to expand Medicaid. Maine voters approved expansion in November through a citizen-led ballot measure, but LePage has fought back at every turn. He said he wouldn't implement expansion unless state legislators found a way to pay for it without raising taxes. But expansion supporters argued the governor's estimate was too high. His administration missed the April 3 deadline to send a plan to the federal government, prompting lawsuits from the Maine Equal Justice Partners and Consumers for Affordable Health Care. Read more on the new appeal from the Portland Press Herald.   Round-up We started the week with a look at how states are defying President Trump on ObamaCare. Health advocates are also seeing momentum on Medicaid expansion. A federal judge ordered the administration to process grants for a teen pregnancy program officials are trying to restrict. A judge in Maine, meanwhile, ordered the state to take steps to implement a voter-approved Medicaid expansion. Lawmakers expressed concerns about HHS's cybersecurity readiness. Medicare trustees said the program's trust fund will run out years sooner than expected. After McConnell said he would cancel the August recess, Schumer called on him to devote the month to health care issues. Abroad, health workers found good news as the Ebola outbreak appeared to be slowing in the Congo. A report claimed Trump is planning a massive reorganization of HHS and the government's welfare programs. The White House has a new ad campaign to combat opioid addiction that is turning heads. Nancy Pelosi said Democrats should evaluate "Medicare For All" if they retake the House. Virginia's governor signed Medicaid expansion into law. And the Justice Department is arguing in court that key parts of ObamaCare are unconstitutional.         SPONSORED CONTENT   Pharmaceutical Care Management Association Pharmacy benefit managers (PBMs) have outlined several policy solutions to ensure patients receive opioid prescriptions when safe and medically appropriate. One important solution would be requiring e-prescribing of controlled substances in Medicare (S. 2460 / H.R. 3528, the Every Prescription Conveyed Securely Act). A study by the Opioid Safety Alliance finds this could save taxpayers $13 billion over 10 years.       What we're reading Defying prevention efforts, suicide rates are climbing across the nation (The New York Times) Cancer patients pay thousands to save their fertility. New laws aim to change that (Huffington Post) What Hurricane Maria's death toll reveals about health care in Puerto Rico (Harvard Business Review)   State by state Delaware lawmakers send bill banning conversion therapy to governor (WisconsinGazette.com) Louisiana is still the worst state nationwide for children, report says (NOLA.com)         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.