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Trump warns Democrats against socialized medicine, takes aim at Britain’s NHS. President Trump bashed Democratic lawmakers Monday for backing a universal, single-payer healthcare system for Americans after they were successful in blocking Republicans from rescinding and remaking Obamacare. "The Democrats are pushing for Universal HealthCare while thousands of people are marching in the UK because their U system is going broke and not working. Dems want to greatly raise taxes for really bad and non-personal medical care. No thanks!" Trump tweeted Monday morning. Republicans’ failure to repeal and replace Obamacare has given Democrats a chance to consider which liberal reforms can be tied into the law, resulting in a large portion of Democratic senators backing Sen. Bernie Sanders’ “Medicare for All” proposal. In London, thousands of people marched Saturday to call for additional funding to Britain's National Health Service. Britain’s health secretary tweeted a response to Trump, firing back that the U.S. had its own problems. “I may disagree with claims made on that march but not ONE of them wants to live in a system where 28m people have no cover,” he wrote. “NHS may have challenges but I’m proud to be from the country that invented universal coverage — where all get care no matter the size of their bank balance,” he wrote. Trump, in the past, has advocated single-payer healthcare. In his 2000 book The America We Deserve, Trump described himself as a "liberal" on healthcare and suggested the U.S. should look to Canada's socialist system as a "prototype." During a Republican presidential debate, he said the socialist systems in Canada and Scotland worked well. Scotland is also covered by the NHS. Trump’s tweet this morning is an example of how he’s adopted a more conventional conservative posture on a lot of issues as president than he once had, even as a candidate for the Republican nomination.
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Congress headed toward another short-term spending deal. Still looking for agreement on immigration, Congress is poised to pass another short-term spending agreement before the Feb. 8 deadline to avoid a partial government shutdown. The deal would keep the government open for six weeks, setting a new deadline of March 23. A potential sweetener is long-term funding for community health centers, which work primarily with low-income patients. The funding for the program expired in September with the Children’s Health Insurance Program. Though CHIP got a six-year allocation during the last spending bill, community health centers are still waiting. Congress passed a short-term bill in December that included $550 million in funding, but it will expire at the end of March. It’s also possible that bills intended to stabilize Obamacare will be considered, if not in a short-term package then in a long-term deal. There appears to be more interest in passing a bill to provide for reinsurance, rather than passing a funding bill to address cost-sharing reduction subsidies for insurers.
Azar scheduled to defend Trump administration’s budget. Alex Azar, the newly sworn-in Health and Human Services secretary, is slated to go before the House Energy and Commerce Committee on Feb. 15 to answer questions about the budget request that his agency will put out. The budget proposal is likely to be made public a few days before his testimony. Last year’s request was posted early by accident. The document will more deeply reveal the intentions of the administration on approaches to healthcare. For instance, it will show whether the administration will make certain assumptions about the viability of Obamacare, whether it expects Congress to make changes to Medicaid, and the extent to which it will support changes to particular programs. The document will reflect priorities of the administration, but the funding decisions will rest with Congress.
State Obamacare enrollment on track to outpace previous years, despite confusion. Signups for Obamacare in states that had later deadlines for open enrollment appear to be outpacing previous years, despite consumer confusion about the law and federal cutbacks to advertising and outreach. As of Jan. 29, nearly 11.8 million people had enrolled in Obamacare coverage in the federal and state exchanges, according to data collected by the pro-Obamacare group Get America Covered. The numbers appear to be headed toward outrunning the end of the previous open enrollment during former President Barack Obama's last year in office, when 12.2 million had signed up. The estimates come as every state has closed its open enrollment period. The Trump administration's healthcare.gov deadline ended Dec. 15, six weeks earlier than under the Obama administration. But the 11 states and D.C. that created their own exchanges could set their own deadlines. Nine had deadlines that were later than healthcare.gov's, excluding Maryland, whose officials later decided to provide a five-day extension. California and New York ended open enrollment this week.
Verma defends Medicaid work requirements. Seema Verma, the administrator for the Centers for Medicare and Medicaid Services, wrote an opinion piece in the Washington Post Sunday framing the Medicaid work requirements as a way to help people out of poverty so that they wouldn’t need to be signed up for the program anymore. She argued that Medicaid was intended for people who were most vulnerable, such as those who are disabled or pregnant, writing that Obamacare “fundamentally changed Medicaid by shifting predominantly low-income adults — often without children, healthy and working-age — into a program that wasn’t designed for them.” The new rules, which have been approved in Kentucky and Indiana, would impose work, schooling or volunteering requirements on certain Medicaid enrollees, and are facing a lawsuit. Verma addressed the criticism in her piece. “This administration anticipated that this stance would be met with criticism from those who espouse that requiring community engagement as a condition of federal support is a barrier to care,” she wrote. “It is unfortunate that some automatically assume that low-income Americans are incapable of contributing to their communities, especially when many of them already do or want to do so. It is even more shameful that they would dress up this unflattering view of their fellow citizens in the guise of compassion.”
Details about Indiana’s work rules for Medicaid. Indiana on Friday became the second state to install work requirements for certain Medicaid beneficiaries. Azar announced the approval of a federal waiver to allow Indiana to establish work requirements. The waiver is part of a three-year extension of the state’s Medicaid expansion. Starting in 2019, the state will require able-bodied and working-age Medicaid beneficiaries to go to school, find a job, or participate in other qualifying events such as volunteering or job skills training for 20 hours a week. Some beneficiaries, including those who are medically frail, students or pregnant women, will be exempt, said Indiana Family and Social Services Administration Director Jennifer Walthall. She estimates that of the state's 400,000 Medicaid recipients, 130,000 would qualify under the new work requirements. Azar said 11 states have applied for work requirement waivers.
Indiana could face legal challenges. Indiana likely will face the same kinds of legal challenges that Kentucky has faced over work requirements for Medicaid. A group of Medicaid beneficiaries is suing Kentucky over the work rules, charging that they violate federal law. Some health advocates charge that the work rules violate Medicaid’s objectives to provide healthcare to beneficiaries. CMS is “clearly now on a fast-track to approve waivers that violate Medicaid law, like basing eligibility for health insurance on work status,” said advocacy group Families USA. The Kentucky case is pending.
Senators seek responses from public on how to use Medicare, Medicaid to fight opioid epidemic. The leaders of the Senate Finance Committee are seeking responses on how to use Medicare and Medicaid to fight opioid abuse. The senators are seeking feedback on a series of questions that include identifying the barriers to access to non-pharmaceutical therapies to treat chronic pain. Other questions include how Medicare and Medicaid can coordinate with state drug monitoring programs. The questions come as in 2016, one in three Medicare beneficiaries got at least one opioid prescription. The number of prescriptions resulted in $4 billion in spending under Medicare Part D, the drug plan for Medicare. A letter from committee Chairman Orrin Hatch of Utah and ranking Democrat Ron Wyden of Oregon asks for responses by Feb. 16.
Lawmakers demand FDA fix IV saline shortage. The Food and Drug Administration needs to do more to solve a shortage of IV saline and other key products during the record-setting flu season, a group of lawmakers said Friday. The FDA has made several moves to mitigate the shortage caused by Hurricane Maria's pummeling of Puerto Rico, a key manufacturing center of IV saline. The actions include speeding up imports of saline from overseas and hastening approval of new saline products. However, lawmakers said in a letter to the agency that the moves have not quelled concerns from healthcare providers. “Providers in our states have voiced concerns over the uncertainty of when these products will become available and when a long-term solution to this shortage will be implemented,” the letter said.
Poll finds big support for drug prices bill. A poll found that 83 percent of voters want legislation that makes it more difficult for brand name drugs to delay generic competition. The poll, sponsored by the advocacy group Patients for Affordable Drugs Now, asked voters about the CREATES Act. The bill aims to stop brand name drug makers from preventing generic companies from getting access to the drug. Generic companies need access to a sample of a brand name product to start making a cheaper generic version, but a brand name drug maker can sometimes stall by not providing the product and say the denial is for safety reasons. The CREATES Act would let a generic drug maker go to court to seek an order to get the samples or to enter supervised negotiations with the drug maker to get a sample. The poll was of 800 registered voters. Senate and House bills were introduced in April but have gone nowhere.
Melania Trump headed to Cincinnati Children’s Hospital. First lady Melania Trump will be in Cincinnati today to hear from hospital officials about their work to combat the opioid epidemic. “Very much looking forward to visit @CincyChildrens today & learn more about their efforts in combating the effects opioids are having on our children & how we can continue to work towards ending the #OpioidEpidemic,” she wrote on Twitter. Trump has met with people affected by the epidemic, by holding roundables in Washington and by visiting a treatment center in West Virginia. "Mrs. Trump knows that Ohio is one of the states hit hardest by the opioid crisis, so she is visiting the children's hospital today to speak with doctors and people on the ground about ways that she can help," said Stephanie Grisham, spokeswoman for Trump. The first lady spoke about the issue alongside the president when he announced he would be directing his administration to declare a public health emergency. She has indicated that drug addiction will be one of her leading platforms, with her focus being on how it affects children.
FDA commish had one simple Super Bowl Sunday message: No double dipping. The head of the Food and Drug Administration took to the Internet to promote good food safety and got some help from “Seinfeld.” Commissioner Scott Gottlieb posted a gif from the classic scene in which George Costanza gets scolded for double dipping his chip. “Try to avoid situations that can spread the flu — and remember especially, no double dipping!” Gottlieb tweeted. Gottlieb kept on the food safety tweet thread, putting out reminders about food safety before the biggest game of the year kicked off. “This game day, don’t commit the ultimate football party foul. #NoDoubleDipping #IllegalUseOfHands,” he tweeted.
RUNDOWN
STAT News Senators traded in tobacco stocks while sitting on health committee
AHCJ Covering Health CMS threatens to bar Modern Healthcare from press calls after reporter refuses to alter story
Axios The push to make drug prices a 2018 campaign issue
Politico Why desperate families are getting religion on health coverage
New York Times Who is able-bodied anyways?
Bloomberg Trump’s tweets anger Brits fearful of U.S. healthcare system.
Calendar
MONDAY | Feb. 5
Feb. 5-6. Academy Health National Health Policy Conference. Details.
3 p.m. Gaylord National Resort and Convention Center. Elinore F. McCance-Katz to speak SAMHSA 14th Annual Prevention Day. Live stream.
TUESDAY | Feb. 6
6 a.m. Centene fourth quarter earnings call. Details.
9 a.m. National Press Club. Health Affairs issue briefing on innovation. Details.
9 a.m. 700 F St NW. Bipartisan Policy Center event with America’s Health Insurance Plans on employer-sponsored health insurance. Details.
9:30 a.m. 2100 M St. NW. Urban Institute event on “Examining Community Health Worker Models in Managing Chronic Conditions.” Details.
3 p.m. 1100 Longworth. Hearing on the Opioid Crisis: Removing Barriers to Prevent and Treat Opioid Abuse and Dependence in Medicare. Details.
THURSDAY | Feb. 8
House in recess. House Democrats head to retreat in Cambridge, Md.
Deadline for government spending bill.
10 a.m. 430 Dirksen. Health, Education, Labor and Pensions Committee hearing about the impact of the opioid crisis on children and families. Details.
10 a.m. National Press Club event with mental health experts. Details.
FRIDAY | Feb. 9
Noon. 226 Dirksen. George Mason University Law & Economics Center event on “Inventing New Liability? Who Should We Blame When Generic Drugs Harm Patients?” Details.
