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Trump predicts Obamacare will be ‘terminated’ through Texas lawsuit. President Trump believes a case making its way through the courts to throw out Obamacare is likely to succeed, which will give his administration another shot at replacing the law. “I believe it’s going to be terminated, whether it be through the Texas case, which is going through the court system as a victory right now, because of, you know, the various elements of that case, you would think it would have to be terminated,” he said in an interview with the New York Times published Friday. Trump blamed the late Sen. John McCain, R-Ariz., for being the deciding vote against a plan that would have narrowly repealed Obamacare, noting that he had not followed through on his years-long promises to undo the law. He alluded to the possibility of reviving a replacement plan if the law is struck down in court. “A deal will be made for good healthcare in this country,” he said. “That’s one of the things I’ll be doing.”

Welcome to Philip Klein’s Daily on Healthcare, compiled by Washington Examiner Executive Editor Philip Klein (@philipaklein) and Senior Healthcare Writer Kimberly Leonard (@LeonardKL). Email [email protected] for tips, suggestions, calendar items, and anything else. If a friend sent this to you and you’d like to sign up, click here. If signing up doesn’t work, shoot us an email and we’ll add you to our list.

Trump proposes ending ‘backdoor rebates’ to lower drug prices. The Trump administration released a plan Thursday to encourage insurers who negotiate drug prices to pass savings directly back to patients, part of a larger administration effort to lower drug prices. Health and Human Services Secretary Alex Azar said in a statement that the plan “has the potential to be the most significant change in how Americans’ drugs are priced at the pharmacy counter, ever, and finally ease the burden of the sticker shock that millions of Americans experience every month for the drugs they need.” The proposal would ban pharmacy benefit managers, the middlemen who negotiate how much to pay for medicines on behalf of insurance plans, from receiving rebates from drugmakers — an arcane practice that the administration blames for high drug prices. Critics have accused pharmacy benefit managers of failing to pass savings on to patients while keeping a cut for themselves and aiding health insurance companies and employers. Under the new plan, patients would pay a price for the drug at the pharmacy that is more similar to what the pharmacy benefit manufacturers would have negotiated after the rebates. Pharmacy benefit managers could also agree on fixed fees for drugs instead of a rebate deal. HHS said patients, particularly seniors, could reduce what they pay for drugs by about 30 percent. The agency released the idea alongside the Office of the Inspector General.

Insurers warned of high premiums and blamed list prices, PhRMA celebrated the rule. Pharmaceutical Research and Manufacturers of America, or PhRMA, the trade group representing drug companies, praised the administration’s rule, saying that it would be effective in lowering out-of-pocket costs for patients. A small number of companies — Express Scripts, OptumRx, and CVS Caremark — control the majority of the marketplace for pharmacy benefit managers. The middlemen have warned that if the federal government pushes for the change, then premiums in Medicare will increase by more than 20 percent. They have said that the rebates they keep are what allow them to keep premiums at bay. America’s Health Insurance Plans, which represents insurers, accused drug companies of distracting from the issue of high list prices, and said its industry was effective at negotiating. “Big Pharma has been working nonstop to deflect attention from outrageously high prices by convincing Americans that health insurance providers and their PBM partners are the problem, acting as so-called ‘middlemen,’” AHIP said. “We are not middlemen – we are your bargaining power, working hard to negotiate lower prices with drug makers to save seniors and other patients about 50 percent a year on their prescription drug and related medical costs.”

Democrats warned of higher premiums. “The Trump Administration’s rebate proposal will increase government spending by nearly $200 billion and the majority of Medicare beneficiaries will see their premiums and total out-of-pocket costs increase if this proposal is finalized,” Energy and Commerce Committee Chairman Frank Pallone, Jr., D-N.J., and Ways & Means Committee Chairman Richard Neal, D-Mass., said in a joint statement “While we agree that the cost of prescription drugs must be addressed, we are concerned that this is not the right approach.”

‘Drug czar’ sworn in, releases national drug control strategy. Jim Carroll was sworn in Thursday as the director of the White House Office of National Drug Control Policy and shortly after released the administration’s priorities to address drug trafficking and drug use. They include implementing a media campaign, encouraging better prescribing of painkillers by doctors, and encouraging better monitoring programs of where drugs are being prescribed in states. “We must be relentless in our efforts to tackle the scourge of addiction that has affected so many families and communities across the United States,” Carroll said. “The strategy builds upon our current whole-of-government approach that educates Americans about the dangers of drug abuse, ensures those struggling with addiction get the help they need, and stops the flow of illegal drugs across our borders.” On April 24, 2018, Trump nominated Carroll, who had previously been his deputy chief of staff.  

Republicans question CMS about improper spending in Medicaid. Louisiana’s legislative auditor released a report in November that suggested overspending in Medicaid on people whose incomes were too high to qualify for the program, drawing the attention of congressional oversight. Sen. Ron Johnson, R-Wis., chairman of the Senate Homeland Security and Governmental Affairs Committee, and Representative Jim Jordan, R-Ohio, ranking member of the House Committee on Oversight and Reform, on Thursday sent a letter to the Centers for Medicare and Medicaid Services requesting more details about the audit, which showed the government may have improperly spent $85 million over 20 months. The errors appear to have come under the previous Medicaid self-reporting standards. Johnson and Jordan asked Seema Verma, CMS administrator, whether her agency had asked about the audit, what steps were being taken to have the payments returned, and how the agency would make sure the same issue didn’t happen again in Louisiana and elsewhere.

Toomey re-named chairman of health subcommittee. Sen. Pat Toomey, R-Pa., on Thursday was re-named chairman of the Senate Finance Subcommittee on Healthcare, overseeing programs such as Medicare, Medicaid, and the Children’s Health Insurance Program. “I look forward to working on a wide range of issues that enjoy bipartisan support,” Toomey said. “This includes building off of past work to improve our nation’s response to the prescription drug and heroin abuse epidemic, meeting the growing challenge of Alzheimer’s disease, and ending counterproductive policies like the medical device tax. There must also be a debate on how we can come together and put our major federal health care programs – which cover over 100 million Americans and account for over $1 trillion in annual federal spending – on a sustainable fiscal path.”

More health workers would go into geriatrics under bill from Aging Committee leaders. Sens. Susan Collins, R-Maine, and Bob Casey, D-Pa., the Chairman and Ranking Member of the Senate Aging Committee, on Thursday introduced the Geriatrics Workforce Improvement Act to increase the number of geriatric health professionals and direct service workers to support our aging population. The bill would reauthorize the Geriatrics Workforce Enhancement Program at $45 million per year over the next five years and reinstate the Geriatrics Academic Career Awards program at $6 million per year.  

Feds make biggest-ever fentanyl bust at the border. Federal law enforcement agents stationed at the U.S.-Mexico border in Nogales, Ariz., made the largest-ever seizure of fentanyl Saturday after stopping a truck that was purportedly trying to bring cucumbers into the country, according to Customs and Border Protection officials. CBP officials said Homeland Security employees stationed at the border crossing found 254 pounds of fentanyl in a single bust. Nogales area Port Director Michael Humphries said the seizure would likely save U.S. lives. “One kilogram of fentanyl contains 1 million fatal doses,” he said. A few grains of fentanyl can put a person in a coma. Fentanyl is up to 50 times as strong as heroin and 100 times stronger than morphine, and it led to more than 20,000 deaths in 2017.

Virginia lawmaker apologizes for co-sponsoring late-term abortion bill without reading it. A state lawmaker in Virginia apologized to her constituents Thursday for failing to read controversial abortion legislation before she co-sponsored it. Del. Dawn Adams, D-Richmond, said she “made a mistake” when she did not read fellow Del. Kathy Tran’s bill that would allow abortions in the third trimester. “I vaguely remember signing on to this, and I did this in solidarity with my colleague and as a symbolic gesture for a woman’s right to choose,” Adams said. “I am sorry that I did not exercise due diligence before this explosion of attention; had I done so, I would not have co-patroned.” The bill, which never made it out of a subcommittee, galvanized the anti-abortion movement in Virginia and nationwide.

Pelosi dodges on Ralph Northam’s controversial comments on late-term abortion. House Speaker Nancy Pelosi, D-Calif., on Thursday dodged a question about Virginia Gov. Ralph Northam’s controversial comments about late-term abortion. In a press conference Thursday, Pelosi steered clear of Northam’s remarks and the debate over a Virginia state lawmaker’s proposal to allow abortions up until birth. “I’m sorry, I just don’t know what he said yesterday,” Pelosi said, when asked about Northam’s widely circulated comments.

RUNDOWN

The Hill Romney warns drug execs: ‘change is coming’

Buzzfeed News One of the biggest at-home DNA testing companies is working with the FBI

The Associated Press Why Congo’s Ebola outbreak still going strong

Politico Trump to throw spotlight on abortion during State of the Union

Reuters Teva’s generic EpiPen launch stalls months after approval