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Maryland Obamacare insurers propose rate increases of up to 91 percent, Democrats pounce. Maryland’s Obamacare insurers are asking for a 30 percent average rate increase for 2019, with some plans seeking hikes as high as 91 percent. The proposals Monday come a few days after Virginia insurers also called for double-digit rate increases. Maryland Obamacare insurers CareFirst, BlueCross, and BlueShield plan to raise rates for an HMO plan on the law’s exchanges by 18 percent, and 91 percent for an extended network, or PPO, plan. Kaiser Permanente, the state’s other Obamacare insurer, asked for a rate increase of 37 percent, according to a state filing. The rates must be approved by the state and must be finalized before open enrollment starts Nov. 1. However, the state’s insurance regulator said the rates don’t reflect legislation passed by the General Assembly to shore up the insurance exchange. Democrats have pounced on the rate increases, charging that Republican policies such as the repeal of Obamacare’s individual mandate, which goes into effect next year, are leading to the hikes. Insurers are worried that taking away the penalty for not having insurance will eliminate a reason for younger and healthier people to get coverage. “Republicans know they own the skyrocketing healthcare costs, but instead of working in a bipartisan fashion to lower the costs, they actively undermined our healthcare system and made the problem worse,” said Senate Minority Leader Chuck Schumer, D-N.Y.

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Democrats will have to wait longer for opioid bills. The House Energy and Commerce Committee said it will vote on 26 bills aimed at combating the opioid epidemic on Wednesday. However, the list of legislation does not include any of the six bills that the panel’s health subcommittee postponed. The subcommittee advanced 57 bills during a markup two weeks ago. But it shelved six bills, most of which were sponsored by Democrats, because they weren’t fully ready and because the markup had already lasted for more than nine hours. Democrats howled that Republicans were shelving their bills while advancing GOP legislation that also wasn’t finished. A House aide said that work on the six bills is continuing and that the committee may get in to the second markup of opioid bills slated for May 17. Committee leaders hope to get all of the bills through the House by the Memorial Day recess.

Most drug distributors at hearing deny they contributed to opioid epidemic. Four of the five drug distributors before a House Energy and Commerce Committee subcommittee denied Tuesday they made the opioid epidemic worse, even though a committee probe found that distributors flooded small towns with millions of opioids. Executives with distributors Cardinal Health, Amerisource Bergen, H.D. Smith and McKesson denied that they contributed to the epidemic. Federal data shows that more than 42,000 people died of a opioid overdose in 2016. The only drug distributor to admit that it contributed to the epidemic was Miami-Luken. The drug distributor was investigated by the Drug Enforcement Administration for shipping too many pills to West Virginia. The committee’s investigation found that drug distributors and wholesalers sent more than 20 million opioids to Williamson, a small town that has roughly 3,000 people. Miami-Luken was among the distributors that sent millions of pills to the town. Drug distributors did say that they could have done better in identifying and terminating relationships with suspicious pharmacies. “I think our organization understood its responsibilities. We did have areas where we could have done better,” said George Barrett, chairman for Cardinal Health.

House Republicans pushing for May vote on food stamp reform. House Republicans are aiming to vote this month on a bill that would overhaul the nation’s food stamp program, but the legislation is facing pushback from both political ends of the party. Republicans want to require 20 hours of work or training for many able-bodied participants in the Supplemental Nutrition Assistance Program, or SNAP. The GOP hopes to pass the changes in the 2018 Agriculture and Nutrition Act, an $867 billion measure authorizing farm programs and policy, as well as SNAP, otherwise known as food stamps. Democrats are largely opposed to the bill. So to pass it, House Republicans will need the backing of most of the GOP conference. Not only does the bill risk losing more moderate Republicans who are uncomfortable with the food stamp changes, particularly in an election year, it could lose conservatives who want bigger cuts to the Farm Bill, which provides billions in agriculture subsidies. “The real question will come down to some of our more conservative members, or our more urban members,” Rep. Tom Cole, R-Okla., told the Washington Examiner. “Are they willing to vote for it for the reforms that are in it? Because we are going to lose a lot of Democrats.”

Trump administration approves New Hampshire work requirement. ​ New Hampshire has become the fourth state to implement a requirement that certain Medicaid enrollees work, volunteer or take classes for 100 hours a week as a condition of staying enrolled in the program. The requirement, approved under a waiver, applies to able-bodied people between the ages of

19 and 64​, and comes with a co-pay when enrollees seek medical care. “Work requirements help lift able-bodied individuals out of poverty by empowering them with the dignity of work and self-reliability while also allowing states to control the costs of their Medicaid programs. They help people gain the skills necessary for long-term independence and success,” said New Hampshire Gov. Chris Sununu, a Republican.​

Melania Trump rolls out ‘Be Best’ platform to help children. First lady Melania Trump announced an awareness campaign Monday that will try to help children facing issues in their lives from online bullying to opioid abuse. The initiative, called “Be Best,” was announced by Trump in the White House Rose Garden. The aim would be to focus on physical, social and emotional health. “It concerns me that in today’s fast-paced and ever-connected world, children can be less prepared to express or manage their emotions and often times turn to forms of destructive or addictive behavior such as bullying, drug addiction, or even suicide,” she said. “I feel strongly that as adults we can and should be best at educating our children about a healthy and balanced life.” Trump vowed to bring attention to organizations, companies and people who “are helping children overcome the many issues they face as they grow up.” That will include discussions with social media sites as well as with people who are battling drug addiction.

Lettuce scare alarms experts about food safety. A major outbreak of E. coli in romaine lettuce is bringing new attention to the importance of tracking how food gets contaminated. One person has died and at least 121 have become sick from the outbreak. Federal health officials are scrambling to learn what caused the outbreak, and their inability to figure it out has shed light on the problems they have tracking contamination in the food supply chain. The outbreak started when lettuce contaminated with E. coli sickened inmates in an Alaska prison. “Right now, we are looking at multiple distribution channels that could explain the nationwide outbreak and have narrowed it down to about two dozen farms from thousands of records,” said Food and Drug Administration spokesman Peter Cassell. One expert said the inability to detect the cause of contamination represents a flaw in a food safety program. “I don’t know why it is so hard, but none of this stuff has identifying labeling or some sort of a system that allows easy trace back,” said Sandra Eskin, director of the Food Safety Project for Pew Charitable Trusts.

States pass laws to prescribe opioids and antidote at the same time to prevent overdose deaths. A growing number of states are requiring doctors to prescribe a drug overdose antidote alongside prescription opioid painkillers to try to reduce drug deaths. Under the laws, doctors are to prescribe naloxone when they give patients a certain dose of pills for drugs such as Percocet, Vicodin, OxyContin, and Tramadol or if patients have ever overdosed before. Naloxone can come in the form of a nasal spray, known as Narcan, or an auto-injector known as Evzio. Arizona, Virginia, and Vermont already have the co-prescribing laws on the books, and lawmakers in California, Florida, New York, Ohio, Texas, and Utah are considering them. The laws are one of several ways that states are trying to stave off the wave of deaths from opioids, which surpassed 42,000 in 2016 and not only include prescription painkillers but illegal drugs such as heroin and fentanyl.

Walmart to put limits on first-time opioid prescriptions. Walmart and Sam’s Club pharmacies said Monday they will soon restrict opioid prescriptions for acute pain to no more than seven days, and restrict dosage to only a 50 morphine milligram maximum per day. The move aligns the mega chain with recommendations from the Centers for Disease Control and Prevention, which put out the recommendation as part of an effort to curb overprescribing of powerful painkillers. The policy, which applies to first-time opioid prescriptions for acute pain, is set to take effect in the next 60 days, Walmart said. The company added that starting in 2020, it will require e-prescriptions for controlled substances, as e-prescriptions are less prone to errors and can be tracked easily.

Conservative groups fighting subpoenas in Trump transgender lawsuits. The Heritage Foundation and two other conservative groups are fighting subpoenas to turn over documents that plaintiffs are seeking as part of their federal lawsuits against President Trump’s transgender military service policy. Active-duty transgender plaintiffs and rights groups in at least two of the federal suits are attempting to force Heritage, as well as the Family Research Council and the Center for Military Readiness, to share any emails or other correspondence with the White House that might have influenced Trump’s decision to roll back open transgender service in July. Lawyers for Heritage and the Family Research Council have argued in court that the subpoenas violate their rights to free speech and to petition the government, and could open both groups to public harassment or reprisals. A D.C. district court is reviewing the motions.

Americans turn in record number of pills on Drug Take Back Day. Americans turned in a record number of pills on National Prescription Drug Take Back Day, making it the most successful campaign in the project’s eight-year history, the Drug Enforcement Administration announced Monday. The DEA said people handed in 475 tons of unused, unwanted, or expired prescription medications as part of the April 28 event, which took place at 6,000 locations nationwide. Since National Prescription Drug Take Back Day started in 2010, the DEA has collected almost 10 million pounds of pills.

Marijuana super PAC created to oust legislative ‘sphincter’ Rep. Pete Sessions. Marijuana reform activists have created a new super PAC aimed exclusively at defeating Texas Republican Rep. Pete Sessions, the House Rules Committee chairman who has blocked cannabis reform legislation from reaching the House floor. Marijuana Policy Project founder and former Executive Director Rob Kampia is leading the effort, which he said is crucial to legalizing medical marijuana federally and affirming federalism for recreational pot, two policies supported in principle by Trump. “Everyone knows who he is and that he’s our biggest problem on Capitol Hill. Half of my job has already been done by Pete Sessions himself,” Kampia told the Washington Examiner.

GOP senator wants to rein in emotional support animals on airplanes. Sen. Richard Burr, R-N.C., wants to crack down on what types of service animals are permitted to fly with passengers uncaged in airplane cabins, following recent episodes in which passengers have tried to bring animals for emotional support aboard flights. “One doesn’t have to look far to find rampant cases of abuse where even emotional support kangaroos have been allowed to fly on planes to the detriment of fellow travelers and handlers of trained service animals,” Burr said in a statement in April. Burr’s legislation, which he introduced last month, would match the definition of a service animal in the Air Carrier Access Act with the one included in the Americans with Disabilities Act. That covers animals whose primary purpose is to provide emotional support.

Valeant rebrands as Bausch Health as CEO addresses backlash over price hikes. Valeant Pharmaceuticals said Tuesday it will change its name to Bausch Health Companies. The marketing maneuver comes as CEO Joseph Papa seeks to overcome criticism from lawmakers and insurers for significant increases in the price of its drugs. “Now is the right time in our turnaround to unite our company’s core businesses, subsidiaries and brands under the Bausch Health name,” Papa said. Two years ago, J. Michael Pearson, the company’s former CEO, fielded questions from the Senate Aging Committee on Valeant’s purchase of older drugs and subsequent price increases.

RUNDOWN

Axios The fight for new Medicare drug codes

The Hill Louisiana to warn thousands of elderly, disabled they may lose Medicaid

Wall Street Journal Takeda wins battle for Shire with $62 billion deal

Bloomberg Don’t expect joints if the FDA ever approves medical marijuana

Associated Press California judge affirms ruling for coffee cancer warnings

Kaiser Health News How the farm bill could erode a part of Obamacare

Washington Post No one wants to be the big, bad wolf of drug costs