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Trump administration allows insurance to be sold across state lines. Small businesses and individual workers will be allowed to band together to provide medical coverage that will be less expensive than Obamacare plans under a rule released Tuesday by the Trump administration. The Department of Labor released its final rule as part of the administration’s actions to give people options outside of Obamacare. Labor Secretary Alexander Acosta framed the provision as a way to “level the playing field” between small businesses and larger companies, which he says have more bargaining power and the ability to spread risk among their employees. Certain plans can be available in September, ahead of the open enrollment period that starts for Obamacare in November. “Small businesses, including the self-employed, will be able to obtain healthcare coverage as if they were a large employer,” Acosta said in a call with reporters Tuesday morning. The proposal is often billed by supporters as one that would “allow people to buy health insurance across state lines” because people and businesses would be able to join an association even if they are working in different states. Opponents of the provision say healthier people would opt for the association health plans and leave the Obamacare-created exchanges. That would drive up prices for Obamacare customers whose income is too high to qualify for federal subsidies, because more sick, expensive people would be left behind. Six million people are expected to enroll in the association health plans, according to the Congressional Budget Office. CBO projected that the plan and short-term-plans, which are another type of alternative health insurance that will be offered by the Trump administration, will increase premiums on the Obamacare exchanges by between 2 percent and 3 percent. Critics also worry that the plans would exclude certain types of medical coverage, such as mental health and maternity care.

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Democrats criticize the association health plans. Senate Minority Leader Chuck Schumer called the rule a “sabotage of our healthcare system” and a “back door to expanding junk insurance plans that weaken protections for people with pre-existing conditions.” He pointed out that various medical groups representing doctors and hospitals had opposed the proposal when it was introduced. Sen. Patty Murray, the top Democrat on the Health, Education, Labor and Pensions Committee, said the rule would “make healthcare in our country worse by undermining access to care for people with pre-existing conditions, destabilizing markets and driving up costs.” The Trump administration, however, said protections will still be in place, saying that people should have multiple options for coverage that provides them a way out of the Obamacare mandates that cause price increases. The plans, they say, will be similar to the type of medical coverage that people receive in a large business. “They will be protected from pre-existing conditions just as they are in the large-group market, as well as on age and gender,” said a senior official in the Labor Department.

Conservative groups release Obamacare replacement plan, but it faces uphill climb in Senate. A group of conservative policy analysts on Tuesday released a plan to revive the Obamacare replacement debate in a reluctant Congress. It seeks to convert the funding for Obamacare’s subsidies and Medicaid expansion into block grants for states to spend on covering their residents. The idea is to provide enough flexibility so that states can tailor policies to fit the needs of their individual populations as opposed to having the federal government implement the same policies on the nation as a whole. It would allow states to use funding to allow Medicaid eligible individuals to enroll in private plans. The proposal also requires a portion of the grant to “offset costs of high-risk patients.” That is a nod to protection for people with pre-existing conditions. At this point, the proposal is more of a broad outline that does not include specific funding numbers in hopes of restarting the healthcare debate in Congress, as a number of Republicans seek to do something in anticipation of this fall’s rate increases ahead of the midterm elections.

The proposal’s chances remain bleak, as it is similar to a proposal from Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., that fizzled last fall for lack of support. There’s no indication that this proposal will fare any better. The GOP has one fewer senator to work with this year after Democrat Doug Jones’ victory in the Alabama special election, and none of the GOP senators who killed last year’s replace effort have suggested they would be more willing to vote for something now.

Bipartisan governors slam Trump administration decision to not defend Obamacare. Nine bipartisan governors criticized the Trump administration Monday for backing a lawsuit that would eliminate Obamacare’s protections for people with pre-existing conditions. The statement said the recent action by the Trump administration was “not right” and should be reversed. It is the latest outcry from politicians over the administration’s decision to not defend Obamacare in court. “The administration’s disappointing decision to no longer defend this provision of federal law threatens healthcare coverage for many in our states with pre-existing conditions and adds uncertainty and higher costs for Americans who purchased their own health insurance,” the statement from the governors says. Ohio Gov. John Kasich was among three Republican governors to sign the statement. Larry Hogan of Maryland and Brian Sandoval of Nevada also signed it.

House resume votes on opioid bills late Tuesday. The House is expected to vote this evening on 17 opioid bills. The votes are part of a larger effort to move more than 70 pieces of legislation by the end of the week. The legislation to be considered includes the Children’s Health Insurance Program Mental Health Parity Act, which ensures access to mental health services for youths in the insurance program. Several of the bills call for studies or new regulations concerning the opioid crisis. For instance, one requires the Food and Drug Administration to post study requirements for certain controlled substances. Another requires a governmental advisory board to report to Congress about opioid prescribing and incentives for treating pain with opioids. A major critique from some Democrats is that the legislation won’t make much of a dent without new funding to expand treatment options. Nevertheless, the bills are expected to sail through the House. The bills then head to the Senate. House Republicans hope to start its conference with the Senate next month to combine all of the opioid legislation into one package.

Senate panel schedules next hearing on drug prices. The Senate Finance Committee will hold its next hearing on prescription drug prices next Tuesday at 9:15, committee Chairman Orrin Hatch, R-Utah, announced. Senators will be able to ask Health and Human Services Secretary Alex Azar about the administration’s blueprint to try to reduce drug prices. The discussion will focus on changes to Medicare and Medicaid and on promoting innovation and competition. “Americans of all ideological stripes agree: The costs of prescription drugs are too high,” Hatch said. “But at the same time, Americans want access to leading, breakthrough treatments. The best way to both reduce costs and ensure that life-changing drugs remain accessible is to boost competition, especially with new drugs that have the potential to cure diseases but face limited competition.”

AARP presses Congress to not backtrack on donut hole coverage. AARP is imploring congressional leaders to keep a requirement that forces drug makers to provide greater relief for seniors in Medicare’s prescription drug “donut hole.” “Any efforts to roll back this progress would only serve to increase out-of-pocket costs for beneficiaries,” the seniors lobby’s CEO, Jo Ann Jenkins, wrote in a letter to Congress last week. Once a senior on Medicare Part D, the program’s prescription drug plan, spends a certain amount on prescription drugs, the senior enters the “donut hole” and must cover all out-of-pocket drug costs. The March spending deal closed the donut hole a year earlier than scheduled, in 2019. It also required pharmaceutical companies to cover 70 percent of drug costs in the donut hole, as opposed to the current level of 50 percent.

Trump administration blames delay for 340B hospital discount program rule on drug pricing plan. The Trump administration delayed a final rule that would set new caps for drug prices under a controversial discount rule because of the administration’s new drug price blueprint, an official told a Senate panel Tuesday. The program requires drug makers to give discounts on products to hospitals that provide care to a certain amount of low-income patients. The program, called 340B, has been the subject of much controversy as the pharmaceutical lobby charges the program has expanded too much and that hospitals are not using the discounts to improve patient care. Hospitals in turn say the drug lobby is trying to curb the program and has been responsible for raising prices. The Department of Health and Human Services proposed to delay for the fifth time a rule that would clamp down on drug companies that overcharge 340B facilities. “We are in the process of looking at the policies in that rule and in the broader context of drug prices,” said Capt. Krista Pedley, director of the Office of Pharmacy Affairs for HHS’ Health Resources and Services Administration. Sen. Elizabeth Warren, D-Mass., bashed the response as an excuse to let drug companies off the hook. “It looks like the administration is trying hard to dig up some excuse to let pharmaceutical companies to charge hospitals more,” she said.

Congress seeks suicide lifeline number that’s easy to remember. The national suicide helpline is facing a makeover that would make it easier to remember under a plan uniting members of Congress from both parties. The plan would direct government agencies to look into changing the 10-digit National Suicide Prevention Lifeline number, 800-273-TALK, to three digits that people can easily remember, similar to 911. “We have heard time and again that one phone call could have saved a life, and we want to make that one phone call easier,” said Sen. Orrin Hatch, R-Utah. When he announced the proposal on the Senate side, he said the current number was “not an intuitive or easy number to remember, particularly for those experiencing a mental health emergency.” Under the bill, the National Suicide Hotline Improvement Act, the Federal Communications Commission, the Substance and Mental Health Services Administration, and the Department of Veterans Affairs would determine how doable it would be to set up a three-digit number, suggest which number to use, and look into how well the current lifeline works. The Senate passed the bill unanimously in November. In the House, the bill had a hearing, markup, and was passed by the Communications and Technology Subcommittee, part of the Energy and Commerce Committee, where it is headed next.

Maine Gov. Paul LePage continues to fight against Medicaid expansion. Republican Gov. Paul LePage has asked the state’s Supreme Judicial Court to step in on an order that it expand Medicaid, saying his administration should not have to expand a “massive new benefit program” that the state legislature hasn’t found a way to fund. LePage vetoed five measures to expand the program as governor, and is in his final year in office. The passage of the bill to expand Medicaid happened through a ballot measure, but the state has missed its deadline to file for expansion. Since then, two court rulings have ordered the LePage administration to file the application.

Pro-Obamacare group launches ads attacking Trump administration pre-existing conditions lawsuit. The Pro-Obamacare organization Protect Our Care is launching digital ads Tuesday to warn the public about the Trump administration’s lawsuit that would gut Obamacare’s protections for people with pre-existing illnesses. The campaign, known as “130 Million Strong Month of Action,” will use paid media and grassroots advocacy, and will target 13 states: Alaska, Arizona, Indiana, Maine, Missouri, Montana, Nevada, North Dakota, Ohio, Pennsylvania, Tennessee, West Virginia, and Wisconsin. “There are over 130 million Americans out there with pre-existing conditions who deserve to know that Republicans are trying to let insurance companies take away their coverage,” said Protect Our Care Campaign Director Brad Woodhouse. “The Trump Department of Justice just declared war on people who have a history of diabetes, asthma, or cancer.”

CVS turns to Postal Service to fight Trump nemesis Amazon. CVS Health is teaming with the U.S. Postal Service to deliver prescription medications to customers’ homes, using one of President Trump’s favorite foils to compete against another: Jeff Bezos’ Amazon. The Postal Service is facing pressure from the White House to raise the price it charges Amazon to ship parcels, despite the potential to raise deficits at the independent agency. A CVS Health spokeswoman confirmed the company is using the agency’s standard delivery service and will not receive any discounted shipping rate. Same-day shipping from CVS, which was available in New York City last year, will be offered for $8.99 in five additional markets, including Washington and Miami. Customers must be within one mile of a CVS store to qualify. The company also will offer one-to-two day deliveries nationwide for a flat fee of $4.99, a service that comes without a location requirement.

Ball State University sued for discrimination by anti-abortion group. The Students for Life chapter at Ball State University has filed a federal discrimination lawsuit against the Indiana-based public institution for refusing to fund their group. The anti-abortion group had requested that the Student Activity Fee Committee, which is made up of students and administrators, grant $300 for the group’s initiative, “Pregnant on Campus.” The initiative helps students who are pregnant or parenting by giving them information for organizations that can assist them emotionally and financially, or help them with other material needs. Although the institution denied funding to Students for Life in February, it has used mandatory student fees to fund other groups, including Feminists for Action, which used the money to promote Planned Parenthood, Secular Student Alliance, who hosted a “God is Dead: Life without Religion” event, and Spectrum, which promotes a pro-LGBTQ agenda. The committee stated it could not support a group that “engages in activities, advocacy, or speech in order to advance a particular political interest, religion, religious faith or ideology,” as noted in a Students for Life news release.

RUNDOWN

Washington Post What separation from parents does to children: ‘The effect is catastrophic’

New York Times New York moves toward legal marijuana with health department endorsement

STAT News Empty desks, squabbles, inexperienced staff: Who exactly is coordinating White House drug policy?

Axios Dems see a midterm advantage in pre-existing conditions battle

Associated Press Some parents of epileptic kids wary of pot-based medication

Kaiser Health News If you have hep C, spitting could be a felony

Wall Street Journal Maine keeps battling over Medicaid expansion

Bloomberg Most under-35s OK with insurers digital spying if it cuts prices