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Obamacare rate hike proposals a warning for Republicans. As outside groups prepare their push to revive healthcare legislation, insurers in two more states seeking double-digit rate increases have just provided another warning for Republicans. If left unaddressed, Republicans will enter the fall’s midterm elections battling headlines of soaring Obamacare rates. Health insurers are asking Washington state regulators to allow them to raise the price of Obamacare premiums in 2019 by an average of 19 percent. New York Obamacare insurers want to raise prices by an average 24 percent, with some plans seeking rate increases as high as nearly 40 percent. In Washington, while no county would be left without any insurers, 14 counties would have just one insurer to choose from. The most common reason New York’s insurers on Obamacare’s exchanges gave for the increases was the 2019 repeal of the individual mandate fine in the new tax law. “Insurers have attributed approximately half of their requested rate increases to the risks they see resulting from its repeal,” New York’s Department of Financial Services said Friday. That could easily be weaponized by Democrats who have sought to blame skyrocketing premiums on Republican “sabotage” of the law (though rising rates was an issue before President Trump took office). Speaking to reporters in his office Tuesday morning, Sen. Bill Cassidy of Louisiana attacked Democratic intransigence on healthcare, saying, “​They would rather a problem to campaign on than a solution to lower premiums.” With legislative prospects bleak, Republicans are hoping that Trump regulatory changes allowing for expanded use of association health plans and short-term insurance would provide new cheaper options, especially for healthier individuals with less need for comprehensive policies.

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Susan Collins’ mind hasn’t changed on Obamacare replacement. Centrist Republican Sen. Susan Collins of Maine says she remains opposed to repealing the Medicaid expansion or considering the Graham-Cassidy Obamacare overhaul bill again. Collins has opposed every Obamacare bill brought up in the Senate. She also joined GOP Sens. Lisa Murkowski of Alaska and John McCain of Arizona last year to defeat a scaled-down “skinny repeal” bill that was supposed to serve as the vehicle for a compromise with the House. A group of more than two dozen conservative health analysts are working to revisit Obamacare later this month, but if Collins is firmly against it, the legislation would be all but dead on arrival. The GOP has a 51-seat majority, one less than when they attempted Obamacare repeal last year, because they lost a seat in the Alabama special election. But McCain has been in Arizona as he works through brain cancer treatment. The GOP would need at least 50 votes to pass a bill, with Vice President Mike Pence casting the tie-breaking vote.

Cassidy ‘pessimistic’ about work requirements for Medicaid. Cassidy said in his office Tuesday that he is “pessimistic” that work requirements for Medicaid that Louisiana lawmakers and Democratic Gov. John Bel Edwards are considering to help deal with a budget crisis would be beneficial. Cassidy said people who are uninsured would likely go to the emergency room for care even if they were removed from Medicaid, but added, “I’m willing to see what happens.” He stressed that he supports a system in which states are allowed to experiment in healthcare. He also said that while residents are gaining more access to primary care providers since Louisiana expanded Medicaid to low-income residents in 2016 under Edwards, access to specialized care is falling short because the reimbursement is too low.

Big Pharma faces rare day of reckoning as Trump pushes price cuts. The pharmaceutical industry’s day of reckoning may have finally arrived. Trump and his administration are determined to move forward on a sweeping initiative to address the rising cost of prescription treatments and, for once, the drug lobby may be unable to block the effort. Instead of a direct attack on the plan, Big Pharma hopes to craft policies that would quiet critics while avoiding potentially costly measures drugmakers have long opposed. It’s planning to work behind the scenes with the White House, the Office of Management and Budget and the Department of Health and Human Services to find common ground on the final regulatory proposals. The head of the industry’s main lobbying group alluded to the strategy this year. “The real question is what’s the right kind of change?” Stephen Ubl, president of the Pharmaceutical Research and Manufacturers of America, said at an event in May. “There are proposals in the president’s suite of 50 ideas that have great potential. Everyone needs to come to the table with constructive ideas on how to evolve those proposals.”

Read the whole story in the Washington Examiner magazine.

Pentagon opens investigation of Trump physician Ronny Jackson. The Defense Department has opened a formal investigation into White House physician Rear Adm. Ronny Jackson after several misconduct allegations came to light that sunk his bid to run the Department of Veterans Affairs, an inspector general spokesman said Monday. The IG did not disclose the scope of the investigation, and Jackson has denied any wrongdoing. Allegations surfaced while Jackson was still a nominee to head VA that he drank on the job and improperly dispensed medications. Jackson withdrew his nomination in April.

Court rules Maine must expand Medicaid. A state court has ruled that Maine must expand its Medicaid program to low-income residents. The ruling is a blow to Republican Gov. Paul LePage, who opposes expansion and said he would not submit a plan unless lawmakers in the state found a way to pay for it without tax increases and without taking money from the state’s surplus funds. The Maine Department of Health and Human Services and the LePage administration have until June 11 to submit the expansion plan to the federal government, Maine Superior Court Justice Michaela Murphy ruled Monday. The provision, which was created under Obamacare, would expand the government-funded Medicaid program to anyone making less than roughly $16,800 a year. An estimated 70,000 people in the state are expected to sign up for the program. Voters in November passed Medicaid expansion through a ballot measure that had the support of 59 percent of voters.

Top Medicaid official cheers work rules in Virginia expansion. The Trump administration official who oversees Medicaid applauded Virginia for adding work requirements to its Medicaid expansion that passed the state legislature last week. The Centers for Medicare and Medicaid Services will decide on a request from Virginia and other states that seek to expand Medicaid. Administrator Seema Verma gave a shoutout to states that seek to add work rules to their expansions of Medicaid under Obamacare. “I think this administration is focused on getting people back to work,” she said. “What we want to do is help people rise out of poverty.” But Verma didn’t say that states that seek federal approval for the Medicaid expansion would get a leg up if they add a work requirement. “When a state submits a waiver application or an amendment, our job is to process those things,” she said, adding that CMS would look at all expansion waivers fairly.

CMS releases grades for state Medicaid, children’s insurance program. The Trump administration released a new scorecard Monday to show the quality of state programs for Medicaid and the Children’s Health Insurance Program. The goal is to provide greater transparency on the quality of state programs that manage Medicaid and CHIP. “The data offered within the scorecard begins to offer taxpayers insights into how their dollars are being spent and the impact those dollars have on health outcomes,” CMS said. The scorecard is based on a series of measures that states voluntarily report to the agency. “The metrics included in the first scorecard reflect important health issues such as well child visits, mental health conditions, children’s preventive dental services, and other chronic health conditions,” CMS added.

Spending on Medicare drugs soars despite drop in prescriptions. Medicare paid 77 percent more for brand-name drugs over a five-year span, despite a 17 percent drop in the number of medicines prescribed, an inspector general study found. The study from the HHS watchdog looked at the impact of high drug prices on costs for Medicare Part D, the program’s prescription drug plan. The study, released Monday, looked at the total reimbursement for all Part D brand-name drugs from 2011 to 2015. Manufacturer rebates negotiated between vendors and drug makers didn’t make much of a dent. “After accounting for manufacturer rebates, reimbursement for brand-name drugs in Part D still increased 62 percent from 2011 to 2015,” the study found.

Kratom advocates fight FDA crackdown. Opponents of the Food and Drug Administration’s expanding dragnet of the herbal supplement kratom are arguing that the agency is eliminating a vital way to fight the opioid crisis. Scientists and activists say the agency’s ban on kratom, which is derived from tree leaves native to Southeast Asia, is not scientifically sound and that the agency is taking away a tool that millions of people use to help manage pain and drug withdrawal symptoms. The FDA says there is no scientific evidence that kratom can help treat opioid withdrawal and that the herb has significant safety issues.

Read the entire story in the Washington Examiner magazine.

New York City proposed legislation would allow ‘X’ gender category on birth certificates. New York City lawmakers are expected to introduce legislation this week that would allow people who do not identify as male or female to change the gender on their birth certificates to a third option: “X.”

RUNDOWN

Atlanta Journal-Constitution EXCLUSIVE: CDC researcher had personal struggles before suicide

CNN Naloxone recall due to particulate matter

Politico Texas plaintiffs personalize uphill legal challenge to overturn Obamacare

Reuters FDA reports five more deaths related to intragastric balloons

Modern Healthcare CMS late with data for new bundled-pay program, leaving providers with little decision time

Medscape FDA approves Pegfilgrastim biosimilar for cancer infection risk

Kaiser Health News A hospital ER charges an ‘after-hours’ fee. Who has to pay it?

Dallas Morning News As patients suffer, companies profit