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Ronny Jackson out as VA nominee, Trump hints at who is next. White House Physician Ronny Jackson has withdrawn his nomination to serve as the next secretary of Veterans Affairs are multiple allegations surrounding workplace misconduct which include improperly doling out prescription drugs. So now that Jackson is out, who will President Trump pick now? Trump gave a slight hint during an interview with Fox & Friends on Thursday when asked if he knew who he was going to nominate. “I do actually,” Trump said. “I better not give it, maybe I do it on next call. I think we’ll have somebody great. Somebody that is more – look, the admiral is not a politician, which is what I liked,” Trump said, indicating that the next nominee would be someone with “political capability.” Jackson was an unlikely choice to begin with to take over the VA as he has no managerial experience over a major agency like the VA. Jackson is well liked in the White House and earned plaudits from Trump for his press conference detailing the president’s health last year. Jackson already faced skepticism among Democrats and some Republicans over his lack of management experience. However, that hill became insurmountable after 23 former and current colleagues of Jackson told Democratic staff on the Senate Veterans’ Affairs Committee about a series of alleged incidents that included drunkenly crashing a car at a Secret Service party. Democratic Sen. Jon Tester, of Montana, top Democrat on the committee, on Thursday said he is ready to help find the next VA secretary who he says should be committed to standing up to special interest groups that want to privatize the VA.

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House panel advances 57 bills, with some glaring exceptions. A House panel advanced more than 50 bills aimed at tackling the opioid crisis Wednesday, but Democrats cried foul after the panel didn’t consider several Democrat-led bills. The House Energy and Commerce Committee’s health subcommittee moved 57 bills to the full panel Wednesday, but didn’t finish work on the 63 that were proposed. The bills now go to the full committee, which is expected to take them up in a few weeks. The legislation focuses on a myriad of areas in the fight to curb opioid abuse, including efforts to expand treatment options and urge the use of non-opioid drugs. One of the bills was not opioid-related. It would authorize an animal drug user fee program. But what wasn’t considered caused major fireworks between Democrats and Republicans. “It appears there are several Medicaid bills sponsored by Democratic members on the list,” said Rep. Frank Pallone, D-N.J., top Democrat on the panel. Among them was a bill aimed at expanding access to birth control for women who give birth to babies addicted to opioids. “This is a bipartisan bill. It is an important bill about babies getting access to treatment,” said Rep. Diana DeGette, D-Colo. “It says the [Department of Health and Human Services] standards shall be implemented and the HHS standard allow for access for the mothers of these opioid addicted babies to get birth control access. The chairman’s amendment takes out the birth control access.” DeGette said the issue isn’t about abortion, but rather about access to birth control, which is recommended by HHS. She said the bill should be included among the final legislation that is brought before the committee in the next few weeks. “I am going to make sure that every member of this committee has to vote on whether women who give birth to opioid-addicted babies should have access to birth control while they get treatment,” she said.

So what did the subcommittee advance? The bills focus on a comprehensive approach to fighting an epidemic that killed more than 42,000 Americans in 2016, according to federal data. One bill would provide grants to federal, state, and local agencies to create or operate labs to better detect fentanyl, a synthetic opioid that is 50 times more potent than heroin. Fentanyl overdoses have been surging in recent years. Another bill seeks to boost telehealth options for people in rural and underserved communities. Some legislation aims to bolster the use of nonaddictive pain therapies. One bill would call for the Food and Drug Administration to look into new clinical trial designs to approve nonaddictive painkillers and help create regulatory guidance for drug makers on how to create such products. The push includes a bill, which passed unanimously, to give the FDA more power to catch shipments from overseas of illicit opioids like the powerful fentanyl, which is 50 times more potent than heroin. Health subcommittee Chairman Michael Burgess, R-Texas, said it was one of the most important pieces of legislation on which the committee will focus. “If we don’t fix this problem it is going to be very difficult to get on top of it,” Burgess said.

California urges Trump administration to boost Obamacare marketing fund. The leader of California’s Obamacare exchange is urging the Trump administration to increase funding for advertising and marketing for the healthcare program during the next open enrollment, after the state’s own effort to increase enrollment fell flat. California spent $110 million on marketing for its Obamacare exchange in the last open enrollment, called Covered California, and its enrollment fell by 2.3 percent. James Scullary, Covered California spokesman, said in an email that the state overall finished open enrollment with 1.5 million customers, roughly the same as where it ended up in 2017. The amount California spent was higher than what the federal government spent to market healthcare.gov under the Trump administration during its last open enrollment. The federal site is used by 39 other states, but the remaining states, such as California, operate their own exchanges. The Trump administration budgeted $10 million for outreach and $36 million for navigators, who help people sign up for the program. Enrollment in healthcare.gov dropped by roughly 5 percent, from 9.2 million to 8.7 million.  “Enrolling new consumers every year is critical to maintaining a healthy consumer pool and keeping premiums low,” Peter Lee, executive director of Covered California, said in a statement. “The drop in new enrollees at the federal level is deeply concerning and can be tied directly to recent policy decisions to not spend resources available to promote enrollment — leading to increased premiums for millions of Americans who do not get federal subsidies.”

An analysis with the letter suggests premiums would drop with investment in marketing dollars. Lee’s letter, to Verma and to Health and Human Services Secretary Alex Azar, included an analysis conducted by his agency that suggested $400 million in outreach efforts would lower premiums by 2.3 percent in 2019 and result in saving $1.6 billion in government and consumer spending. Over time, such increases could reduce premiums by 3.2 percent from 2019 to 2021 and result in $6.6 billion in savings, according to the Covered California analysis. “This report highlights the decline in federal enrollment, driven by a nearly 40 percent drop in new enrollees, and why that is of concern,” Scullary said. “In contrast, the enrollment of state-based marketplaces — including Covered California — has remained stable during the past two years.” Despite a reduction in overall enrollment in the state, California officials have said they saw the open enrollment period in their state as successful because more new enrollees had entered since the first open enrollment in 2013. They have said they believe re-enrollment had dropped because more people chose to purchase coverage outside of the exchange due to the way the state had structured its subsidies.

Senators want to cut foreign shipments of illicit opioids. A new Senate bill would allow specially trained postal workers to search incoming foreign mail suspected of containing illicit opioids such as fentanyl, a major driver in overdose deaths in recent years. The bill authored by Sens. Bill Cassidy, R-La., and Tammy Baldwin, D-Wis., aims to bolster efforts to stem the tide of fentanyl coming into the country, as a majority of the shipments come from China. The legislation follows a recent congressional probe that found that it was easy to buy fentanyl online and have it shipped overseas through the U.S. Postal Service.

Americans for Prosperity starts six-figure ad blitz calling for passage of ‘right to try.’ Americans for Prosperity is launching a six-figure national ad campaign calling on Congress to pass a bill that would allow terminally ill patients to try experimental medications. The ads will run on TV and online and show members of both parties discussing the importance of passing the bill. It urges viewers to call members of Congress to voice their support for passage.

HHS says ‘disruption’ is coming to the US healthcare system. The No. 2 official at the Department of Health and Human Services said the Trump administration isn’t afraid of causing “disruption” in the healthcare system to improve care. “If we need disruption to deliver the care Americans deserve, then disruption is on the way,” Deputy Secretary Eric Hargan said at a Thursday conference hosted by Academy Health. Hargan rolled out various initiatives by the federal government involving healthcare technology, saying that healthcare had become “too expensive, too inaccessible — and we face too many stubborn public health problems, like chronic disease and substance abuse.” He announced that the administration will be creating a “Blue Button 2.0” program under Medicare to allow beneficiaries to connect their data to apps that are run by private developers. The system allows beneficiaries to see what medical procedures were billed during doctor or hospital visits, and currently can be downloaded only by PDF. HHS also has proposed that hospitals publicly post their list prices for various medical procedures and ways to make electronic medical records better for patients so they can review and use their health information, Hargan noted.

RUNDOWN

Axios Romaine lettuce outbreak is a virulent one in an already busy 2018

The Hill Experimental drugs bill runs aground despite support from Trump, Pence

CNN FDA reexamines safety of controversial new drug

Politico 7 governors launch ‘unprecedented’ effort to study gun violence

Associated Press E. coli outbreak linked to romaine lettuce grows to 84 cases

Kaiser Health News ‘Rapid Autopsy’ programs seek clues to cancer deaths within hours of death

Reuters Johnson & Johnson wins appeal to overturn $151 million hip implant verdict

New York Times Common pain relievers beat opioids for dental pain relief