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States challenging Obamacare fire back at opponents.Twenty states led by Texas and Wisconsin that are challenging the constitutionality of Obamacare on Thursday filed a brief responding to arguments made against the lawsuit by other states and (in part) the federal government. The states have been arguing that because last year’s tax law repealed the individual mandate’s penalties, the requirement is no longer a constitutional use of Congress’s taxing power and thus must be overturned along with the rest of the law, which the 20 states argue cannot be separated, or severed. Last month, the Trump Department of Justice declared that it was not going to defend Obamacare, agreeing largely with the plaintiff states, though taking the more limited view that only the requirements for insurers to cover those with pre-existing conditions without charging them more were inseverable from the mandate — meaning the rest of the law could stand. The Trump administration’s decision to argue in court for striking down the ban on pre-existing condition exclusions immediately vaulted the issue into the 2018 campaign. Sixteen states led by California (plus the District of Columbia) have stepped into the vacuum to fully defend Obamacare, and were supported by a number of outside amici briefs. Opponents have argued, among other things, that when the 2017 Congress repealed the mandate penalties, it expressed its view that they could be severed from the rest of the law, which thus superseded, for the purposes of determining intent, any calculations of the 2010 Congress that passed Obamacare in the first place.

In replying on Thursday, Texas and the 19 other states argued,”the 2017 Congress enacted only a constitutional tax cut, not the unconstitutional mandate, and it is only the judicial invalidation of the mandate that necessitates a severability analysis.” It also took issue with the DOJ’s suggestion that outside of the pre-existing related regulations, the rest of the law could stand if the mandate were struck down, pointing to other parts of the law that are affected by the mandate. The lawsuit notes, for instance, that Obamacare cut certain federal payments to hospitals with the understanding that those cuts would be offset as the mandate would prompt more people to sign up for Medicaid; and also that the mandate is meant to restrain premiums and thus affects Obamacare’s subsidies and exchanges. Texas and the other states are asking for an immediate injunction on the enforcement of Obamacare, arguing that its continued enforcement would cause “irreparable injury” to the states.

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Trump narrows field of possible Supreme Court nominees to three. President Trump has reportedly finished formally interviewing candidates to replace Justice Anthony Kennedy on the Supreme Court, with three federal appeals court judges emerging as the leading contenders. In the week since Kennedy announced his retirement, ending 30 years on the Supreme Court, Trump has spoken with seven possible nominee Reports indicate that Judges Brett Kavanaugh of the U.S. Court of Appeals for the District of Columbia Circuit, Raymond Kethledge of the 6th U.S. Circuit Court of Appeals, and Amy Coney Barrett of the 7th U.S. Circuit of Appeals are the frontrunners.

Liberal group pressures Collins, Murkowski to defend abortion, reject Trump’s Supreme Court pick. A liberal judicial advocacy group is running ads that call on Republican Sens. Lisa Murkowski of Alaska and Susan Collins of Maine to oppose Trump’s nominee to the Supreme Court. The ads from Demand Justice, which is working to tank Trump’s pick to succeed Kennedy, focus on the president’s prior comments about wanting to name justices to the Supreme Court who will overturn Roe v. Wade, the landmark 1973 case that established a woman’s right to an abortion.

Senate Democrats walk a 2018 tightrope on Supreme Court confirmation vote. Democrats in the Senate are walking a tightrope, balancing pressure on threatened red state incumbents to support Trump’s forthcoming Supreme Court nominee with the aggressive opposition of the party’s liberal base.

Conservative leaders back Mike Lee for Supreme Court nomination. More than two dozen conservatives are rallying behind Sen. Mike Lee, R-Utah, to replace Justice Anthony Kennedy on the Supreme Court. Twenty-seven conservative leaders signed a statement in support of Lee, including Sen. Rand Paul, R-Ky., Rep. Mia Love, R-Utah, Conservative Partnership Institute Chairman Jim DeMint, and FreedomWorks President Adam Brandon.

Ryan-backed group launches ad campaign on opioid crisis. A top outside group backed by House Speaker Paul Ryan is launching a new ad campaign highlighting congressional work against the opioid epidemic four months out from the midterm elections. The American Action Network is pouring $2.5 million into ads in ten House districts, including multiple involving top-tier races, after the House passed a series of bills aimed at curbing the epidemic over the past month.  

Healthcare comes in third as top issue for midterms. A plurality of U.S. voters said in a new poll that immigration is the most important issue for the midterm elections in November. In a five-day-long poll from Reuters/Ipsos released Friday, almost 15 percent of voters said immigration was the number one issue, making it the top issue for voters. The economy came in a close second at 14 percent, and healthcare was third at about 12 percent. Voters’ priorities change depending on party affiliation. Healthcare is still the top priority for registered Democrats as almost 16 percent said it was their biggest ballot issue, and the economy came in a close second.

‘Under 3,000’ migrant kids separated from parents, including 100 children under age of 5, says HHS chief. Fewer than 3,000 children under the Office of Refugee Resettlement’s care have been separated from their parents who entered the U.S. illegally with them, and fewer than 100 of that number are under the age of five, Health and Human Services Secretary Alex Azar estimated Thursday. “Multiple data set reviews … identified under 3,000 children in total, including 100 children under the age of five, in ORR care who may have been separated from purported parents who were taken into HHS custody,” Azar told reporters in a media call Thursday.

Pro-Obamacare advocacy group says Nebraska has enough signatures to put Medicaid expansion on the ballot. Advocacy groups in Nebraska have collected enough signatures to ask Nebraska voters in November whether to expand the Medicaid program to cover low-income people. Were it to pass, anyone making under $16,000 a year would be able to sign up for government-funded healthcare coverage. If Medicaid is expanded in Nebraska, an estimated 90,000 people would join the program. Insure the Good Life, the organization collecting the signatures to put the issue on the ballot, said it gathered more than 133,000 signatures, above the minimum requirement of 85,000 signatures. The signatures will be verified over several weeks.

New Hampshire governor signs law requiring insurers to provide free birth control.

New Hampshire’s Republican Gov. Chris Sununu on Thursday signed a bill into law that requires health insurers to offer a 12-month supply of birth control at no additional cost to patients.

Illinois moves to expand addiction treatment under Obamacare. Illinois has sent an application to the federal government to add more addiction treatment and overdose coverage for people who are enrolled in Obamacare plans. The proposal will take effect in 2020 if it is approved by officials at the Centers for Medicare and Medicaid Services. The application would add to the “essential health benefits” that must be covered by benchmark health insurance plans. Benefits would include covering prescriptions for Narcan, a nasal spray that reverses an opioid overdose, when people are prescribed a certain amount of opioid painkillers; as well as coverage for alternative treatments for chronic pain that are non-addictive. It would limit the amount of prescription opioids doctors can prescribe to seven days and would cover telepsychiatry to treat addiction and mental health disorders. Adding the benefits will cost Obamacare enrollees, who number roughly 300,000, about 30 cents more per month in premiums, according to the Chicago Tribune.

RUNDOWN

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Modern Healthcare Mississippi Revamps Medicaid Work Requirement Request

New York Times Americans Are Having Fewer Babies. They Told Us Why.

The Sacramento Bee Doctors, Nurses, Insurance Companies Spending Big to Influence California’s Healthcare Future

Science Magazine Hidden conflicts? Pharma Payments to FDA Advisers After Drug Approvals Spark Ethical Concerns

Stat News A Case Study in the Fast-Rising Threat of Antibiotic-Resistance

Politico Sources: EPA blocks warnings on cancer-causing chemical