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Opponents of Texas Obamacare lawsuit lay out strategy ahead of pivotal hearing. A collection of 17 states will argue in next week’s big Obamacare hearing that Texas and 19 other states’ legal challenge to get rid of the healthcare law doesn’t make legal sense. The thrust of the pro-Obamacare group’s argument is that Congress has full authority to implement the law, including its individual mandate, even though the mandate has been zeroed out.

The argument is a defense against the central claim in the lawsuit from Texas, namely that Congress’ decision in tax reform to zero out the mandate penalty, a key component of Obamacare, means that the rest of the law should fall with it.

But North Carolina Attorney General Josh Stein argued on a press call Thursday that the mandate, famously upheld in the 2012 Supreme Court Obamacare decision as a tax, still counts as a tax and thus is within Congress’s authority, even if it’s a zero tax.

“A tax doesn’t have to generate revenue in order for it to be a tax,” Stein said.

Even if the court buys Texas’ argument that the mandate is no longer a tax, the lawsuit should still be thrown out, Stein added, saying that just because the individual mandate goes away doesn’t mean the rest of the law has to go away. If Congress wanted to repeal the entire law then they would have done so in tax reform, but they did not, Stein said. “All the other provisions in the law are valid and Congress clearly indicated their desire to keep the rest of the law,” he said.

Next week’s hearing will review only the preliminary injunction to get rid of the entire law while the lawsuit is being argued. A judge is expected to issue a ruling after the hearing. “After that we would continue to proceed down the road to get this litigated in full,” California Attorney General Xavier Becerra said.

Missing from the hearing will be the Justice Department, which decided earlier this year to no longer defend Obamacare in court. The Justice Department supports the Texas lawsuit, but only to a point. Instead of getting rid of the entire law, the Justice Department argues that only Obamacare’s protections for pre-existing conditions should go away.

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Trump administration seeks to give Medicare drug plans more control over their offerings. The  Centers for Medicare and Medicaid Services moved Wednesday to give Medicare drug plans more choices in the products they can offer patients, in a bid to boost their buying power and lower drug prices. Starting in 2020, Medicare prescription drug plans will be allowed to take advantage of a tool, called an indication-based formulary, that expands the choices of products they can cover, allowing plans to opt for cheaper drugs in certain cases.

The announcement Wednesday is the latest part of the Trump administration’s blueprint for lowering prescription drug costs that have spiraled upward in recent years. The goal behind the announcement Wednesday is to make Medicare more like the private sector in terms of drug negotiation. The tool applies to Medicare Part D, the program through which private plans cover prescription drugs that seniors buy at pharmacies. Currently, there are restrictions on which drugs can be covered on a Part D plan’s formulary, which is the list of prescription drugs that a plan will cover. If a drug is on a plan’s formulary, the plan must cover the drug for any admissible use — even if the plan otherwise would instead cover a different, cheaper drug to treat particular conditions. Accordingly, starting in 2020, Part D plans will be able to use an indication-based formulary, which will let them tailor their formularies to include different drugs for different clinical indications. The tool is already used for private sector plans, CMS said.

Some are not happy with the decision. The American College of Rheumatology slammed the decision by CMS, saying it would take decision-making out of the hands of doctors and give it to insurers. The group also said this new policy was especially disconcerting on top of another policy CMS introduced earlier this month introducing another private sector tool called “step therapy.” The method involves giving a patient a cost-effective treatment first, and then moving them on to a pricier treatment if it doesn’t work. The college said that this new policy is worse than step therapy, in terms of potentially restricting patient access to needed treatments.

“Unlike step therapy, which often delays effective treatments, this proposal would go even further and allow plans to remove therapies from the formulary altogether, leaving patients completely unable to access treatments that doctors and patients choose together,” the college said in a statement. “The ACR calls on the Trump administration not to go forward with this plan, or at a minimum to clarify the process for allowing exemptions for patients for whom a specific therapy is medically necessary.”

Trump administration reportedly to end family planning grants early. Potentially major changes are in store for the family planning grant program. The Trump administration plans to announce that Title X family planning funding grants will be for six months, instead of the normal year-long cycle in which health centers across the country are given money for contraception and preventive health services. The Trump administration announced earlier this year that it plans to cut funding to organizations that provide abortions like Planned Parenthood. The administration also created new rules that restrict whether doctors can refer a patients for abortions. Politico first reported the Title X funding grant change. Sen. Patty Murray, D-Wash., bashed the reported decision. “Shortening these grants is a gimmick, plain and simple—and it’s all about moving as quickly as possible to undermine health care access for millions of people and to gag providers from discussing the full range of reproductive care options with patients,” Murray said in a statement.

U.S. insurance coverage plateaus in first months of 2018. Health insurance coverage in the first three months of 2018 was about the same as the year before, but more Americans are saddled with high-deductible plans this year, according to new data released Thursday. The Centers for Disease Control and Prevention released the insurance coverage data on Thursday as Democrats charge that moves by the Trump administration are hampering enrollment in Obamacare. In the first three months of 2018, 28.3 million people (8.8 percent of the U.S. population) were uninsured at the time of they were interviewed by the CDC. That isn’t statistically different from the first quarter of 2017, but it is 20 million fewer people than in 2010, CDC said.

However, more Americans are enrolled in high-deductible plans this year. The percentage of people under 65 with private insurance in a high-deductible plan increased from 43.7 percent in the first quarter of 2017 to 47 percent in 2018. The CDC survey did not specify a reason for the plateau in coverage for 2018. However, a May report from the think tank Commonwealth Fund said that gains in insurance coverage made since Obamacare’s passage in 2010 are starting to erode.

RUNDOWN

The Hill Washington’s fall agenda: Pre-existing conditions fight takes center stage in midterms

Axios There’s a promising opioid alternative in the works

Washington Post FDA pushes for development of non-opioid pain medication

Kaiser Health News HHS watchdog to probe enforcement of nursing home staffing standards

Associated Press Even a small amount of medical debt can cause headaches

STAT News The Senate could soon pass an opioid package. But a new law is still a long way away

Forbes How Medicare wastes $4.8 billion a year on long-term care hospitals

NPR What is meat anyway? Missouri label law says it comes from an animal, but some disagree