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Trump administration supports repeal of Obamacare’s medical device tax. President Trump’s advisers are urging him to sign a bill into law that would repeal Obamacare’s medical device tax, framing the action as fulfilling his promise to “provide relief to Americans suffering from the failures of Obamacare.” The Protect Medical Innovation Act, which the House is expected to take up today, would repeal the 2.3 percent tax on medical devices that has already been suspended by Congress a couple of times. The tax was one of several measures that were implemented under Obamacare to help offset the provisions in the healthcare law, but members of the industry have long pushed for repeal, saying it will cost jobs and stymie innovation. In a statement of administration policy from the White House obtained by the Washington Examiner, the Trump administration called on Congress to pass the bill and repeal the “unnecessary and economically harmful” tax. “Repealing this tax would lower healthcare costs, save American jobs and promote a patient-centered healthcare system,” according to the Trump administration. The letter continued: “This tax is an obstacle for patients seeking access to medical advances, and threatens to undermine the position of the United States as the global leader in healthcare investment and innovation.” The idea of repealing the medical device tax has in the past been one of the few areas of bipartisan agreement on Obamacare. In 2013 a nonbinding  resolution in support of repealing the tax passed a Democratic senate with 79 votes — and with liberal icon Sen. Elizabeth Warren, D-Mass., voting to repeal it under heavy lobbying from the medical device industry, which is powerful in her home state.

Welcome to Philip Klein’s Daily on Healthcare, compiled by Washington Examiner Managing Editor Philip Klein (@philipaklein), Senior Healthcare Writer Kimberly Leonard (@LeonardKL) and Healthcare Reporter Robert King (@rking_19).  Email [email protected] for tips, suggestions, calendar items and anything else. If a friend sent this to you and you’d like to sign up, click here. If signing up doesn’t work, shoot us an email and we’ll add you to our list.

Insurer uncertainty fuels Democrats’ attacks ahead of midterm elections. Democrats are seizing on the Trump’s administration’s decision to pause payments to Obamacare insurers, arguing that the uncertainty is going to lead to a further spike in rates just before this November’s midterm elections. While there’s time for the issue to be resolved before insurers have to finalize rates, pro-Obamacare groups and Democrats aren’t waiting, already saying that the pause in payments is part of a larger campaign of “sabotage” against Obamacare. “Once again, Republicans are proving that they do not care how many families they hurt in their fevered obsession with sabotaging America’s health care laws,” House Minority Leader Rep. Nancy Pelosi, D-Calif., said after the announcement. After years of playing defense on Obamacare, Democrats are gearing up to go on the offensive, blaming Republicans for driving up healthcare costs.

Senate confirms Robert Wilkie, Trump’s pick to lead the VA. Robert Wilkie has been confirmed as the next secretary to lead the Department of Veterans Affairs, becoming the first nominee for the job to face any opposing votes in the Senate. Wilkie was confirmed by an 86-9 vote. Sen. Bernie Sanders, I-Vt., voted against Wilkie, saying that he believed the Trump administration would seek to “privatize” the VA, a move he and Democrats oppose. Sanders was joined in his opposition by eight Democratic senators, including Sens. Kirsten Gillibrand and Cory Booker of New York, Sens. Kamala Harris and Dianne Feinstein of California, Elizabeth Warren and Ed Markey of Massachusetts, and Jeff Merkley and Ron Wyden of Oregon. This is the first time in the 30-year history of the post that senators have voted against a president’s nominee. Wilkie, 55, has vowed to “shake up complacency” at the government’s second-largest agency, whose veterans have faced long wait times for medical care.

Republican senators seek to stop D.C.’s individual mandate. A group of six GOP senators want to stop the District of Columbia’s effort to create their own individual mandate that everyone in the locality get health insurance.  The senators introduced on Tuesday an amendment to an appropriations bill that would stop federal funds from re-implementing the mandate’s financial penalty. The tax reform law zeroed out the penalty starting in 2019. “We need to finish the job on Obamacare, not prop it up with a broken system,” said Sen. Ted Cruz, R-Texas, one of the six senators to introduce the amendment.  Several states have sought to pursue their own individual mandate penalty after the federal penalty is expected to go away. Insurers are worried that the loss of the penalty will cause younger and healthier people to not sign up for Obamacare, causing further destabilization in the law’s insurance marketplaces. The House already passed an amendment to stop the D.C. mandate in a spending bill. In addition to Cruz, the amendment was introduced by Sens. Tom Cotton, R-Ark., Mike Lee., R-Utah, Ron Johnson, R-Wis., Cindy Hyde-Smith R-Miss., and Marco Rubio, R-Fla.

Eli Lilly opposes using imports for tackling high drug prices. Major drug maker Eli Lilly denounced imports from overseas to provide competition for extremely high-priced drugs. Lilly’s comments on Tuesday during an earnings call comes nearly a week after the Trump administration said it plans to examine using foreign imports to fight high prices. Lilly said the method itself was concerning. “We think that is the wrong road to go down,” said Lilly CEO David Ricks on the call. “We agree it should be solved, [it’s] the method we disagree with.” The FDA will import drugs approved overseas to alleviate a drug shortage. However, Health and Human Services Secretary Alex Azar, who previously ran Eli Lilly’s U.S. division, wants the agency to create a task force to look into importing drugs overseas to compete with a drug that is off patent and has risen dramatically in price. Ricks said that the FDA should “fix the regulatory system to begin with,” instead of using imports. “This is a regulatory failure from our perspective,” he said.

Lilly keeping an eye on probable major changes to rebates. Ricks also said that Lilly is taking a wait-and-see approach to the Trump administration’s drug pricing blueprint, which was announced back in May. “There are dozens of ideas in there,” he said. But he is planning for changes to how rebates are done through Medicare. The Trump administration is already drafting regulations that would change Medicare’s rebate system, which has been criticized by Azar. Under Medicare Part D, the program’s prescription drug plan, the drug maker negotiates with a third party vendor like an insurer or drug middleman for a rebate to a drug. But Azar has said that the rebate system creates an incentive for higher prices since both insurers and the drug middlemen, called pharmacy benefit managers, get a cut of the rebate. A higher rebate means a bigger cut for the vendors. Ricks said that he is open to changes to rebates. “We are shifting too much of the cost via list pricing directly to consumers,” he said. “If consumer pricing came down [it] would improve volume and medication adherence for patients.”

Health insurer Centene ‘very enthusiastic’ about Obamacare. Health insurer Centene is looking forward to the next Obamacare open enrollment and plans to continue investing in the market, company executives said Tuesday. “We remain very bullish about the exchanges and the stability of the market,” Jeff Schwaneke, Centene’s chief financial officer, said Tuesday during the company’s second-quarter earnings call. “We think it remains very stable and we’re very enthusiastic about the open enrollment coming up.” The health insurer has 1.5 million Obamacare enrollees in 16 states, up from 1.08 million last year. Executives said that because the company will be applying to sell coverage in more states and expanding in existing states for 2019, then they expected more enrollment growth ahead.

Ebola outbreak in Congo officially over.​ The outbreak of Ebola in the Democratic Republic of Congo that killed 29 and sickened 24 more has ended, according to officials from the World Health Organization. The last confirmed patient with Ebola was discharged June 12 after he or she no longer tested positive for the virus. Officials were unable to declare the outbreak over until now, waiting until 42 days, or two incubation periods, passed without any more people testing positive for Ebola. During the outbreak, health officials used an experimental vaccine to prevent the virus from becoming an epidemic, vaccinating at least 3,330 people. “The outbreak was contained due to the tireless efforts of local teams, the support of partners, the generosity of donors, and the effective leadership of the Ministry of Health,” said Tedros Adhanom Ghebreyesus, the WHO’s director-general.

Bill to revamp suicide lifeline heads to Trump. The House on Monday nearly unanimously passed the National Suicide Hotline Improvement Act, which 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, so that it’s more similar to a number like 911. The bill passed the Senate earlier this year, where it was introduced by Sen. Orrin Hatch, R-Utah. “I believe that by making the National Suicide Prevention Lifeline system more user-friendly and accessible, we can save thousands of lives by helping people find the help they need when they need it most,” Hatch said in a statement after the House passage. Every minute we wait, we leave helpless hundreds of Americans who are struggling with suicidal thoughts. There are literally lives on the line here—and leaving them on hold is not an option.”

House passes four other healthcare bills. The House on Monday passed the Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness Act, or EMPOWER Act. The legislation reauthorizes health professional workforce programs and workforce training programs for geriatric care. House lawmakers also unanimously approved the Palliative Care and Hospice Education and Training Act, which would increase federal research funding for palliative care, as well as training for healthcare providers. “These bipartisan bills will help ensure our communities, and country as a whole, maintain a skilled health workforce,” Energy and Commerce Committee Chairman Greg Walden, R-Ore., and Subcommittee on Health Chairman Michael Burgess, R-Texas. “They will boost critical training and educational services, while also bolstering recruitment and retention of these specialized health professionals. Following today’s strong votes to advance these critical authorizations, we encourage our Senate colleagues to quickly follow suit.” Other bills that passed include the Dr. Benjy Frances Brooks Children’s Hospital GME Support Reauthorization Act and the Title VIII Nursing Workforce Reauthorization Act.

Manchin to meet with Brett Kavanaugh. Sen. Joe Manchin, D-W.Va., will sit down with Judge Brett Kavanaugh, Trump’s nominee to the Supreme Court, next week, becoming the first Democrat to do so. A spokesman for Manchin said the meeting will take place Monday, July 30. Since Kavanaugh was nominated to replace Justice Anthony Kennedy, he has met with 23 senators, all Republicans, according to the White House. White House press secretary Sarah Sanders chided Senate Minority Leader Chuck Schumer, D-N.Y., during Monday’s press briefing for playing “political games” with Kavanaugh’s nomination. She accused Schumer of encouraging Senate Democrats not to meet with the Supreme Court hopeful. But Manchin is among a handful of red-state Democrats who is seen as a potential vote to confirm Kavanaugh. Other Senate Democrats, meanwhile, have already announced their intent to oppose Kavanaugh’s nomination. His detractors are raising concerns about the future of abortion rights and access to affordable healthcare if Kavanaugh is confirmed to the high court.

Plaintiff in Janus Supreme Court case leaves job, joins think tank. Mark Janus, plaintiff in the Supreme Court case Janus v. American Federation of State County and Municipal Employees, which said it was unconstitutional to force public sector employees to pay union fees, is no longer a public sector worker himself. Janus is quitting his job with the Illinois Department of Public Health in order to become a spokesman for the Illinois Policy Institute, the nonprofit group that championed his case. The news is an ironic coda to last month’s Janus ruling. The court decision upended a four-decade Supreme Court precedent and is expected to become a major financial drain for the labor movement as public sector workers use their newly acquired right to opt out of paying union dues. But Mark Janus will not be among those workers.

Bill aims to curb ‘pay for delay’ agreements that keep drug prices high. A new bill aims to curb a way that brand name drug makers delay generic competition by paying a company to delay entering the market with a cheaper generic alternative. The bill from Rep. John Sarbanes, D-Md., would require biologic and biosimilar drug makers to report to the Federal Trade Commission of any “pay-for-delay” agreements. Once a brand-name drug goes off patent or loses market exclusivity, then the Food and Drug Administration approves one generic to compete with that drug. The generic company gets 180 days of market exclusivity before more generics can enter the market. But brand name companies sometimes will pay the generic company with 180-day exclusivity to delay its launch. Other generic makers cannot enter the market until the first generic drug maker has finished its 180-day period. A 2013 report from the FTC found that in 2012 there were 40 such deals. Sarbanes’ bill focuses on biosimilars, which are drugs that are similar to specialty drugs called biologics. The FDA has approved 12 biosimilars but only three made it to market due in part to litigation. “This bill will help lower prescription drug costs by bringing more affordable biosimilar drugs to the market,” Sarbanes said in a statement.

Pennsylvania Obamacare insurers propose lower rates. Pennsylvania’s Obamacare insurers have lowered their average 2019 rate request from 4.9 percent to nearly 1 percent, the state’s insurance regulator said Monday. Back in June, the state’s insurers on Obamacare’s insurance marketplace asked for a 4.9 percent increase. However, the state said Monday that insurers lowered their requested rates due to a series of factors. After considering their experience in 2018, “including lower insurer expenses for cost-sharing reduction payments covering deductibles, co-payments, and co-insurance for lower income customers, the department lowered the amount of a standardized factor,” the state said in a release. “Additionally, some carriers made minor changes to assumptions in their filings following input from the Insurance Department during the department’s review process.” The rates still must be finalized by the state before open enrollment for 2019 starts this fall and so they could change.

House lawmakers seek ways to combat deceptive marketing that makes it harder for addicts to get treatment for opioid addiction. The House Energy & Commerce Committee’s oversight subcommittee held a hearing Tuesday on advertising and marketing among substance abuse treatment centers. The hearing comes after a yearlong investigation into marketing for such centers. “As the committee dove deeper into the advertising and marketing practices within this industry we found a Pandora’s box of online advertisements, websites, phone numbers, lead generators, call centers, and television commercials,” said Rep. Greg Walden, R-Ore., the committee chairman. Another problem surrounds “patient brokering,” where a third-party call center recruits an addict and lures them to treatment facilities in return for financial kickbacks. “In some of the worse cases, call aggregators or call centers may refer patients to facilities that don’t meet their needs based on a financial arrangement and once patients enter treatment they may be vulnerable to exploitation by unscrupulous business owners,” said Rep. Gregg Harper, R-Miss., the subcommittee’s chairman.

RUNDOWN

CNN Outrage in China over thousands of faulty vaccines for children

Reuters Medicare patients may lower drug costs by not using their insurance

New York Times For the first time, a female Ebola survivor infects others

Associated Press Healthcare industry branches into fresh meals, rides to the gym

Columbus Dispatch Dewine tells Ohio’s pharmacy middlemen that he is ready to sue them

Washington Post This mother’s tweet about drug prices went viral. Trump’s plans are unlikely to help her

Kaiser Health News Hospitals gear up for new diagnosis: Human trafficking

Politico Americans skeptical of Trump’s drug plan, if they have even heard of it

CT Mirror In fight against HIV, outreach workers take ‘Prep’ to the streets