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Ivanka Trump: I’m an ‘optimist’ on passing paid family leave. First daughter and senior White House adviser Ivanka Trump said she is confident that despite the political infighting in Washington that Congress will reach a consensus on passing a law allowing families to take paid leave at the birth or adoption of a child. “Because I’m an optimist,” said Trump at the Bipartisan Policy Center in Washington, D.C., when asked why the policy would gain support. “That’s the only way you get things done.” Washington, she said, was “not a city that rewards compromise.” But she said she is still hopeful, noting that senators held a hearing on the issue for the first time in several years and that the president included paid family leave as a priority in both of his budgets. Trump has been meeting with members of Congress since the president came into office to convince them of the merits of paid family leave. She told the audience at the event that she had worked to underscore the ways that the policy could not only support better participation in the workplace but stronger family ties. The issue, she said, is “starting to achieve much-needed momentum” on Capitol Hill.

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.

Trump administration hasn’t decided whether it will approve more Medicaid work requirements.  The Trump administration is still evaluating whether it will approve more work requirements in states that want to add them to their Medicaid program, following a court ruling blocking them in Kentucky. Centers for Medicare and Medicaid Services Administrator Seema Verma said that her agency was “trying to figure out a path forward” on the requirements, which it supports and has approved in three states other than Kentucky. “We are very committed to this,” Verma said at the Politico Pro Summit in Washington, D.C. “We are looking at what the court said. We want to be respectful of the court’s decision while trying to push ahead with our policy and our goals.” At least eight other states, including Arizona, Kansas, Maine, Mississippi, North Carolina, Ohio, Utah, and Wisconsin, have pending requests.

Hospitals lose bid to roll back cuts to drug discount program.  Washington’s hospital lobby lost an effort to stop the Trump administration from cutting payments under a drug discount program for hospitals that cover low-income patients. The U.S. Court of Appeals for the District of Columbia upheld a lower court ruling that struck down a lawsuit from the American Hospital Association and other hospital groups on the payment cuts to a program called 340B. The decision issued Tuesday is a major win for the Trump administration and the pharmaceutical lobby that had been pressing for changes to the program. The program requires drugmakers to provide steep discounts on certain drugs to hospitals that serve a certain number of low-income patients. But the Trump administration charged in November 2017 that the program had grown too much, and it made $1.6 billion in cuts to reimbursements to hospitals starting on Jan. 1, 2018. The AHA, two other hospital groups, and three hospitals sued the administration in November 2017 to roll back the cuts.  The hospital lobby has said that any effort to cut the payments will result in safety net hospitals that primarily care for low-income patients will be hurt.

ER doctors sue Anthem over ‘dangerous’ policy denying coverage. Emergency room doctors in Georgia are suing health insurer Anthem Blue Cross Blue Shield for refusing to cover certain medical services that the company determined didn’t constitute an emergency. The lawsuit was filed Tuesday in U.S. District Court in Atlanta by the Medical Association of Georgia and the American College of Emergency Physicians. It asks Anthem to rescind an emergency room policy retroactively denying medical coverage for patients who receive ER care, and to pay the claims it has denied. The groups say that patients shouldn’t have to hesitate to seek emergency treatment out of fear that they will be charged if an insurer determines their condition could have been treated elsewhere. Anthem has said that its policy is intended to discourage patients from going to the emergency room when they could seek medical care elsewhere, such as at a doctor’s office or urgent care clinic. Medical care in an emergency department tends to be significantly more costly, and can increase costs for other customers on an insurance plan. The company declined to comment when asked to respond to the lawsuit.

Obamacare insurers ask for 2 percent average premium increases in Nevada. Health insurance companies have asked to increase Obamacare premiums by an average of 1.9 percent in Nevada for 2019, according to rate filings. “This is the lowest proposed rate increase the division has received since the beginning of the Affordable Care Act,” said Insurance Commissioner Barbara Richardson. Two health insurers will offer up to 15 individual plans on the exchange, where customers can receive federal subsidies that lower the cost of premiums. The initial filings show that outside of the exchange, customers will be able to buy up to 41 plans from four different insurers, which have have requested average increases in premiums of 3.1 percent.  Republican Gov. Brian Sandoval said he was “pleased” with the proposals and that they were “great news for Nevadans.” “Even though there has been uncertainty in the past, these proposed filings reflect the hard work the Silver State has done to try and stabilize the health insurance market for its citizens,” he said.

Idaho voters to decide whether to expand Medicaid. Idaho voters will determine through a ballot measure in November whether to expand the Medicaid program to cover low-income people in the state. Advocates collected 56,192 signatures to bring the question before voters on Election Day. If Medicaid is expanded in Idaho, an estimated 62,000 people would join the program.

Senator has more questions over NIH’s handling of controversial alcohol study. Sen. Chuck Grassley, R-Iowa, wants to know the total cost of taxpayer funding that went to a controversial study on alcohol funded in part by the National Institutes of Health. Grassley said on Tuesday that he got a response from NIH Director Francis Collins on an NIH study on the long-term effects of alcohol consumption that was reportedly funded largely by alcohol companies. Collins said last month that NIH will end funding for the trial. Collins added that a preliminary report found a small number of NIH employees violated agency policies by soliciting gifts and circumvented standard operating procedures “designed to ensure fair competition for NIH research funding. But Grassley said that the letter “raises additional questions. For instance, taxpayers deserve to know “the total cost” of the study once it is officially closed, he said. Grassley also wants to know how the employees will be punished. “Transparency is critical to a well-functioning government, and too often there’s not enough of it in our federal agencies,” he said.

Obamacare allies keep pressure with “Summer of Sabotage.” The pro-Obamacare group Protect Our Care outlined its campaign this summer to highlight premium hikes to Obamacare that they say is a result of “sabotage” by the Trump administration. The group released a report on Monday on ways the Trump administration is undermining Obamacare’s insurance marketplaces, including a push for access to cheaper plans with fewer benefits than Obamacare plans. “Right now so much of this is flying under the radar and we can’t allow that to happen,” said Brad Woodhouse, campaign director for Protect Our Care, on a call with reporters Wednesday.

Novartis joins Pfizer in delaying price hikes. Novartis has become the second pharmaceutical giant in just over a week to delay drug price increases after rival Pfizer faced public bashing from President Trump. Novartis, a Swiss-based company, is voluntarily putting off increasing drug prices, according to CEO Vas Narasimhan. The company wants its drug costs to be “reasonable,” he said. Novartis has been under scrutiny for paying the firm of Michael Cohen, Trump’s former personal lawyer, $1.2 million to offer advice on the administration. A report from Senate Democrats revealed that the company hired Cohen in order to influence policy on lowering drug prices. Following pressure from the president on Twitter last week, It remains unclear how long the delay of the hikes will be. Pfizer announced it would hold off on price increases that were set to go into effect July 1 “to give the president an opportunity to work on his blueprint to strengthen the healthcare system and provide more access for patients.”

Democrats push for FDA to hold firm on limiting nicotine in cigarettes. A group of 12 Democratic senators called for the Food and Drug Administration to quickly reduce nicotine levels in tobacco products in comments on the agency’s efforts. “FDA’s own estimates found that reducing nicotine levels in cigarettes could prevent tens of millions of individuals from ever becoming smokers and save eight million lives by the end of the century,” the senators said in a July 16 letter to FDA Commissioner Scott Gottlieb. The senators don’t just want nicotine levels reduced in cigarettes but other combustible tobacco products. They are also spooked by earlier delays from the FDA in implementing regulations for e-cigarette oversight. “We have been concerned by FDA’s delay in oversight of newly-regulated tobacco products and want to ensure that this initiative, given its life-saving potential, is not unnecessarily delayed,” the letter said. Democratic Sens. Richard Blumenthal of Connecticut led the letter.

RUNDOWN

Politico Trump’s migrant fiasco diverts millions from health programs

Modern Healthcare Now is the time to update Stark law, HHS, providers tell Congress

Bloomberg McKesson, Cardinal Health must face New York opioid suits

Axios Opioid addiction hits a key economic indicator

Kaiser Health News Hurricane Maria still taking a toll on Puerto Rico’s seniors

Associated Press States: Workaround succeeding after cut in health subsidies

Washington Post The truth about ‘breakthrough’ drugs