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Individual insurance market enrollment continues to shrink, but Obamacare exchanges steady. Enrollment in the individual insurance market declined by 12 percent in the first quarter of 2018 compared to the same quarter in 2017, according to a Kaiser Family Foundation analysis released Tuesday. The report suggests that people without access to Obamacare subsidies are being priced out of the individual market for health insurance. In the first quarter of 2018, there were 14.4 million people who got coverage in the overall individual market. That total is 12 percent lower than the first quarter of 2017, when there were 15.2 million people on the individual market. Of those 14.4 million people in the individual market this year, 10.6 million had coverage through Obamacare exchanges, including 9.2 million receiving federal premium subsidies, Kaiser said. Enrollment is also below where it was in the first quarter of 2015, when 17.4 million people got coverage on and off the exchanges. Overall Obamacare exchange enrollment, however, has held steady. There were 10.6 million people on the exchanges in the first quarter of 2018, slightly above the 10.3 million people in the first quarter of 2017, the analysis found.

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Midterm election candidates attacked over high drug prices. A new political action committee devoted to supporting or opposing candidates based on their stance on high drug prices is gearing up for combat ahead of the 2018 midterms. The group Patients for Affordable Drugs formed earlier this year a political action committee called Patients for Affordable Drugs Action and is targeting candidates for the 2018 midterms. It is the only PAC dedicated solely to drug pricing, which is often cited as a major issue for voters, and the group is still figuring out which races to highlight ahead of the midterms. The group’s executive director is Ben Wakana, a Democratic operative who served as a press secretary for the Department of Health and Human Services as the prior administration fought to implement Obamacare. Despite his Democratic roots, he insisted to the Washington Examiner, “We are going to be active in statewide races and congressional races on both sides of the aisle. We are committed to doing an equal number of pro-Democrat and pro-Republican races.”

New York to reject Obamacare hikes related to zeroing out penalty for failing to buy insurance.  New York will reject premium increases on Obamacare plans that are caused by the zeroing out of the penalty on the uninsured, Democratic Gov. Andrew Cuomo announced Monday. Insurers in New York have already asked to increase the rates of premiums for Obamacare plans by an average of 24 percent, or roughly $1,500 more per year. They are attributing half of the increase to the zeroing out of the fine on people who don’t have health insurance, known as an “individual mandate.” Cuomo in a speech Monday at Mount Sinai Hospital in New York appeared to be pushing back on the proposals. He said that if state officials were to allow the proposed rate increases to go into effect, then insurers would pocket millions of dollars and that costs would increase for customers. He announced he was directing the Department of Financial Services to reject any rate increases associated with the penalty going away. The prices, he said, “must be based on actual cost and not political manipulations.”

Insurers were not warned that the announcement was coming. Health insurers had been asked by state officials to disclose what the impact would be without the zeroing out of the penalty. Leslie Moran, senior vice president at the New York Health Plan Association, said that the organization agreed that “decisions on health insurance premiums should be based on math not politics.” She pointed to state and federal estimates that projected premiums would increase roughly 10 percent without the penalty. “A key priority must be maintaining a stable marketplace in New York,” Moran said. “Politicizing the 2019 rate requests will not help in this effort.”

Robert Wilkie sworn in as VA secretary. Vice President Pence swore in Robert Wilkie on Monday to take the helm at the Department of Veterans Affairs. In remarks at the ceremony President Trump called veterans “American heroes” who “deserve only the best, and they will have it under Robert Wilkie. I have no doubt about it.”  Wilkie was assistant secretary of defense under the administration of former President George W. Bush and has been Pentagon undersecretary of defense for personnel and readiness.

Joe Manchin dubs two-hour Brett Kavanaugh sit-down a ‘very productive meeting.’ Sen. Joe Manchin, D-W.Va., said Monday that his two-hour long discussion with Judge Brett Kavanaugh was “very productive” as the Supreme Court nominee begins to court Senate Democrats to back his possible confirmation. “It’s very productive. That’s all I can say,” Manchin told reporters after the meeting. According to the West Virginia Democrat, the two talked about a number of topics, including healthcare and executive power, but declined to delve too deeply about their talk. “In two hours you talk about everything,” Manchin said. The meeting was Kavanaugh’s first with a Senate Democrat and one of only two on the books after a host of meetings with Senate Republicans. Sen. Joe Donnelly, D-Ind., is slated to meet with him on Aug. 15.

Bernie Sanders says Koch-funded study makes case for ‘Medicare for All.’ Bernie Sanders argued Monday that a new study that estimated a daunting $32 trillion-over-a-decade price tag for his “Medicare for All” actually makes the case for it.  The Vermont senator and former Democratic presidential candidate said in a video posted late Monday that the study from the right-of-center Mercatus Center, which gets funding from GOP mega-donors Charles and David Koch, proves that an expansion of Medicare to every American would save money on administrative costs. However, Sanders does not acknowledge the key takeaway from the study: that such a system would cost $32.6 trillion over a decade and need major tax hikes to cover the gap. “Let me thank the Koch brothers of all people for sponsoring a study that shows ‘Medicare for All’ would save the American people $2 trillion over a ten-year period,” Sanders said in a video posted on Twitter. The study said the savings would come from lower administrative costs and lower drug prices under a government-run single-payer system, where private insurance is abolished and the federal government pays for healthcare. But the study cautioned that its estimate was “conservative” because it assumed Medicare would be able to maintain low payment rates without taking into account any disruption to the market.

Trump administration approves Maine’s request to shore up Obamacare exchange. The Trump administration on Monday approved a request from Maine to set up a program to help prop up Obamacare insurers. Maine is the second state in two days to get approval to set up a reinsurance program to help buttress losses from insurers. The Centers for Medicare and Medicaid Services approved a similar request from Wisconsin on Sunday. CMS said on Monday in a letter to the state that it will approve a reinsurance program from January 2019 to Dec. 31, 2023. Under reinsurance, a state covers high losses from an Obamacare insurer to get them to lower premiums overall. Wisconsin and Maine are the fifth and sixth states to get reinsurance approvals. The other states to get approval are Minnesota, Alaska, Oregon, and Hawaii, according to data from the National Conference of State Legislatures. CMS said in its letter that reinsurance will lower premiums in the state, which will mean that the federal government will pay fewer premium tax credits to low-income customers. Maine gets to keep the savings from the lower tax credits in order to help fund the reinsurance program.

Despite price hikes, older drugs weigh on Pfizer’s profits. Despite price increases early in 2018, Pfizer’s profits from drugs with generic competitors dropped in the three months through June. Income in Pfizer’s Essential Health business – which includes Lipitor and other brands that now have external rivals – dipped to $2.82 billion amid rising supply costs, as sales slid to $5.2 billion. Earnings in the unit were dragged down partly by the inclusion of Viagra, whose patent expired in December 2017. Pfizer raised the price of Viagra in January by nearly 10 percent and lifted charges for on-patent drugs like Chantix by a similar amount. Those increases are typically not reflected in earnings until months later. Companywide, net income at the New York-based drug manufacturer rose 26 percent to $3.9 billion in the second quarter as revenue climbed 4 percent to to $13.5 billion. Growth was driven by several of Pfizer’s newer products, such as stroke treatment Eliquis and cancer drug Ibrance.

Pediatricians implore doctors to talk to kids about infertility, sexual dysfunction. The American Academy of Pediatrics is for the first time recommending that doctors, including mental health providers, talk to parents as early as their children’s infancy about the difficulties their children will face, or that they bring it up when they begin to notice that a child may be affected. Doctors should talk with both the parents and children together, and also with the children alone, once they become teenagers. Children can become infertile or have sexual dysfunction as a result of surgery, radiation, chemotherapy, or taking hormones as part of a gender transition. Others have genetic conditions or developmental issues that will create these issues.

FDA warns against painful side effects from ‘vaginal rejuvenation.’ The Food and Drug Administration is warning women and doctors that devices on the market purporting to make cosmetic alterations to the vagina have not been approved by regulators for that purpose and could result in painful side effects. The agency has warned seven companies that their laser- or radiofrequency-based products are inappropriately being marketed as providing “vaginal rejuvenation” procedures. The companies have claimed that the devices will tighten the vagina or treat symptoms from menopause, urinary incontinence, or sexual function. The FDA also has reports of incidences in which the devices are being marketed to women who have been treated for breast cancer and are having signs of early menopause. These types of devices have instead been approved to destroy genital warts, as well as precancerous cervical or vaginal tissue. The FDA has found that when used outside of the purpose for which they were approved, the devices have led to burning of the vagina, scarring, and pain during sex or urination.

Most babies not breastfed immediately after birth, threatening lives. Three in five babies are not breastfed during the first hour of birth, putting them at higher risk of disease or death, according to a joint report by UNICEF and the World Health Organization. Global health officials are urging greater uptake of breast feeding shortly after birth because it helps boost a baby’s immune system, because breastmilk is rich in nutrients and antibodies. This is considered particularly critical in parts of the world that lack clean water. “Breastfeeding gives children the best possible start in life,” Dr. Tedros Adhanom Ghebreyesus, WHO’s director-general, said in a statement. “We must urgently scale up support to mothers – be it from family members, health care workers, employers and governments, so they can give their children the start they deserve.”

RUNDOWN

New York Times Trump spurns Medicaid proposal after furious White House debate

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CNN How Trump’s abortion gag rule policy impacts the global AIDS crisis

The Hill Liberal Dems lay groundwork for ‘Medicare for All’ push

Denver Post Kaiser Permanente says Colorado will no longer be a Medicaid provider for 2,500 patients

Washington Post Meet the unicorn of healthcare policy

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