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Opioid drugmakers sued over rising insurance costs. In the latest front in the battle against opioid abuse, a wave of lawsuits is accusing companies that produce and distribute opioids of increasing health insurance costs across the country. In five class-action lawsuits filed Wednesday, plaintiffs say the addiction resulting from the over-prescribing of opioids caused residents and businesses in each of the states – California, Illinois, Massachusetts, New Jersey, and New York – to pay more in health insurance costs. The suits do not specify damages, but seek to represent everyone who has bought a private health insurance policy in those states since 1996, the year Purdue Pharma introduced OxyContin.

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.

Obamacare allies hold events on anniversary of House passage of Obamacare repeal. Obamacare advocacy groups are planning to hammer House Republicans on Thursday for the passage one year ago, on May 4, of Obamacare repeal. The pro-Obamacare group Protect Our Care will hold a press call featuring former Obama administration official Andy Slavitt, who was a frequent critic of Obamacare repeal efforts. The left-leaning think tank Center for American Progress also blasted the votel. “This effort ultimately died because people across the country sent a very clear message to Washington: Healthcare is a basic human right,” said Topher Spiro, vice president of health policy for the center. The events come as Democrats seek to make House Republicans’ Obamacare vote a major issue in the upcoming 2018 midterms.

FDA chief may target system of rebates between insurers and drug makers. The head of the Food and Drug Administration hinted at a radical action that could make all rebates and discounts negotiated between drug companies and insurers in violation of federal law. FDA Commissioner Scott Gottlieb railed against high drug prices during a speech before the Food, Drug and Law Institute in Washington Thursday. Gottlieb said a major driver of high prices is the rebate system negotiated by drug middlemen and insurers and drug companies. Gottlieb then said the federal government could re-examine the current safe harbor for drug rebates under the federal Anti-Kickback Statute, according to his prepared remarks. Currently rebate arrangements fall under a safe harbor and do not violate the federal law that prevents kickbacks. Gottlieb said re-examining that policy “could help restore some semblance of reality to the relationship between list and negotiated prices, and thereby boost affordability and competition.” Critics say too little of the benefits of the negotiated rebate trickles down to consumers. Gottlieb’s comments come ahead of a speech by President Trump expected next week on attacking drug prices.

E. coli contaminated lettuce causes first death. At least one person has died as a result of eating romaine lettuce infected with E. coli, federal officials say. The death was in California, which has the highest number of illnesses in the country. The California Department of Public Health didn’t provide details about the death, citing patient privacy laws. The Centers for Disease Control and Prevention reported Wednesday that 23 more people had been infected with E. coli that could be tied to eating romaine. Since the last case count update on April 27, 23 more people have become sick, bringing the total to 121 sicknesses in 25 states. The states added to the latest count were Kentucky, Massachusetts, and Utah. 52 people have spent time in the hospital, and 14 had kidney failure.

‘Deaths of despair’ and premature deaths on the rise. Deaths from alcohol, suicide, opioids and other drugs increased by 50 percent from 2005 to 2016, according to a scorecard out Thursday by the Commonwealth Fund. Rates rose across all states but doubled in Delaware, Ohio, New Hampshire, New York and West Virginia. Deaths from treatable medical conditions also rose slightly in two-thirds of states from 2014 to 2015 after previously experiencing a decades-long downward trend. In six states — Colorado, Maine, Nebraska, Oklahoma, Vermont, and Wyoming — the increase was greater than 5 percent.

Top Democrat introduces bill that would extend Medicare to long-term care. Rep. Frank Pallone, the top Democrat on the House Energy and Commerce Committee, introduced a bill Wednesday that would allow Medicare to cover long-term care, including the care that is delivered in nursing homes, adult day care centers, home health aides and assistance provided by family caregivers. Currently these programs are mostly covered through Medicaid and only once families have depleted their savings. The Medicare Long-Term Care and Service and Supports Act would make the provision available to all people regardless of income. It would go into effect after a two-year waiting period that would function as a deductible. “The growing need for long-term care is one of the greatest threats to retirement security for American seniors, and the adult children who care for them,” Pallone said.

Cigna CEO promises Express Scripts merger will curb rising drug costs. Cigna’s chief executive officer defended the company’s merger with the top U.S. pharmacy benefit manager on Thursday, arguing that the transaction would help the insurer curb growing healthcare costs for corporate clients. The Bloomfield, Conn.-based company expects the $52 billion merger with Express Scripts to close by the end of the year, but a review by the Department of Justice may affect that timeline. The deal would help address rising specialty pharmaceutical costs, CEO David Cordani said, and presents an opportunity to better implement evidence-based care for 16.2 million customers. “Rising specialty pharmaceutical costs are a top concern,” he said on the earnings call. Prescription benefit managers, which essentially operate as middle-men between insurers and drug manufacturers, are facing heightened congressional scrutiny, and some lawmakers have sought to increase price transparency in the industry.

Iowa lawmakers pass bill that would outlaw abortions immediately after fetal heartbeat detected. Iowa’s state legislature approved a measure Wednesday that would bar doctors from completing abortions following the detection of a fetal heartbeat. The measure includes exemptions in the case of rape, incest and when a pregnant woman’s life is in danger. Iowa currently prohibits most abortions following the 20th week of pregnancy. Some Iowa lawmakers view the bill as a catalyst to overturn Roe v. Wade. Planned Parenthood said it expects the decision will be challenged in court and have accused Iowa Republicans of approving an “intentionally unconstitutional” measure. The bill is headed to Republican Gov. Kim Reynolds, who has not indicated whether she’ll sign it.  

Obama’s doctor: Trump doctor Harold Bornstein ‘disgraced himself’ and should be investigated over letter. President Barack Obama’s longtime doctor says Trump’s former doctor has “disgraced himself” for allowing Trump to dictate a medical letter painting him in good health for his presidential campaign. “Trump is Trump, he would write that kind of letter,” Dr. David Scheiner said of the medical letter released during the presidential campaign that used Trump-like language to gloat about Trump’s health. But as for Bornstein, Scheiner said he has “disgraced himself” as a medical professional for his “extraordinarily unethical” actions. “I think it demands some kind of an investigation to see whether he should be chastised publicly by the medical society,” the Obama doctor suggested. Bornstein told CNN that Trump dictated the whole letter and he didn’t actually write it himself.

Speculation about Trump’s health begins to re-emerge. A segment on MSNBC’s “Morning Joe” came to a sudden halt Wednesday after co-host Mika Brzezinski suggested a raid on Trump’s doctor’s office was conducted to hide evidence of a sexually transmitted disease. Co-host Joe Scarborough quipped about Trump’s infamous remark on the Howard Stern Show about STD avoidance being his “personal Vietnam.” “Wait a minute, maybe that’s why they raided his doctor’s office,” Brzezinski shot back. After a moment of awkward silence, Scarborough jumped in, switching the focus to the next segment. Scarborough in the past has raised speculation about other parts of Trump’s health, saying at one point that people inside the White House have told him the president has early signs of dementia. Trump’s medical records and his White House physical did not include any mentions of sexually transmitted diseases, and during the hour-long press briefing with Jackson reporters didn’t ask whether the president had ever had one.

RUNDOWN

The Hill Conservative groups hope to release new Obamacare replacement this month

Bloomberg White House asked to fight opioids by overriding drug patents

Axios Opioid ties emerge as liability for both parties in West Virginia

U.S. News Advocates investing in troubling communities hope to bring about more than just surface-level change

Kaiser Health News Sprained your ankle? The cost of a brace could sprain your wallet

New York Times On anniversary of House Obamacare repeal vote, Democrats look to extract a price

Associated Press New York lawmakers to hold hearing on physician-assisted suicide