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Democrats cast Kavanaugh as a battle for the future of Obamacare. Obamacare will play a starring role again in Congress this summer, this time helping determine the fate of Supreme Court nominee Brett Kavanaugh. Democrats said Tuesday they plan to make the confirmation of Kavanaugh a fight over the future of Obamacare, which is under a lower court challenge that could eventually make it to the Supreme Court. Democrats hope the Obamacare argument will resonate with Sens. Susan Collins, R-Maine, and Lisa Murkowski, R-Alaska, who joined Sen. John McCain, R-Ariz., to defeat the last ditch effort at repealing Obamacarelast year. Collins has not revealed how she will vote on Kavanaugh but praised his qualifications. She also criticized Democrats for trying to compare the Supreme Court nomination process to the effort to repeal Obamacare. “This is the Supreme Court,” Collins said. “It’s not a legislative body. There is no parallel.” A suit brought by 20 states led by Texas and Wisconsin argues that last year’s repeal of the penalties for not purchasing insurance means that Obamacare’s mandate is no longer a constitutional exercise of taxing power and must be invalidated along with the rest of the law. Sen. Chris Murphy, D-Conn., said that if the Texas lawsuit fails then Obamacare foes will try again with another lawsuit.

Does Obamacare focus suggest Democrats’ have nothing on Kavanauagh? The fact that the Trump administration has not only declined to defend Obamacare, but that it has argued further that pre-existing condition related regulations must be struck down, no doubt provides an opening to Democrats. But it’s a rather narrow one. The suit is still in the briefing phase at the district court level, and faces many legal hurdles before it has a chance of getting to the Supreme Court, including establishing standing to sue in the first place. It is rather telling then, that Democrats would focus so much on this line of attack. The best explanation is that they don’t have much on Kavanaugh, which is saying something. Kavanaugh has been well known in Washington legal circles for decades, and when his name was added to Trump’s Supreme Court list last November, it immediately raised eyebrows and made him one of the favorites for the next vacancy. So, liberal groups have had nearly eight months to dig up dirt on Kavanaugh. If right out of the gate they are hinging their whole line of attack on this Obamacare gambit related to a longshot lawsuit, it suggests they have not found much on him.

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Senate steps forward on paid family leave after more than a year of work with Ivanka Trump. Senators are coming together to examine ideas on paid family leave Wednesday, encouraged along by the support of first daughter and senior White House adviser Ivanka Trump. A key Senate panel is holding a hearing to weigh some of the ideas currently on the table following 17 months of talks between Trump and lawmakers. While Democrats have long supported paid family leave, Republicans in recent months have shown growing interest, even though the parties still disagree on policy details. The hearing, according to Trump, “represents an incredibly important opportunity for Congress to work across the aisle and advance a national paid family leave plan that supports American families and the American workforce.” The first daughter has not endorsed a specific idea, but her staff stressed in an interview that the main aim is to allow members to bring their ideas forward and arrive at a plan that gains support and can pass. “We are in a unique place right now in that Republicans are at the table and embracing this idea,” a senior White House official said, adding later, “For something to pass it’s going to have to be bipartisan legislation, so let’s look at the various innovative approaches.”

NARAL launches ad blitz to fight Supreme Court pick. The abortion rights group NARAL Pro-Choice America launched a new ad campaign across five states seeking to fight Kavanaugh’s confirmation. Kavanaugh, they charge, will overturn Roe v. Wade, the landmark 1973 ruling that overrode state laws restricting abortion. The digital ads will run in Texas, Alaska, Maine, Colorado and Nevada. The group is specifically targeting Murkowski and Collins, as well as Sen. Dean Heller of Nevada, one of the most vulnerable GOP senators facing re-election in 2018. NARAL is also targeting Sen. Cory Gardner, R-Colo., who is up for re-election in 2020, and Sen. John Cornyn, R-Texas, who has effusively praised Kavanaugh and is expected to vote for him.

CMS slashes budgets for Obamacare nonprofits by 75 percent. The Trump administration will give $10 million in 2019 to Obamacare nonprofits called “navigators” that help people sign up for insurance, a major drop from the nearly $40 million they received this year. The Centers for Medicare & Medicaid Services said on Tuesday that the need for the navigators has diminished because Americans are more familiar with Obamacare’s insurance exchanges. The administration gave $36 million to 98 navigators in 2018, which was a 40 percent cut from 2017 funding given out by the Obama administration. “The exchange is now an established marketplace for individuals seeking insurance,” CMS said on Monday. “Last year we had our most cost effective and successful open enrollment to date.” CMS also only provided $10 million in 2018 for Obamacare open enrollment advertising, a 90 percent cut from 2017 funding under Obama’s CMS. The agency added that navigators must also inform residents of the option to pick short-term plans, which are cheaper healthcare plans that offer fewer benefits. The administration has proposed expanding the duration of short-term plans from 90 days to 12 months. Critics say the short-term plans could destabilize Obamacare’s exchanges as younger people will leave the exchanges for the short-term plans because they are cheaper, leaving Obamacare insurers with a risk pool disproportionately made up of more expensive enrollees.

Trump: Pfizer is ‘rolling back price hikes’ on prescription drugs. President Trump announced that pharmaceutical giant Pfizer would rethink its plan to hike some of its drug prices, a move the company has confirmed. “Just talked with Pfizer CEO and @SecAzar on our drug pricing blueprint,” Trump tweeted Tuesday evening. “Pfizer is rolling back price hikes, so American patients don’t pay more. We applaud Pfizer for this decision and hope other companies do the same. Great news for the American people!” Last week, Prizer announced that more than 40 drugs including Viagra and antidepressant Zoloft would face a 10 percent cost increase. But the company pointed out that most of the 400 medicines and vaccines would not encounter any price alteration. In a statement issued Tuesday, the company reversed course. Pfizer’s chairman and CEO Ian Read announced that the company 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.” Pfizer was referring to the blueprint the Trump administration issued in May to address high drug prices, which primarily targets changes to Medicare in order to minimize drug costs, and ways to bring generic drugs to market faster. But the drug company only gave Trump until Jan. 1 or the hikes go back into effect. The announcement comes after Trump lambasted Pfizer on Monday and warned that the administration would “respond” to the increased drug prices.

Trump administration moves to end union dues skimming of homecare workers. The Trump administration announced Tuesday that it would change Medicaid’s rules to prevent unions from automatically getting a cut of the checks sent to state-subsidized home healthcare workers. Under the proposed new rules announced by CMS, states would be prohibited from diverting any funds away from the workers to a third party, such as unions. Critics of the current arrangement argue that homecare workers often aren’t aware that they are members of unions or that the deductions are being made, since they usually start automatically once they enter the subsidy programs. Under Tuesday’s proposed rules change, providers would likely still be eligible to join unions but would have to act on their own to make the payments.

Senate committee approves Trump’s nominee Robert Wilkie to lead the VA. Robert Wilkie, Trump’s nominee to lead the Department of Veterans Affairs, was approved in the Senate Veterans Affairs Committee on Tuesday, setting up a final confirmation vote that could happen in a matter of days.

Senate panel weighs additional hearings on corporate megamergers. Key senators are weighing whether to hold additional hearings on a slew of corporate megamergers under review by the Department of Justice. Among the major deals under review by the Trump administration are proposed acquisitions in the healthcare industry between CVS Health and Aetna as well as Express Scripts and Cigna.

Nevada will use fentanyl to execute death row inmate Wednesday. Nevada will on Wednesday become the first state to use fentanyl in the execution of a death row inmate. The state opted to use the synthetic opioid on convicted double-murderer Scott Dozier because it could not obtain alternative drugs, according to a local report. Dozier’s execution will be the state’s first in 12 years due to pushback from pharmaceutical manufacturers. Fentanyl is a synthetic opiate painkiller 50 to 100 times stronger than morphine, according to the Drug Enforcement Administration. The drug led to 20,000 overdose deaths in 2016, according to federal data. Dozier will be injected with fentanyl, as well as the sedative midazolam and another drug. State officials will not disclose how they obtained the drugs, but stated they were ordered through Cardinal Health.

Lawmakers spar over need for changes to drug discount program. Republicans and Democrats clashed over the scope of change needed to the controversial drug discount program called 340B. During a hearing in the House Energy & Commerce Committee’s health subcommittee Wednesday, Republicans argued that the program that provides drug discounts to safety net hospitals has spiraled out of control. Democrats on the panel bashed several pieces of legislation tackling the program, including a two-year moratorium on new enrollment.

RUNDOWN

Bloomberg Amazon has global aspirations for medical supplies marketplace

Politico How the new face of the migrant crisis got stuck with the job

STAT News Could FDA use off-label data for drug approvals? It’s possible, agency official said

Kaiser Health News If high court reverses Roe v. Wade, 22 states poised to ban abortion

Washington Post Pence: I want Roe v. Wade overturned, ‘but I haven’t been nominated to the Supreme Court’

Wall Street Journal Drug supply chain feels the Trump effect

Reuters As Arkansas ushers in new Medicaid rules, thousands fear losing benefits

Los Angeles Times A plan to prevent more than 1 in 5 cancer deaths, without having to invent new treatments