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Susan Collins opposes GOP bill to safeguard pre-existing condition protections because it doesn’t go far enough. The Maine Republican opposes a new bill from her co-partisans to enshrine pre-existing condition protections because it doesn’t include other key Obamacare consumer protections. Collins’ opposition likely imperils passage of the bill led by Sen. Thom Tillis, R-N.C., as Democrats have called the bill a scam and a political fig leaf. Collins said Monday that the bill was a good first step but doesn’t do enough to protect consumers.

“I do support the objective of it, but the problem is it doesn’t deal with essential benefits like maternity care and treatment of substance abuse and some of the other consumer protections of the [Affordable Care Act] that I think are important,” she said. Tillis and nine other Republican senators introduced the bill on Friday to amend the Health Insurance Portability and Accountability Act to guarantee availability of coverage in the individual or employer-sponsored group market for all Americans, including those with pre-existing conditions. Collins’ opposition complicates any path to approval out of the Senate, where Republicans now hold only a 50-49 majority and can’t rely on Democratic help.

Tillis defends the bill against attacks. Tillis shot back Monday at critics who say the bill doesn’t do enough to ensure that protections for sick people are maintained. “I think there is an agenda on the other side to try to eliminate any real progress on preserving pre-existing conditions,” he said. But one expert said the bill itself does not prevent insurers from excluding coverage for treatments. “Before the ACA, I saw examples of body parts or systems being excluded from coverage for people with pre-existing conditions,” tweeted Larry Levitt, senior vice president for Kaiser Family Foundation, on Friday after the bill was announced. “For example, an insurer might offer someone with asthma coverage, but exclude any services associated with the respiratory system.”  Levitt said that Tillis’ bill would still allow insurers to make these exclusions, hampering care for people with pre-existing conditions. Tillis said that is not the intent of the bill. “If we can look at the details to make it clear that is not the intent we will do it,” he said.

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Democrats demand Trump administration improve Obamacare oversight. Congressional Democrats are demanding that the Trump administration explain how it will improve Obamacare’s insurance exchanges, after a federal watchdog found current efforts lacking, buttressing critics’ case that the administration is sabotaging the health law. “The nation’s health department, which has the self-identified objective of ‘improving Americans’ access to health care,’ should not be working against the interests of patients and families and their goals of obtaining quality, affordable health insurance,” the lawmakers wrote in a letter Monday to Health and Human Services Secretary Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma. The letter was signed by Sens. Patty Murray of Washington, Ron Wyden of Oregon, and Bob Casey of Pennsylvania, and by Rep. Frank Pallone, D-N.J.

In a scathing report released last week, the Government Accountability Office found that the administration did a poor job overseeing the law’s insurance exchanges for the 2018 open enrollment. The watchdog agency found the Trump administration didn’t measure the consumer experience on healthcare.gov, which CMS manages, despite an administration goal of improving the consumer experience. Residents from 38 states use the website to buy Obamacare plans.

Grassley seeks more information on flawed alcohol study at NIH. Sen. Chuck Grassley, R-Iowa, wants more answers from National Institutes of Health Director Francis Collins on a scrapped study on the effects of alcohol on heart health. The study was scrapped because it was funded by the alcohol industry and designed to get results that would prove beneficial to the industry, Collins told a Senate panel last week. Grassley said that he wanted to know what discipline the employers that violated NIH policies will face in connection with the study. NIH also has to disclose how much taxpayer money has been spent on the study once it is finally closed. “The violations that you describe are serious in nature, and I commend your decision to end the study and hold those responsible for violating NIH policies accountable,” Grassley wrote. He wants answers to his questions by Sept. 12.

Speaking of NIH, Public Citizen wants controversial sepsis trial halted. The advocacy group Public Citizen called for the closure of an ongoing NIH-funded trial examining new treatments for sepsis. The group complains that the design of the trial is flawed. Patients are being given one of two treatments for sepsis, both of which are risky and neither of which is the standard treatment, Public Citizen said on Tuesday. “Because no other group of patients in the trial is receiving the usual treatment for sepsis, researchers can’t ensure that the experiment isn’t causing increased deaths and organ failure,” Public Citizen said in a release. It added that the design of the trial resembles those use to test drugs on animals, not on humans. The group wrote a letter to Health and Human Services’ Office for Human Research Protections asking to halt it.

West Virginia has a high number of adults with pre-existing conditions. One third of adults in West Virginia have pre-existing health conditions, according to a new analysis released Tuesday, a statistic that could prove useful to Democratic senator Joe Manchin as he campaigns hard on the healthcare issue in this year’s midterm election. In Charleston, W.Va., 38 percent of the adults have a pre-existing condition, said a new analysis from the research firm Kaiser Family Foundation. Bristol, a town that straddles the border between Tennessee and Virginia, had the highest percentage of adults with a pre-existing condition, with 41 percent.  Manchin is making his support for pre-existing condition protections a major plank of his re-election campaign this fall. His opponent is Republican state Attorney General Patrick Morrisey, who signed on to a lawsuit with 19 other states that seeks to strike down Obamacare and the protections. Manchin has repeatedly touted his support for Obamacare’s pre-existing condition provisions, including in multiple campaign events. He is running in a state that President Trump won by more than 30 percentage points in 2016.

RUNDOWN

Axios A trade deal with Mexico could have big implications for drug patents

Forbes Can Gavin Newsom turn California into a single payer state?

Politico How the opioid crackdown is backfiring

Kaiser Health News Suicide by opioid: New research suggests overdoses should be classified as self-harm

Reuters Almost one in 20 U.S. adults now use e-cigarettes

New York Times How to tame healthcare spending? Here’s a one-percent solution

Texas Tribune To pay for trauma centers, state program sinks thousands of Texas drivers into debt