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Little Sisters of the Poor battles states in court over birth control mandate. The Catholic charity Little Sisters of the Poor is fighting an effort by California and Pennsylvania to block the Trump administration’s effort to roll back Obamacare’s birth control mandate. The charity was part of a large lawsuit brought by religious nonprofits that challenged the Obama administration over an Obamacare requirement for employers to provide birth control without requiring a copay from employees. The Trump administration rolled back that mandate last month. However, California and Pennsylvania are suing to preserve the mandate. In response, Little Sisters of the Poor is asking the 9th Circuit Court of Appeals to stop the two states. “No one needs nuns in order to get contraceptives, and no one needs these guys reigniting the last administration’s divisive and unnecessary culture war,” said Mark Rienzi, senior counsel at Becket, the law firm that is representing the Catholic charity.
Massachusetts first state to require birth control coverage without exemptions. Massachusetts Gov. Charlie Baker on Monday signed a bill that would mandate all employers cover birth control regardless of religious or moral objections, pushing back at rules that were activated at the federal level. Baker, a Republican, said on Twitter Monday that his signing of the bill, which was passed along bipartisan lines in the legislature, would ensure “critical access to important contraceptive coverage.” The law goes into effect immediately, but insurers have six months to implement changes. The law in Massachusetts would run counter to federal regulations issued in October, in which the Trump administration rolled back an Obama-era rule that required employers to opt out of birth control coverage each year if they have religious objections. Planned Parenthood urged other states to pass similar legislation. “Birth control coverage is still at risk for women nationwide under the Trump administration,” said Cecile Richards, president of Planned Parenthood Action Fund. “We need everyone — lawmakers on both sides of the aisle, business leaders, artists — to follow Massachusetts’ lead and take action.”
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FDA pushes for generic painkillers harder to abuse. The Food and Drug Administration is moving to spur development of generic and cheaper opioids that are difficult to abuse. The agency released new guidance Tuesday aimed at helping drugmakers develop the products much easier. While there are already some abuse-deterrent painkillers on the market, they are brand-name drugs that are more expensive than a generic. An abuse-deterrent opioid can’t be injected or chewed, common routes of abuse by addicts. It also makes it difficult to crush a tablet to snort it. Federal data shows that 91 Americans die every day from opioid overdoses. The FDA has approved 10 abuse-deterrent opioids, but doctors have been slow to prescribe them, according to FDA Commissioner Scott Gottlieb. A major reason has been price, as generic opioids already on the market don’t have the abuse-deterrent formulation. Gottlieb said the FDA is taking additional steps to help makers of generic abuse-deterrent opioids. These include meeting with generic makers early in the regulatory process to avoid any potential hiccups.
Poll: Public fractured over Obamacare’s individual mandate. Public sentiment over Obamacare’s individual mandate, which requires everyone to buy insurance, is divided, a new poll finds. Nearly 40 percent of respondents in a poll from the left-leaning think tank Urban Institute want the mandate repealed, while another 29.6 percent think it should be kept. About 30 percent of respondents were undecided about its fate. The poll found that most Republicans or leaning Republican, 65.5 percent, favor repeal. In a twist, only 44 percent of Democrats support keeping the mandate. “Among those supporting repeal, 40.5 percent report that their main reason is that people should not be required to have insurance if they don’t want to,” according to a statement. Meanwhile, the main reason adults favor keeping the mandate is to spread the costs of the sick and healthy over an entire risk pool.
Deaths from drugs, alcohol, suicide projected to reach 1.6 million over the next decade. Deaths from these causes were responsible for 350 deaths per day in 2015, or 14 per hour, according to an analysis by Berkeley Research Group and published by the Trust for America’s Health and Well Being Trust. According to the projections, deaths from those causes will reach 192,000 in 2025 from 127,500 deaths in 2015. “These numbers are staggering, tragic and preventable,” John Auerbach, president and CEO of TFAH, said in a call with reporters. He said the illnesses were tied to issues of pain, disconnection, despair and a lack of opportunity. The analysis, called “Pain in the Nation,” also highlights 60 policies that it recommends to reverse those trends, including extensive education about opioid misuse, expanding needle exchange programs, and sending people with addictions to treatment centers rather than jails. On alcohol misuse, the report recommended increasing prices and limiting the times and places in which alcohol can be sold. The alcohol industry has likened such recommendations as Prohibition-era moves that they say could make the problem worse. To prevent suicides, the report recommended anti-bullying programs in schools and better support for veterans.
Trump’s HHS pick worth as much as $20.6 million. President Trump’s nominee for Health and Human Services secretary is worth as much as $20.6 million, according to his newly filed federal disclosures with the Office of Government Ethics. An analysis by the Associated Press found that Alex Azar’s financial portfolio at Eli Lilly, where he was a former president, was worth between $9.5 million and $20.6 million. He was paid $2 million during his final year, which ended in December. Azar wrote in his disclosure that he no longer holds any stock from Lilly. In addition to his earnings from Lilly, he received $1.6 million in severance and sold $3.4 million in stock. He declared between $100,000 and $1 million in capital gains from those sales. Azar has been selected by Trump to replace the former secretary, Dr. Tom Price, who resigned after it was revealed his travel on charter jets during the past year cost the federal government more than $1 million. The first of Azar’s confirmation hearings is scheduled for Nov. 29 in the Senate Health, Education, Labor and Pensions Committee.
Lamar Alexander: Country ‘could use’ bipartisan solution on healthcare. Sen. Lamar Alexander said Monday that he is confident that his Obamacare stabilization package brokered with Sen. Patty Murray, D-Wash., could be passed by the end of the year. The Tennessee Republican and chairman of the Senate Health, Education, Labor and Pensions Committee told CNBC that if President Trump supported the deal, the legislation would be part of Congress’ end-of-year spending deal. But Trump has opposed the deal that would make Obamacare insurer payments for two years, calling the payments “bailouts.” “I think the country could use a bipartisan solution on healthcare, and it wouldn’t hurt the president and Congress one bit to enact one,” he said. The deal would pay insurers cost-sharing reduction payments to reimburse them for lowering co-pays and deductibles for low-income customers on Obamacare’s exchanges, as they are required to do under the law. In exchange, states would get more power to waive Obamacare’s insurer regulations. Trump halted the payments last month, leading insurers to raise premiums on the exchanges by double digits to recoup the cost.
CMS adds hospitals to rural community demonstration. The Centers for Medicare and Medicaid Services announced Monday that 13 hospitals, in addition to 17 previously signed up, were selected to participate in a program in which they will receive Medicare payments for inpatient hospital services. The initiative is a five-year program that was extended through the 21st Century Cures Act. The goal of the program is to test reimbursement for small rural hospitals that are also too large to be considered Qualified Access Hospitals.
RUNDOWN
The Hill Facing hard decisions, health centers plead for restored funding
Kaiser Health News Displaced Puerto Ricans face obstacles to getting healthcare
Roll Call States face children’s health coverage uncertainty
The Oregonian Oregon health agency’s money troubles double in new report
Tampa Bay Times Democratic gubernatorial candidate takes firm stance on Medicaid expansion
Reuters Counting the costs: U.S. hospitals feeling the pain of physician burnout
Wall Street Journal Eli Lilly bets big on insulin delivery devices
New York Times After vote on taxes, spotlight shifts to undecided senators
Calendar
TUESDAY | Nov. 20
Congress is out all week.
THURSDAY | Nov. 23
Nov. 23-24. Thanksgiving holiday. No Daily on Healthcare newsletter.
MONDAY | Nov. 27
Senate in session. House not in session.
TUESDAY | Nov. 27
House in session.
12:30 p.m. House Oversight and Government Reform Committee will hold a field hearing at the Johns Hopkins Hospital in Baltimore to examine the opioid epidemic and the recommendations of President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis.
