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Seema Verma slams Obama administration for ‘soft bigotry of low expectations” on Medicaid. The administrator of the Centers for Medicare and Medicaid Services on Tuesday praised programs that move “working-age, able-bodied adults” out of Medicaid and criticized the Obama administration for focusing its efforts on increasing enrollees rather than helping them move out of poverty. “Believing that community engagement requirements do not support or promote the objectives of Medicaid is a tragic example of the soft bigotry of low expectations consistently espoused by the prior administration. Those days are over,” said Verma, speaking at the National Association of Medicaid Directors annual meeting in Arlington, Va., where she laid out the Trump administration’s goals for the Medicaid program. Verma said the administration would be more likely approve Medicaid waivers that include work requirements. “Let me be clear to everyone in this room,” Verma said. “We will approve proposals that promote community engagement activities. Every American deserves the dignity and respect of high expectations and as public officials we should deliver programs that instill hope and say to each beneficiary that we believe in your potential.”
Kevin Brady not giving up on including individual mandate repeal in tax reform. House Ways and Means Committee Chairman Kevin Brady, R-Texas, isn’t giving up on including a repeal of Obamacare’s individual mandate in the GOP’s tax reform bill. Brady told radio host Hugh Hewitt Tuesday that he is still considering including mandate repeal in the tax bill, which was being marked up by his committee Tuesday. Brady said he is expecting an updated score from the nonpartisan Congressional Budget Office on the impact of including repeal. “I’ve asked for an updated score so I know exactly what that provision would raise,” he said. “We’re listening to our members here in the House about how they’d react to that. And so I’ve been asked to consider it.” President Trump called for the mandate repeal to be included, as have numerous House conservatives. The initial version of the tax reform bill announced last week didn’t include mandate repeal, and it wasn’t included in an amendment to the bill approved by House Ways and Means on Monday, the beginning of the four-day markup.
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FDA, Pentagon in turf war over drug approvals. The Food and Drug Administration is pushing back on an attempt by Congress to give the Department of Defense the power to approve new drugs and medical devices used on the battlefield. FDA Commissioner Scott Gottlieb said Tuesday that he is seeking an alternative to proposed language in the National Defense Authorization Act, which is being negotiated by House and Senate conference members this week. The alternative seeks to head off an agency brawl over the authority for approving new drugs used by service members. “We think keeping it within the FDA’s context is the right thing,” Gottlieb said at an event sponsored by the Hill newspaper. Gottlieb said his compromise would speed approval of drugs and devices designed for troops. The dispute stems from the approval of freeze-dried plasma. A representative for the House Armed Services Committee panel told Politico that freeze-dried plasma hasn’t been approved for 10 years. Gottlieb said he is committed to getting freeze-dried plasma approved quickly, saying it could be done as early as next year.
FDA hints at pulling more opioids from the market. Gottlieb also suggested Tuesday that the agency could push to remove more opioids from shelves. He said the agency is conducting reviews on how opioid painkillers are being abused. The comments come after the FDA made the unprecedented move in June of calling for the opioid Opana Extended Release to be pulled from shelves because of rampant abuse. Gottlieb said Tuesday that FDA is evaluating whether to pull the entire class of drugs that contains the ingredient oxymorphone, which includes Opana. Gottlieb said the June notice on Opana was unprecedented for the FDA. Normally the FDA would call for a drug to be pulled if the risks outweigh the benefits. But for Opana, the FDA pulled it because it was being used via injection.
Major healthcare measures on the ballot today. Voters in several states are heading to the ballot box Tuesday to select local or state representatives, as well as governors, and a handful of them also will be voting on measures that will affect healthcare policy. The referendums include Medicaid expansion in Maine, high drug prices in Ohio, a constitutional convention in New York and tax breaks for disabled veterans in Texas.
House holds off on cutting several Obamacare taxes. The House tax bill will not include repealing Obamacare’s taxes on health insurers and medical device makers, but House leaders promised to take them up after they finish with tax reform. Brady introduced an amendment to the tax reform bill during the committee markup hearing Monday. But Brady touched on the omission of repealing Obamacare’s medical device and insurer tax in the amendment. Brady said Republicans are working with Democrats to create a “common-sense temporary and targeted relief from many of these taxes to be acted on in the House before the end of the year.” He said the taxes would be brought up “separately and immediately after conclusion of our tax reform efforts.”
Democrat: GOP trying to chip away at abortion rights through the tax bill. Abortion politics overtook Monday’s marathon tax bill debate when a Democrat accused the GOP of trying to undo abortion rights by changing a college savings tax break. “The inclusion of this language is yet another Republican attempt to block a woman’s constitutional right to abortion, but this time in the guise of changing the tax code,” Rep. Judy Chu, D-Calif., said in Monday’s markup of the Tax Cuts and Jobs Act. Chu was flagging a provision that would allow parents to designate unborn children as the beneficiaries of section 529 college savings plans. Anti-abortion groups have applauded the provision. In criticizing it Monday, Chu asked the markup’s witness, Joint Committee on Taxation chief of staff Thomas Barthold, what would happen to such an account opened by an expectant mother who suffered a miscarriage. Barthold responded that state governments manage 529 plans and determine what happens in the case of a beneficiary’s death. He also said the status of an unborn child hasn’t similarly been defined elsewhere in the tax code. “This is an attempt by anti-abortion advocates to redefine personhood, but in the tax code,” Chu responded.
Psychology group hits back at Trump’s mental health comments about Texas shooting. President Trump’s assertion that Sunday’s mass shooting at a Texas church was a “mental health problem” is a distraction from finding real solutions to gun violence, according to the American Psychological Association. Trump said Monday that the shooting at First Baptist Church in Sutherland Springs, which left at least 26 people dead, was a “mental health problem” and not a “guns situation.” The association responded on Monday that most people who have mental illness are not violent. “A complex combination of risk factors, including a history of domestic violence, violent misdemeanor crimes and substance use disorders, increases the likelihood of people using a firearm against themselves or others,” American Psychological Association President Antonio Puente said.
Drug Policy Alliance pushes back against drug-induced homicide laws. The opioid epidemic appears to have caused a surge in drug-induced homicide charges, which refers to the crime of selling or sharing drugs that result in a death. According to the Drug Policy Alliance, news articles about individuals charged with or prosecuted for drug-induced homicide have increased more than fourfold, from 363 in 2011 to 1,178 in 2016. Since 2011, Midwestern states Wisconsin, Ohio, Illinois and Minnesota have been the most aggressive in prosecuting drug-induced homicides, with northeastern states Pennsylvania, New Jersey and New York and southern states Louisiana, North Carolina and Tennessee rapidly expanding their use of the laws, according to the report. The alliance said the laws were intended to reach groups of people who traffic drugs, but are instead used by prosecutors against family, friends or low-level sellers. The alliance is concerned that fewer people will seek treatment out of fear of prosecution.
Federal court to hear FEMA case involving churches. A Houston federal court will hear arguments Tuesday in Harvest Family Church v. FEMA, a case that will decide whether flooded houses of worship in Texas can have access to certain disaster relief grants on equal footing with other non-profits. The Becket Fund for Religious Liberty filed a lawsuit against FEMA on behalf of three Texas churches. Since the lawsuit was filed, all three churches were told by government officials that they are not eligible for FEMA aid.
Alzheimer’s bill introduced. The Building Our Largest Dementia Infrastructure for Alzheimer’s Act, introduced in both the House and Senate, would focus on increasing early detection and diagnosis, reducing risk and preventing avoidable hospitalizations. The bill has the support of the Alzheimer’s Association and the Alzheimer’s Impact Movement, which contributed to its proposals and praised its introduction. “Too often, Alzheimer’s and other dementias are viewed just as an aging issue, ignoring the public health consequences of a fatal disease that more than 5 million Americans are living with,” said Harry Johns, Alzheimer’s Association and AIM President and CEO. “The BOLD Infrastructure for Alzheimer’s Act will ensure communities across the country have access to resources to promote effective Alzheimer’s interventions and better cognitive health that can lead to improved health outcomes.”
Democratic senator presses for more opioid funding. Sen. Jeanne Shaheen, D-N.H., said that while combatting the opioid epidemic receives bipartisan support, that support starts to wane when the issue of funding is raised. “There is bipartisan support to address this problem. Now where the support breaks down is around funding issues,” Shaheen said at an event sponsored by the Hill Tuesday. Congress has moved to combat the opioid epidemic legislatively, chiefly through approval of the Comprehensive Addiction and Recovery Act that set up new grant programs for combating opioids but didn’t include new funding. The 21st Century Cures Act, which was signed into law last year, included $1 billion to fight the opioid epidemic. Shaheen said she would push to include more opioid funding in a spending deal to fund the government as the current deal expires Dec. 8.
GAO slams CMS for approach to opioid oversight. The Centers for Medicare and Medicaid Services is not doing nearly enough to identify and prevent opioid abuse, a federal watchdog found. The Government Accountability Office said in a report Monday that CMS doesn’t look into Medicare beneficiaries potentially at risk from taking high doses of opioids. The GAO said CMS does monitor opioid prescriptions to people on Medicare Part D, the program’s drug plan, but lacks information on most beneficiaries at the risk of harm. Because of the lack of oversight, CMS is limited in its ability to assess “progress toward meeting the broader goals of its Opioid Misuse Strategy, which includes activity to reduce the risk of harm from opioid use.” GAO calls for CMS to not only identify beneficiaries at risk for opioid abuse, but also identify healthcare providers who inappropriately prescribe opioids. The Trump administration agreed to the first recommendations but not the requirement that all sponsors identify high-prescribing opioids.
Dems want gun violence committee. A group of House Democrats plans to force an up-or-down vote on a bill that would create a select committee focused on preventing gun violence. Rep. Mike Thompson, D-Calif., will propose a measure this afternoon that would establish a 12-member bipartisan committee to look at mass shooting causes, the gun background check system, how people with a mental illness obtain weapons, and ways to prevent people convicted of domestic violence from purchasing firearms.
RUNDOWN
The Hill GOP unlikely to repeal Obamacare mandate in tax bill
STAT News Scope of opioid lawsuits widens to include hospital accreditor
Axios Valeant sells low-selling female libido drug
Kaiser Health News Ohio’s drug pricing ballot question triggers voter confusion
Reuters Brexit with no deal could cause chaos in drug supply, report warns
Los Angeles Times San Diego’s Hepatitis A outbreak continues to grow, but more slowly
New York Times CVS will offer next-day delivery of prescription drugs
Calendar
TUESDAY | Nov. 7
Nov. 4-8. American Public Health Association 2017 Annual Meeting and Expo. Theme: Creating the Healthiest Nation: Climate Changes Health. Details.
Nov. 5-7. Ritz-Carlton Half Moon Bay. San Francisco. Technomy. Details.
Nov. 6-8. Mandarin Oriental. 18th Annual Pharmaceutical and Medical Device Compliance Congress. Details.
Nov. 6-8. National Association of Medicaid Directors fall conference. Details.
WEDNESDAY | Nov. 8
7:45 a.m. Hamilton Live. 600 14th St. Northwest. Washington Examiner event on “Breaking Down the Tax Reform Bill” with House Speaker Paul Ryan. Details.
8:30 a.m. 400 7th St. SW. Federal Trade Commission workshop on “Examining Competition Issues Related to Prescription Drug Markets.” Details.
10 a.m. Rayburn 2123 House Energy and Commerce hearing on “MACRA and Alternative Payment Models: Developing Options for Value-based Care.” Details.
10:30 a.m. 2175 Rayburn. Education and the Workforce Joint Subcommittee on Early Childhood, Elementary, and Secondary Education and Higher Education and Workforce Development hearing on “Close to Home: How Opioids are Impacting Communities.” Details.
3 p.m. 1330 G St. NW. Kaiser Health News discussion on “Advance Care Planning: What You Need To Know Now.” Details.
3:30 p.m. National Constitution Center. Philadelphia. Axios event on “A New Era in Cancer Innovation” including former Vice President Joe Biden. Details.
THURSDAY | Nov. 9
8:30 a.m. 500 5th St. NW. National Academy of Medicine Culture of Health meeting. Details.
8:30 a.m. 1801 K St. NW. Alliance for Health Policy event on “Care Delivery in the Future: The Role of the Health Care Workforce.” Details.
FRIDAY | Nov. 10
Federal government closed in observance of Veterans Day.
MONDAY | Nov. 13
Nov. 13-15. Crystal Gateway Marriott. National Alliance of Healthcare Purchaser Coalition. Details.
9 a.m. National Press Club. 529 14th St. NW. Alliance for Health Policy event on “Navigating Next Steps on Payment Reform: A Breakfast for Reporters.” Details.
