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Trump administration plays regulatory hardball in drug-price talks. The Trump administration is threatening drug manufacturers with enhanced regulations as part of an aggressive behind-the-scenes campaign to win lower prices for prescription treatments, according to people familiar with the talks.The effort follows President Trump’s proclamation last month that drug companies were preparing to announce “massive” cuts on the price of prescription treatments. The sources say no plans were in the works prior to that statement, and now federal officials are scrambling to make Trump’s statement a reality. The Department of Health and Human Services has held a slew of meetings with more than a dozen pharmaceutical companies over the past few weeks, and agency representatives have told manufacturers they must reduce the price of prescription treatments, or the agency will move forward on more stringent regulations than those suggested so far. The agency threatened to launch a sweeping initiative that could, among other things, affect federal reimbursement for some of the industry’s more innovative and lucrative treatments. HHS also has pressured companies to ignore long-standing policies and procedures that could prevent the drugmakers from independently announcing price cuts, the sources told the Washington Examiner. The discussions have yet to result in any public announcement on reduced drug prices.

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Obamacare off-exchange plans drop off by half, study finds. The number of health insurance plans sold outside of Obamacare’s exchanges fell by half in 2018, according to a study by the Robert Wood Johnson Foundation. Plans sold outside the exchanges fell from 8,700 in 2017 to about 4,000 in 2018. Eight states had no plans that were sold outside the exchanges in 2018, compared with five in 2017. The plans are sold outside of the exchanges but still have the same requirements, including that they must cover a range of medical services and cannot turn away customers with pre-existing conditions, such as diabetes or cancer, and cannot charge them more than healthier patients. They differ from health insurance offered on the exchanges because they do not provide federal subsidies that make health insurance less expensive. Authors of the report believe the trend will continue because congressional Republicans eliminated the Obamacare fine for going uninsured beginning in 2019, known as the individual mandate. The Trump administration also is providing people with alternatives for health insurance that will be less expensive but are likely to cover fewer medical benefits than Obamacare plans do.

Obamacare insurers on track to see most profitable year yet, study says. Health insurance companies are making more money than ever from selling Obamacare plans, according to an analysis by the Kaiser Family Foundation. The organization found that in the first quarter of 2018, health insurers posted a better financial performance than any other year of Obamacare, which started in 2014. The levels of profitability are on track to be about the same as they were before Obamacare went into law.

Trump’s VA pick up for confirmation hearing. Trump’s nominee to lead the Department of Veterans Affairs will face the Senate Veterans Affairs Committee this afternoon. Robert Wilkie, a top Pentagon official, is under scrutiny for defending controversial policies in his career as a Senate Republican aide during the 1990s, including pushing back on a resolution that called for equal pay for women and supporting an organization that wanted to incorporate the Confederate flag in its logo. Wilkie denounced Martin Luther King Jr. and described homosexuals as “weak, morally sick wretches,” per the Washington Post. In addition, he worked for former Senate Majority Leader Trent Lott, R-Miss., and defended him in 2003 after he lost his leadership role for praising Strom Thurmond’s 1948 pro-segregation presidential campaign. After leaving Congress, Wilkie – an officer in the Air Force Reserve – served as assistant secretary of defense during President George W. Bush’s administration from 2005 to 2009.

Voters support making drug companies post prices on ads: Poll. Seventy-six percent of the public supports Trump’s proposal to require drugmakers to post their list prices on commercials, according to the results of a new poll from the Kaiser Family Foundation. Roughly one in seven people who have seen commercials about drugs have discussed them with their doctors, and of those individuals, about half discussed the price of the drugs with their doctor, the poll found. Fifty-seven percent of voters say that a candidate’s support for passing bills to bring down prescription drug costs is a very important, though not the most important, factor in their vote.

Healthcare low on the list of factors driving people to vote. Roughly one in 10 voters said that a candidate’s support for a variety of different healthcare positions was the “single most important factor” in which candidate they would choose, according to the Kaiser Family Foundation poll. Only 11 percent reported that a candidate’s support for moving all people onto Medicare was a driving factor in their vote. The poll did not ask voters whether they personally supported the provision or whether supporting such a system would motivate them to vote against the candidate. A slightly higher share, 14 percent, said “continuing protections for people with pre-existing health conditions such as diabetes, cancer, and heart disease” was the “single most important factor” in their vote. This factor ranked higher than all the others voters were asked about, including repealing Obamacare, at 9 percent, passing bills to reduce drug prices, at 8 percent, and passing legislation to stabilize Obamacare, at 7 percent.

Senate HELP addresses healthcare costs. A key Senate panel is hoping to ignite bipartisan work on measures to lower healthcare costs after earlier efforts to stabilize Obamacare collapsed. The Senate Health, Education, Labor and Pensions Committee held a hearing Wednesday on how to reduce healthcare costs, part of an overall effort to address costs by pursuing legislation for bipartisan reforms such as price transparency. HELP Chairman Lamar Alexander, R-Tenn., said the goal of the hearing, which is part of a series, is to understand the true drivers of healthcare costs. “Our goal here is rather than perpetuate the stalemate over health insurance to [move towards a] larger discussion on healthcare costs,” Alexander said. He added that he and ranking member Sen. Patty Murray, D-Wash., “haven’t won any prizes on health insurance.” The comment was a nod to a failed bipartisan effort to stabilize Obamacare’s marketplaces, which collapsed over abortion funding. Several panelists offered their theories on why healthcare is so expensive in the U.S. and ideas for how to lower healthcare costs, including price transparency and competitive bidding for Medicare Advantage plans.

Parents separated from kids at the border sue to be reunited, demand mental health services for emotional trauma. Parents who were separated from their children at the border prior to the Trump administration’s June 20 order to keep family units together are now taking legal action to be reunited with their kids. Three women, each of whom arrived between ports of entry on the southern border with their daughters from Central America, filed a complaint in the U.S. District Court for the Central District in California through attorneys from Public Counsel and Sidley Austin LLP Tuesday asking all parents be reunited with their children, given mental health services to deal with the trauma of being separated, and be released from federal custody. The three plaintiffs are being held in detention in California and Washington while their children are in Arizona and Texas.

Bills tackling maternal health, premature births sail out of Senate panel. Bills to reduce premature births and deaths from childbirth passed Tuesday among healthcare measures advanced by voice vote in a key Senate panel. The Senate Health, Education, Labor and Pensions Committee advanced the Maternal Health Accountability Act, which would allow the federal government to support the creation of maternal mortality review committees in states. The committees are made up of epidemiologists, ob-gyns, social workers, and others to study maternal deaths and make recommendations about how they can be prevented. It isn’t clear why deaths related to childbirth and pregnancy are happening, but the numbers appear to be rising — a trend not observed in other developed countries — and many are linked to conditions involving bleeding or high blood pressure. They are particularly high among black women.”The numbers of mothers who die of childbirth in this country has been to high for too long, and we know too little about it,” said Sen. Patty Murray of Washington, the top Democrat on the committee.

Appropriations bill adds $3.7 billion for fighting opioid epidemic. An appropriations bill released Tuesday includes $3.7 billion to help treat the opioid crisis. The bill would fund HHS and several other agencies for fiscal 2019. It follows $3.3 billion that was added to a March spending bill that funds the federal government through September. Sen. Roy Blunt, R-Mo., chairman of the appropriations subcommittee that focuses on HHS, said the bill provides flexible funding for states. “This bill directs resources to the hardest-hit states and rural communities, which are affected [by the opioid crisis] at a higher rate than urban or suburban areas,” Blunt said. A large majority of the funding, $1.5 billion, would go to states through grants. Another $476 million would go to the Centers for Disease Control and Prevention for opioid overdose prevention and surveillance, including a public awareness campaign. Community health centers would receive $200 million to support and enhance services for substance abuse and mental health.

Schumer unveils bill to decriminalize marijuana. Marijuana would be decriminalized at the federal level under legislation formally introduced Wednesday by Senate Minority Leader Chuck Schumer, D-N.Y. His bill, the Marijuana Freedom and Opportunity Act, would establish “dedicated funding streams” for women and minority businesses to grow and distribute the drug. “The time to decriminalize marijuana is now,” Schumer said, adding that his bill was “about giving states the freedom to be the laboratories that they should be.” 

RUNDOWN

Kaiser Health News ‘You can’t have perfection:’ Lawmakers who forged ACA look back

San Jose Mercury News Two doors apart, Planned Parenthood and a pro-life pregnancy center react to Supreme Court ruling

STAT News Ariadne Labs: Atul Gawande’s testing ground for new ideas in healthcare

Des Moines Register Why did Iowa Medicaid savings estimates abruptly triple? Director offers an explanation

NPR What can cancer specialists learn from patients who beat all the odds?

Reuters AstraZeneca, Merck eye $1 billion boost from cancer drug success