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Vulnerable Republicans bury Obamacare repeal vote. Shortly after the House narrowly passed a bill to repeal and replace Obamacare in the spring of 2017, a majority of the House Republican Conference headed to the White House for a major celebration with President Trump. But now with their majority in jeopardy, several vulnerable House Republicans are softening their rhetoric surrounding Obamacare and avoiding reference to the vote that led to that celebration. Polling indicates that healthcare is a top issue for voters and that the effort to repeal Obamacare was unpopular. Rep. Cathy McMorris Rodgers, R-Wash., a member of House leadership who attended the May 2017 Rose Garden ceremony and is in a tough re-election race, does not even list Obamacare on her campaign website. The site does, however, tout her votes to reauthorize the Children’s Health Insurance Program and her support for several other healthcare bills. Same goes for Rep. Tom MacArthur, R-N.J., who was instrumental in getting the bill through the House by getting the Freedom Caucus on board with a critical amendment. MacArthur’s campaign website does not make any mention of the amendment. MacArthur opposed “his own party’s efforts at a speedy Obamacare repeal,” the campaign website said. MacArthur did not elaborate what he was referring to. MacArthur did vote in favor of the final Obamacare repeal bill that passed in May, a fact not listed on his website. It was MacArthur’s amendment, which provided some wiggle room to states to waiver some Obamacare regulations, that led to criticism from Democrats that Republicans voted against pre-existing conditions.

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Mitch McConnell blames entitlement programs for rising deficit. Senate Majority Leader Mitch McConnell on Tuesday blamed “bipartisan reluctance” to reform federal entitlement programs for the rising federal deficit, which the Treasury Department said Monday reached $779 billion in 2018. “There’s been a bipartisan reluctance to tackle entitlement changes because of the popularity of those programs,” McConnell told Bloomberg News. “Hopefully at some point here, we’ll get serious about this. We haven’t been yet.” McConnell added that he thought the Obama administration missed a window of opportunity to reform programs like Social Security, Medicare, and Medicaid, which account for about 70 percent of what the federal government spends annually. “We had that opportunity during the Obama years, and I talked to President Obama about it a number of times, and it would’ve been the perfect time to do it,” said McConnell. “Think of Reagan and Tip O’Neill coming together in the early ‘80s to raise the age for Social Security. It took it out of the political arena and made it possible to be successful. Added the Kentucky Republican: “That’s what we had the chance to do during the Obama years because we had divided government for six of the eight years, unfortunately it was not achieved.”

Odd stance for McConnell. It’s odd for a majority leader to suggest that when his own party has total control of Washington, it becomes harder to address a serious issue. During the six years he’s talking about (January 2011— January 2017), Democrats controlled the White House and Senate for four of those years. By the time Republicans gained control of the Senate in January 2015, Obama was essentially a lame duck. So it’s a bit odd to say that the best time to address a major problem is when Republicans are in the opposition. Since Republicans took over the unified control, they failed to repeal Obamacare, which could have reduced spending if done properly, and then they passed a large tax cut, which reduced revenues and increased deficits. They have not restrained spending growth to offset the reduction in revenue. 

CMS: New Medicaid chief won’t have to recuse herself from working with Maine. Mary Mayhew, who started her role as deputy administrator and director of the Center for Medicaid and CHIP Services on Monday, will not to recuse herself from working with the state where she served as the top health official, but will do so anyway, according to CMS. “As she left her employment with the state over a year ago, Director Mayhew does not have a recusal obligation under law or regulation with regard to her work in the state of Maine,” a CMS official said. “However, in order to avoid even the appearance of any conflict of interest or undue influence, Director Mayhew is recusing herself from participation in any particular matters in which Maine is a party or represents a party, including its pending State Plan Amendment.” The agency released the clarification in response to media speculation on the matter.

Government scientists perplexed over sudden spread of severe, polio-like illness. The Centers for Disease Control and Prevention has been unable to get to the bottom of the sudden spike in a rare illness that paralyzes children. “I am frustrated that despite all of our efforts we have not been able to find the cause of this mystery illness,” Dr. Nancy Messonnier, director at the CDC’s National Center for Immunization and Respiratory Diseases, said in a call with reporters Tuesday. Officials describe the illness, known as acute flaccid myelitis, or AFM, as similar to polio. It affects the nervous system by weakening patients’ muscles, making moving difficult and causing a facial droop as well as slurred speech. Health officials suspect as many as 127 people are infected across 22 states, where they are under investigation.

Alabama House members write letter of support for Medicaid work requirements. All but one representative from Alabama in the House has signed onto a letter of support for Medicaid work requirements in Alabama. The public comment period for the work requirement ends on Sunday, and if the Trump administration approves it soon then the state would be the first to have the requirements despite the fact that it hasn’t used Obamacare’s expansion. “Reformers are really watching Alabama to see what CMS might do with it,” said Kristina Rasmussen, vice president of federal affairs for the conservative Foundation for Government Accountability. “It is so well written that it could turn into a template for other states, particularly non-expansion states.”

Health CEO pleads guilty for $150 million healthcare fraud involving unnecessary prescriptions of opioids. A healthcare CEO pleaded guilty to a scheme that distributed more than 6.6 million opioids and the administration of medically unnecessary injections. Mashiyat Rashid, the CEO of the Tri-County Wellness Group of medical providers in Ohio and Michigan, pled guilty to one count of conspiracy to commit healthcare fraud, wire fraud and a count of money laundering, according to the Justice Department. Rashid admitted to conspiring with physicians to require Medicare beneficiaries that wanted controlled substances to also get medically unnecessary injections. “Rashid paid physicians based on the number of injections that Medicare paid for, regardless of the medical necessity of the injections,” according to a release from DOJ. “In turn, the physicians conducted these repetitive and unnecessary injections on patients in order to increase revenue for Rashid, themselves, and their co-conspirators.

Minnesota attorney general sues drugmakers over insulin prices. Minnesota Attorney General Lori Swanson is suing the three U.S. major makers of insulin for driving up prices. The lawsuit charges that Sanofi-Aventis, Novo Nordisk and Eli Lilly raised the price of insulin to make it less affordable to patients. “The list price of some insulin products has more than doubled since 2011 and tripled since 2002,” according to a release from the attorney general. It charges that the drug companies fraudulently set an “artificially high ‘list’ price for their insulin products but then negotiated a lower actual price by paying rebates for pharmacy benefit managers.” There isn’t a generic version of insulin, which has been around for decades. Quick reminder that Health and Human Services Secretary Alex Azar was the head of Eli Lilly’s U.S. division and took heat during his confirmation hearing for his ties and the price of insulin.

Smoking one legal joint in Canada could result in ban from US. Foreigners who use marijuana legally in Canada can be banned from entering the U.S. for smoking a single joint, a top border official said Tuesday, on the eve of Canada allowing the drug’s recreational use. Outlining broad discretion for border agents, U.S. Customs and Border Protection executive assistant commissioner Todd Owen said that smoking marijuana could result in being excluded from this country. “Is it possible to be not let into the States by saying, ‘Yes, I did smoke a joint’, or ‘I have smoked in the past?'” Owen was asked. “Yes,” the senior border official replied. “Admission of illegal drug use are [sic] grounds to be found inadmissible into the United States. So yes, that’s possible.”

In the ‘Conners’ premiere, Roseanne Barr killed off by opioid overdose. Roseanne Barr’s eponymous character did die of an opioid overdose. The Tuesday night premiere of the rebooted “Roseanne” spin-off “The Conners” proved actress and comedian Roseanne Barr’s claims last month about how she would be killed off on the show. Although the show first depicts that the Connor family believes Roseanne’s sudden death was from a heart attack, as detailed by CNN, they discover hidden pain pill bottles around the house that she obtained from her neighbors. The uninsured neighbor said she would have never given Roseanne’s character the pills if she knew she had a problem. Barr was dismissed earlier this year for a tweet where she called former Obama aide Valerie Jarrett a mixture between the Muslim Brotherhood and “Planet of the Apes.” The tweet was perceived as racist, leading to the star’s dismissal from ABC hours after she posted it, but Barr maintains that she was not racist and did not know that Jarrett was African-American.

RUNDOWN

NPR Midterm election could reshape health policy

Morning Consult In departure from past elections, seniors lean towards Democrats

CNBC Walgreens wants to be seen as a healthcare company, not just a retailer

New York Times 1,495 Americans describe the financial reality of being really sick

McClatchy As Washington state health insurance premiums soar, candidates point fingers

STAT News Trump wants drug companies to include prices. These five companies have the most at stake

Stateline How fentanyl changes the opioid equation

Reuters Express Scripts covers Amgen, Lilly migraine therapies, excludes Teva drug