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Obamacare premiums drop for the first time. Average premiums on the Obamacare marketplaces are set to drop by an average of 1.5 percent, to $406 a month, in 2019, according to the Trump administration, the first time a decline has happened since the market launched in 2014. The outcomes buck predictions that Obamacare-related actions by the Trump administration and Republicans would lead to spikes in premiums and insurer exits. Instead, 23 more insurers will be entering the exchange and 29 will be expanding, according a report the Trump administration released Thursday. This past year 56 percent of counties had only one insurer offering coverage, but that number has dropped to 39 percent for 2019. Centers for Medicare and Administrator Seema Verma pointed to the results as evidence that the administration’s actions on healthcare were yielding results. On a phone call with reporters Thursday, she said the outcomes had been “gratifying” for her team, saying they had actively worked to stabilize the market and pushing back against charges by critics that the Trump administration had worked to “sabotage the law.” “Despite predictions that our actions would increase rates and destabilize the markets, the opposite has happened,” she said in a statement.

How the premiums fell. The rate changes for 2019 suggest that premiums are stabilizing and that insurers are feeling more confident about doing business in the exchanges. The outcomes also indicate that insurers overshot their rate proposals when they applied to sell plans for this year, meaning that there is a readjustment or leveling out for 2019. Seven states that had been expecting higher increases also moved to lower premiums by getting approval from the Trump administration for a reinsurance program.

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Trump signs bills banning pharmacy ‘gag clauses.’ President Trump has signed two bills into law to block insurers from enforcing “gag clauses” that forbid pharmacies from telling customers about how they can pay less for drugs. The Patient Right to Know Drug Prices Act and the Know the Lowest Price Act are intended to help patients find out whether a prescription would cost less if they were to pay for it out of pocket rather than through their health plans.

Trump had called for the bills to be passed as part of his administration’s larger commitment to reduce prescription drug costs for patients, and the bills had moved easily out of Congress. “If there’s anything bipartisan, it’s lowering drug prices,” Trump said, adding that signing the bill representing him delivering on his healthcare promises. Under the new rules signed into law Wednesday, pharmacists aren’t obligated to tell a customer about the lower cost, but cannot be forced to keep quiet. Alex Azar, secretary of the Department of Health and Human Services, said at the White House that the bill gave patients the “right to know.” “You can ask your pharmacist, ‘Can I pay less for this medicine than my insurance will make me pay?'” he said of the legislation. He vowed more regulatory action on drug prices, saying that the latest move represented only the “tip of the iceberg.”

Senate rejects resolution to curb short-term health plans. The Senate on Wednesday rejected an effort by Democrats block the Trump administration from promoting short-term healthcare plans as an alternative to Obamacare. Though the measure received the support of all 49 Democratic senators, it failed to gain the two Republican votes necessary, as only Sen. Susan Collins, R-Maine, voted in favor. The Senate voted 50-50 on the measure, not quite the majority it needed to pass. The legislative maneuver was part of Democrats’ ongoing strategy to keep healthcare at the center of the conversation ahead of the Nov. 6 midterm elections, and to force Republicans to take a difficult vote on Obamacare. The vote was on a discharge petition by Sen. Tammy Baldwin, D-Wis., to block health insurance companies from selling short-term plans, a type of coverage extended under Trump as an alternative to Obamacare plans that Democrats and the healthcare law’s allies deride as “junk insurance.” Democrats were able to force the vote through the Congressional Review Act, which allows Congress to cancel administration rules with a simple majority vote. The measure would have faced unlikely passage in the House, and the White House had said in a statement of administration policy Tuesday that Trump would veto it.

Democrats hammer Republicans for voting against the resolution. “Democrats and pro-Obamacare allies framed Wednesday’s vote as a reckoning on Republicans’ commitment to protecting people with pre-existing medical conditions, such as cancer, diabetes, and asthma. The Trump-promoted plans aren’t required to cover applicants with pre-existing conditions and can exclude coverage for mental health, maternity care, or prescription drugs. Baldwin, who is up for re-election, said on the Senate floor Wednesday that her latest move was part of her effort to stop the Republican “sabotage” on healthcare. “These junk plans will reduce access to quality plans for millions and increase costs,” Baldwin said.

Republicans counter that Democrats are trying to take away choices for Americans. Republicans said that Democrats want to take away a new affordable option for people who feel that Obamacare is too expensive. They mostly shrugged off concerns from experts that the plans could endanger pre-existing condition protections for people on the exchanges. “Protections for people with pre-existing conditions can remain in place,” said Sen. Ron Johnson, R-Wis. “We are making these health insurance options that are unbelievable affordable.” Johnson is correct that the option to buy more comprehensive plans are available on the exchanges. However, pro-Obamacare groups and Democrats charge that the plans will entice younger and healthier people to leave the exchanges in favor of the cheaper short-term plans. This could destabilize the insurance exchanges, which could endanger access to plans that protect people with pre-existing conditions.

Heller slammed by his opponent. Sen. Dean Heller, R-Nev., the most vulnerable GOP incumbent, voted against the resolution. Minutes after his vote was cast his general election opponent Rep. Jacky Rosen, D-Nev., criticized him for the decision. “Senator Heller has tried to rewrite his record on health care but when push comes to shove, he goes right back to supporting the Republican agenda that makes health care more expensive for hardworking families and attacks protections for Nevadans with pre-existing conditions,” she said.

Murkowski defends her vote against the resolution. Sen. Lisa Murkowski, R-Alaska, said that limited health insurance options in her state were a primary factor in her decision to vote against a Democratic resolution that would have curtailed cheap short-term health plans promoted by the Trump administration as an alternative to Obamacare plans. The centrist GOP senator had voted several times against Obamacare repeal last year. But she said that But Murkowski said that Alaskans need more affordable plan choices. She said that, in 2016, there were 15,000 state residents who paid the individual mandate penalty for not having insurance. The mandate financial penalty will go away in 2019 due to the tax law. “These short-term plans, while not ideal … is an option for them to consider,” she said of the residents that paid the mandate penalty.

Planned Parenthood already plotting response if Roe v Wade is struck down. Planned Parenthood is pushing to create a regional network of abortion providers to help women in states that might outlaw abortion if the Supreme Court strikes down Roe v. Wade, the 1973 ruling that made abortion a constitutional right. Representatives of the women’s health and abortion provider outlined the plan on Wednesday, a day after newly confirmed Justice Brett Kavanaugh heard his first oral arguments at the Supreme Court.

Justice Department approves $69 billion CVS-Aetna merger. The Justice Department has approved a mega-merger between CVS pharmacy chain and insurance giant Aetna, but the companies have to divest their prescription drug business on Medicare to complete the transaction. A major concern on the part of the Justice Department had been on how the merger would affect competition in Medicare Part D, the program’s prescription drug plan. Both CVS and Aetna are major competitors on the sale of Part D plans to Medicare beneficiaries. But those concerns appear to have been abated after Aetna agreed to divest its Medicare Part D business. “Today’s settlement resolves competition concerns posed by this transaction and preserves competition in the sale of Medicare Part D prescription drug plans for individuals,” Assistant Attorney General Makan Delrahim of the Justice Department’s Antitrust Division said in a statement. The Justice Department had worried that the merger would lead to increased prices in the 22 states where Aetna offered Medicare Part D plans. As part of the settlement, Aetna must divest its Medicare Part D business to the insurer WellCare and “allow WellCare the opportunity to hire key employees who currently operate the business,” the department said in a release.

Doctor group said CVS-Aetna should have been blocked. The American Medical Association, the nation’s largest doctor group, said that the merger inadequately protects patients. “We are disappointed that the DOJ did not go further by blocking the CVS-Aetna merger,” the group said in a statement. The AMA had presented evidence arguing that patients would be harmed by the merger because of antitrust issues.

Ways & Means launches investigation into maternal mortality rate. The House Ways & Means Committee launched a probe on Wednesday into the high risk of dying during childbirth. The Alliance for Innovation on Maternal Health released a report that found that women who are giving birth now in the U.S. are at a higher risk of dying than mothers when they gave birth 30 years ago, the committee said in a statement. The investigation will look into ways that federal agencies can help to curb the growing rates. Several other panels are looking into the problem. A subcommittee of the House Energy & Commerce Committee was expected to have a hearing on it in September but it was postponed to a later date. The Senate Health, Education, Labor and Pensions Committee advanced in June the Maternal Health Accountability Act aimed at tackling the issue.  

Flu shot reduces chances of pregnant woman’s hospitalization risk from flu: CDC. Over the past six flu seasons, the flu shot reduced a pregnant woman’s risk of getting hospitalized by about 40 percent, according to the Centers for Disease Control and Prevention. It is the first study to show how vaccination with the flu shot can prevent a flu-related hospitalization. Previous studies have shown that getting the shot can reduce a pregnant woman’s chances of getting the flu, CDC said in a release. “This study’s findings underscore the fact that there is a simple, yet impactful way to reduce the possibility of complications from flu during pregnancy: get a flu shot,” said Allison Naleway, a study co-author, in a statement. CDC looked at records of more than two million women in Australia, Canada, Israel and the U.S. that were pregnant from 2010 to 2016 to identify women who were hospitalized due to the flu.

Patty Murray presses surgeon general for response to STD rise. Sen. Patty Murray, D-Wash., wants Surgeon General Jerome Adams to take action on the rising cases of sexually transmitted diseases in the U.S. Murray sent a letter on Wednesday to Adams bemoaning the rise after declining rates just a few years ago. She wrote the rise dictates a “clear need for federal, state and local public health agencies, providers and policy officials to act immediately.” Murray cited a report last month from the Centers for Disease Control and Prevention that found nearly 2.3 million cases of STDs gonorrhea, syphilis and chlamydia were reported to the agency in 2017, a nine percent increase from 2016.

RUNDOWN

Axios Trump’s health secretary promises ‘more to come’ on drug prices

The Hill Ebola cases spike as nervous communities stop cooperating with healthcare workers

Politico ‘Just ridiculous lies:’ Democrats incensed about misleading GOP ads for Medicare for all

Kaiser Health News Will Maine voters decide to aging in place affordable?

Wall Street Journal Sen. Grassley asks FTC to probe hospital contracts

NPR Ex Pennsylvania Governor Ed Rendell defies Justice Department on supervised injection sites

STAT News With safety and cash at stake, a squabble over drug compounding puts the FDA in a bind