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Senate reaches deal to vote on opioid package next week. The Senate will vote next week on a raft of more than 70 proposals to combat the opioid crisis, including a bill to address shipments of illicit fentanyl from overseas. The Opioid Crisis Response Act is the Senate response to a collection of more than 50 opioid-related bills that passed the House in June. Sen. Lamar Alexander, R-Tenn., said late Thursday that there is “bipartisan urgency to work with our House colleagues to get the legislation to the President’s desk.” The legislation includes the Synthetic Trafficking and Overdose Prevention Act that aims to give the U.S. Postal Service more tools to flag suspicious shipments of illicit fentanyl from overseas. Overdoses from fentanyl represent more than half of the roughly 42,000 people who died of an opioid overdose in 2016, according to data from the National Center for Health Statistics.Alexander said in a statement that the legislation also includes new authority for the Food and Drug Administration to install new requirements for the packaging of opioids. Under the proposal, the FDA could require prescription opioids to be packaged in set amounts like a three- or seven-day supply of blister packs, he said. The package will likely pass the Senate by an overwhelming margin, but then the House and Senate must conference to iron out differences between the legislation.

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House panel advances bill to end “gag clauses” that prevent consumers from getting cheaper drugs. A House panel advanced a bill on Friday to ban the use of “gag clauses” in health insurance contracts that prevent consumers from paying lower prices for prescription drugs. The House Energy and Commerce’s health subcommittee unanimously advanced the reform as part of a series of six healthcare bills during a markup hearing on Friday. One of the pieces of legislation is a draft bill that bans private insurers and drug middlemen called pharmacy benefit managers from inserting “gag clauses” into contracts with pharmacists. The clause prohibits the pharmacist from telling a consumer it is cheaper to pay for a drug out of pocket rather than through insurance. The Senate passed a bill on Wednesday that would prohibit such “gag clauses” for seniors on Medicare. Another bill aimed at private plans is still under consideration.

Kavanaugh addresses leaked documents about abortion. Abortion took center stage on the third day of Supreme Court confirmation hearings Thursday after confidential documents were leaked by the New York Times. In those documents, which date back to his time in President George W. Bush’s administration, Kavanaugh questioned whether a consensus existed on Roe v. Wade being “settled law.” In response to an email regarding an opinion piece that would have run under the names of women who opposed abortion, Kavanaugh proposed deleting that phrase, and wrote a note saying, “I am not sure that all legal scholars refer to Roe as the settled law of the land at the Supreme Court level since Court can always overrule its precedent, and three current Justices on the Court would do so.” Kavanaugh did not say in the document what his personal views were on abortion or even whether he personally considered the matter “settled.” He told Sen. Dianne Feinstein, D-Calif., on Thursday that in the email, he meant “the broader point was simply that it was overstating something about legal scholars.” “I’m always concerned about accuracy, and I thought it was not an accurate description of all legal scholars,” he said, adding later that Roe is “an important precedent.” However, he declined to say if he thought Roe was “correct law.”

Delaware Sen. Tom Carper beats back Dem primary challenge from ‘Medicare for All’ backer. Democrat Tom Carper survived the first real primary challenge of his 17-year career representing Delaware in the Senate, beating progressive Kerri Evelyn Harris Thursday night.

Carper’s victory comes after a contentious primary that received increasing national attention in its final weeks as progressives, emboldened by wins in Florida and New York primaries, held out hope that Harris could come from behind. But he won by nearly 30 points. Running on a platform of “Medicare for All” and debt-free college, Harris, 38, attacked Carper for his centrist, business-friendly ways. Carper, 71, lamented the impact Harris could have on Delaware and the Democratic Party writ large if she defeated him, arguing that the space for centrists would shrink in Congress.  Harris tried to make “Medicare for All” a wedge issue in the race, repeatedly attacking Carper for failing to support a single-payer system. Carper has declined to support a bill that would enroll all people in the U.S. into Medicare but said he supports the concept.

Trump returns to Montana to avenge his doctor against Sen. Jon Tester. Trump made his second campaign trip on behalf of Montana GOP Senate candidate Matt Rosendale on Thursday, aiming to lift his chances against incumbent Democratic Sen. Jon Tester, who Trump accuses of defaming his personal physician, scuttling his nomination to lead the Department of Veterans Affairs. Trump fixated on Tester’s role in Dr. Ronny Jackson’s unsuccessful nomination, telling a crowd in Billings, Mont., that “one of the saddest things I have seen” is what Tester “did to a great, great man, Adm. Ronny Jackson. Adm. Jackson was subjected to horrible lies and smears.” “I am a victim of that, too, but I’m sort of getting used to it,” Trump said. Tester was influential in circulating shocking reports of professional misconduct against Jackson, who withdrew his nomination in April. Some of the allegations fell apart under scrutiny and were attributed to a professional rival. “Adm. Jackson, his reputation was attacked, and all of those horrible things that were said about him turned out to be lies and they turned out to be false. Remember?” Trump said. “Ronny Jackson is a doctor, he is an admiral, he is actually the doctor that gave me my physical,” Trump told the crowd. “And he said that I am in great shape. And the Democrats, liberals, deep state, they were very upset to hear that. So they got tougher and tougher and they lied more.”

Most insurers aren’t nervous about losing individual mandate. More than half of health insurers do not expect the zeroing out of Obamacare’s fine on the uninsured will have much impact on enrollment in the exchanges, according to a new survey. The zeroing out of the fine, known as the “individual mandate” fine, goes into effect in 2019 as part of the tax law President Trump signed into law late last year. Whether the mandate had an impact on compelling people to buy health insurance who would otherwise choose to go uninsured has been an central point of debate as Republicans have sought to chip away at Obamacare. The survey, conducted by eHealth, provides additional insight into the issue. It shows that 54 percent of insurers feel fine’s undoing will have little impact on enrollment and that 73 percent concluded it would not impact their strategy. This view deviates from forecasts by the Congressional Budget Office estimating that without a fine, 5 million fewer people would be enrolled in the exchanges, and other estimates from actuaries at the Centers for Medicare and Medicaid Services estimating the number would fall by 2 million.

Bucking predictions, Obamacare shows average premium increases of less than 4 percent. Predictions that Obamacare-related actions by the Trump administration and Republicans would lead to spikes in premiums and insurer exits appear to have been off the mark, a new analysis suggests. The analysis, assembled by the Associated Press and the consulting firm Avalere health, found that premiums for Obamacare customers are expected to rise by a mild 3.6 percent on average, after increasing by an average of 30 percent in 2018 and by an average of 27 percent in 2017. The analysis looks at premiums across 47 states. In 41 of them, premiums are expected to rise by no more than 10 percent, or to fall. Premiums will cost a little over an average of $600 a month.

Hospitals team up to start own drug company. A group of hospitals is teaming up to form a nonprofit that will manufacture generic drugs. The nonprofit rolled out Thursday, called Civica Rx, is intended to help hospitals curb rising prices and drug shortages, and represents about 500 hospitals. The effort is led by Intermountain Healthcare, which is based in Salt Lake City, as well as the Mayo Clinic and HCA Healthcare. Civica Rx is first focusing on getting an adequate supply of generic medicines that are regularly given to patients and then will focus initially on 14 generic drugs. It plans either to make the drugs itself, which will need approval by the Food and Drug Administration, or to contract them out. The nonprofit did not indicate which drugs would be included but said the products would be available as early as 2019. The nonprofit also said that it would be transparent about what the costs are and not institute the same complicated, covert rebate scheme most healthcare systems use, involving insurers and pharmacy benefits managers, which serve as drug middlemen.

Hospital groups aims to tackle long-standing problem. Hospitals have been dealing with shortages of decades-old drugs for years. Some of the more persistent drug shortages include a shortage of saline a few years ago and persistent shortages of sterile injectable drugs. But a major reason for these shortages has been major quality issues at the few drug makers that produce the products. Civica Rx will also need to get FDA approval for new products. While the  agency has taken steps to hasten approval of new products, the timeline for approval can still stretch for months.

More than 4,500 Arkansas residents lost Medicaid coverage due to work rules: Report. Arkansas stripped Medicaid coverage for more than 4,500 state residents because they failed to meet new work requirements, according to a new report. The state’s program is being heavily scrutinized as the Trump administration has encouraged states to add work requirements to their Medicaid program. The 4,574 enrollees had until 9 p.m. on Wednesday to report their work hours or get an exemption for August to restore their coverage or they would be locked out of Medicare for the rest of 2018, according to the Arkansas Democrat Gazette. However, the state said that it can extend the deadline by a month for enrollees that had trouble getting online and using the state’s system to report work hours or apply for an exemption to the work rule.

Maryland charges opioid maker giving kickbacks to doctors. Maryland’s attorney general charged on Thursday that opioid maker Insys Therapeutics and local healthcare providers gave a powerful opioid to patients who didn’t need it, and exacerbated the opioid epidemic in the state. Maryland wants Insys to pay the state more than $20 million it made in revenue from its alleged conduct. Maryland is the latest state to target an opioid maker for deceiving consumers or hiding the abuse potential of opioids. “The allegations against Insys describe a calculated scheme employing doctors, pharmacists and sales reps to increase profits and market share at the expensive of the health and well-being of vulnerable patients,” said Attorney General Brian Frosh in a statement Thursday. The state charges that Insys paid doctors thousands of dollars through a speaker program with the hopes of writing more prescriptions of Subsys, an extremely potent opioid used only for treating cancer pain. If a doctor didn’t fill out enough prescriptions, they didn’t get invited to the program any more. Insys told the Washington Examiner that it doesn’t comment on pending legal proceedings. The company said back in February that it is complying with the state’s investigation into the company.

Maryland isn’t the only state to go after opioid manufacturers. Maryland is the latest state to target opioid makers as the opioid epidemic that federal data shows claimed more than 42,000 lives in 2016 rages on. More than 20 states have sued the drug company Purdue Pharma, maker of popular opioid painkiller Oxycontin, for misleading the public on the abuse potential of the drug.

GOP bill blocks HHS from developing video games. Rep. Ralph Norman, R-S.C., introduced legislation this week that would prevent the Department of Health and Human Services from developing video games, which Norman says is a waste of taxpayer funds. “One example of this is that more than $500,000 was spent developing a video game that encouraged players to eat more fruits and vegetables,” Norman said. “Healthy eating habits are important, however, it is #wasteful to use our taxpayer dollars creating a video game to encourage kids to eat healthier. Additionally, more than $600,000 of taxpayer dollars was given to allow for the development of video games that allowed teenagers to explore their future selves,” he said. Norman’s bill was introduced without any cosponsors, and it wasn’t immediately clear if House GOP leaders were thinking of bringing the bill to the floor.

RUNDOWN

The Hill Trump’s health chief meets with lawmakers on lowering drug prices

CNN Separated families are suing the Trump administration for mental health treatment costs

Politico Murkowski, Collins face new abortion pressure on Kavanaugh

New York Times Future of abortion under a new Supreme Court? Look to Arkansas

STAT News FDA says new limits on foreign scientists makes it harder to attract top talent

Idaho Statesman Newly formed ‘Work, not Obamacare PAC’ to fight Idaho Medicaid expansion

Kaiser Health News The high cost of hope: When the parallel interests of pharma and families collide