/Overnight Health Care — Presented by PCMA — Trump health chief reveals talks with states on Medicaid block grants | New head of FDA faces tough test | Trump officials defends work requirements in court

Overnight Health Care — Presented by PCMA — Trump health chief reveals talks with states on Medicaid block grants | New head of FDA faces tough test | Trump officials defends work requirements in court

Overnight Health Care — Presented by PCMA — Trump health chief reveals talks with states on Medicaid block grants | New head of FDA faces tough test | Trump officials defends work requirements in court

Welcome to Thursday’s Overnight Health Care.

Today, Health Secretary Alex Azar told lawmakers he has been in talks with states about block granting Medicaid, Trump’s revamped AIDS council met for the first time, the administration was back in court defending Medicaid work requirements, and public health advocates are watching the new acting FDA chief.

We’ll start with news on Medicaid:


Trump health chief reveals talks with states on Medicaid block grants

There was interesting news at today’s Senate Finance Committee hearing after Sen. Bob CaseyRobert (Bob) Patrick CaseyHere are the Senate Democrats backing a Trump impeachment inquiry over Ukraine call Ex-GOP congressman to lead group to protect Italian products from tariffs The Hill’s Morning Report – Progressives, centrists clash in lively Democratic debate MORE (D-Pa.) pressed Alex Azar on Medicaid.

Azar revealed that his department is in talks with states about instituting block grants in Medicaid without congressional approval.

“We have discussions with states where they will come in and suggest ideas,” Azar said. “There may be states that have asked about block granting, per capita, restructurings around especially expansion populations… It’s at their instigation.”

Why it matters: Imposing block grants in Medicaid has long been a major conservative goal for the health insurance program for the poor.

Allowing states to impose the changes without congressional approval would be extremely controversial in itself and could provoke legal challenges.

Democratic lawmakers fear the changes would force cuts to the program. And during the hearing they pushed Azar for more answers.

We’ve got more form the hearing here.



Trump administration defends work requirements in court

The Trump administration appeared in court Thursday to defend its approval of Medicaid work requirements that opponents say are designed to kick people out of the health care program for the poor.

D.C. District Court Judge James Boasberg heard oral arguments in two separate cases challenging the administration’s approval of programs in Kentucky and Arkansas that require people to work or volunteer 80 hours a month to keep their coverage.

The Department of Health and Human Services (HHS) asked Boasberg to dismiss the lawsuits, arguing that work requirements improve peoples’ lives and health by helping them find jobs.

But Boasberg, an Obama appointee, at times appeared skeptical of the administration’s defense that their efforts met Medicaid’s objective of providing health care to the poor.

“These requirements are intended to make people’s lives better,” said James Burnham, the Department of Justice attorney representing HHS in both cases.

“That’s not the purpose of Medicaid,” said Boasberg, who had previously blocked the Kentucky requirements from taking effect.

What’s next: Boasberg said he would try to issue his rulings, simultaneously, by the end of the month.

More on the legal fight here.


FDA’s new tobacco efforts pose test for new agency chief

The newly named acting commissioner of the Food and Drug Administration (FDA) is poised to take over at a crucial time for the agency, as outgoing Commissioner Scott Gottlieb leaves an ambitious legacy largely unfinished.

President TrumpDonald John TrumpPelosi: Impeachment worth losing House in 2020 Pelosi: Turning Texas blue is ‘our hope for the future’ State Dept. ramps up probe into Clinton email server: report MORE‘s decision to tap Norman “Ned” Sharpless as acting commissioner of the FDA is drawing praise from health advocates, who see it as an opportunity for the agency to continue its work uninterrupted.

The administration is also preaching continuity: “We are going to be carrying forward Dr. Gottlieb’s vision,” Health and Human Services Secretary Alex Azar told House members at a hearing Tuesday, when he made the announcement about Sharpless. “His agenda is my agenda. My agenda is his agenda.”

Could he be permanent? Azar said the administration has already begun the process of finding a permanent replacement, and it’s possible Sharpless will be considered. Sharpless is a close ally of Gottlieb, and he has praised the FDA’s recent actions to curb youth vaping.

‘Acting’ could be drawback: Gottlieb’s push to restrict the sale of e-cigarettes and reduce the levels of tobacco in traditional cigarettes is just getting started. None of the proposals has been implemented, and there’s some concern that an acting commissioner may not have the political capital to press ahead. Many of the most controversial proposals face stiff opposition from industry and some GOP members of Congress.

Read more on the FDA’s new acting chief here.


Speaking of e-cigarettes:


Gottlieb warns Juul, Altria

The outgoing FDA commissioner met with e-cigarette maker Juul and its new investor, the tobacco giant Altria on Wednesday, to discuss their commitments to reducing vaping among teenagers. Gottlieb demanded a meeting with both companies last month, questioning their commitment to keeping their products out of the hands of kids.

In an interview on CNBC Thursday, Gottlieb said he talked with both companies about the future.

He said health officials are in the middle of conducting the 2019 tobacco survey, and if the results show any more of an uptick in youth vaping, the companies should be prepared for major restrictions. Altria in December paid nearly $13 billion for a 35 percent stake in Juul.

“One of the things we’re going to have to examine is whether we take the entire category of pod based e-cigarettes off the market,” Gottlieb said. “At some point the youth use of those products becomes so intolerable that they have no redeeming public health value, and we’ll just have to sweep the market of those products. And that includes Juul.”

Gottlieb noted that Altria had already decided to remove its pod-based e-cigarettes from the market because so many teens were using them.

“But then they went out and made an investment in Juul,” Gottlieb said.


Gillibrand, Gardner team up for opioid bill

Sens. Kirsten GillibrandKirsten GillibrandDNC raises qualifying thresholds for fifth presidential debate The Hill’s 12:30 Report: Trump defends call as Ukraine controversy deepens New Hampshire feels overlooked in Democratic presidential race MORE (D-N.Y.) and Cory GardnerCory Scott GardnerEmbracing President Mike Pence might be GOP’s best play The Hill’s 12:30 Report: Intel chief defends handling of whistleblower complaint The Hill’s Morning Report – Presented by National Association of Manufacturers – Trump, Congress draw battle lines on impeachment MORE (R-Colo.) are introducing a bill to limit initial opioid prescriptions for acute pain to seven days.

They are naming the bill after the late Sen. John McCainJohn Sidney McCainCindy McCain: I can see Arizona ‘going Democrat’ in 2020 Ukraine scandal shows that foreign influence is a bipartisan affair America’s newest comedy troupe: House GOP MORE (R-Ariz.) who sponsored the legislation in the last Congress.

Gillibrand is running for president, while Gardner is facing a tough reelection in Colorado next year.  


Trump’s revamped AIDS council meets for first time

The president’s new advisory panel on HIV/AIDS will meet Thursday and Friday for the first time since President Trump fired all the panel’s members in late 2017.

The council is led by Carl Schmid of The AIDS Institute, a patient advocacy group, as well as Washington state Health Secretary John Wiesman. Both co-chairs were sworn in earlier this year.

Other appointments to the 11-member council include academics, public health officials, and drug company executives. The council is slated to spend two days discussing the administration’s plans to end the HIV epidemic in 10 years, a goal first announced during Trump’s State of the Union address in February.

The council was formed by former President Clinton, with the primary duty of providing advice, information and recommendations to the administration on ways to promote treatment, prevention and cure of HIV/AIDS.

In late December 2017, Trump terminated every member of the panel after six members resigned in protest, saying that Trump doesn’t care about HIV.

Read more here



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What we’re reading

State-run reinsurance programs lowered ObamaCare premiums: Study (Washington Examiner)

How the not-for-profit Civica Rx will disrupt the generic drug industry (Stat News)

Trump pledges support for health programs but his budget takes ‘legs out from underneath the system’ (The Washington Post)

How Eli Lilly’s new generic insulin could impact prices across the market (Kaiser Health News


State by state

Medicaid eligibility change keeps moving in Florida Senate (South Florida Sun Sentinel)

Massachusetts state officials concerned about health care billing surprises (State House News Service)

ACLU wastes no time and sues to block Kentucky’s newest abortion ban (Louisville Courier-Journal)


From The Hill’s opinion page:

Unleash the full potential of the Human Genome Project

Majority of the maternal death-rate is based on race, but we can fix it