Overnight Health Care: Trump officials allow states to loosen ObamaCare coverage requirements | GOP lawmakers air concerns with Trump drug price plan | Dem single-payer fight shifting to battle over Medicare 'buy-in' | US life expectancy falls

BY NATHANIEL WEIXEL AND PETER SULLIVAN - 11/29/18 07:42 PM EST 1

We'll be the first to admit there hasn't been a lot of uplifting public health news lately. Today's top stories have the U.S. life expectancy decreasing and the number of uninsured children increasing. Before we get to that, we'll start with today's latest ObamaCare news.

Trump administration allows states to loosen ObamaCare coverage requirements

The Trump administration told states today it will allow them to use ObamaCare insurance subsidies to help people pay for plans that don't meet the law's coverage requirements.

The new use of subsidies is part of a larger push toward giving states more flexibility to waive ObamaCare requirements and pursue conservative health care policies that were previously not allowed under the Obama administration.

So what, specifically, does this mean?

States will now be allowed to subsidize health plans that exist outside the traditional ObamaCare insurance market. They could also reduce subsidies for more comprehensive plans.

Under the examples outlined by CMS Administrator Seema Verma, a state could also create an entirely new subsidy program.

They could base subsidies on age, rather than income, or set income limits higher or lower than the federal requirements.

The administration says it's giving states freedom from ObamaCare limitations.

Is this actually legal? Democrats don't think so. House Energy and Commerce Ranking Member Frank Pallone, Jr. (D-N.J.) and Ways & Means Ranking Member Richard Neal (D-Mass.) sent a letter to administration officials demanding answers. The administration doesn't have to answer, of course, but come January Neal and Pallone will run their respective committees, and will have subpoena power.

Read more on the move here.

U.S. life expectancy falls, driven by suicides and drug overdoses

U.S. life expectancy declined in 2017 as more Americans died of drug overdoses and suicides, furthering a troubling trend of declining lifespans not seen in a century, the Centers for Disease Control and Prevention found in a report released Thursday.

Life expectancy was 78.6 years in 2017, down from 78.7 years in 2016, the CDC said.

Life expectancy also declined in 2015 and stayed flat in 2016, making this the first three-year period of general decline since the late 1910s. That decline took place during World War I and a sweeping flu epidemic -- and before dozens of medical advances.

The CDC blamed the change on drug overdoses and suicides, which reached new highs in 2017.

In 2017, the rate of drug overdose deaths was 9.6 percent higher than in 2016, with 70,237 people dying from drug overdoses, many of them from the epidemic of opioid abuse.

Read more here.

Number of uninsured children increases for first time in a decade

The number of uninsured children in the U.S. increased for the first time in a decade, according to a new report that puts much of the blame on policies spearheaded by Republicans.

An estimated 3.9 million children did not have health insurance in 2017, an increase of 276,000 compared to the previous year, according to the Georgetown University Center for Children and Families.

No state made statistically significant progress on children's coverage last year, despite an improving economy and low unemployment rate, according to the report, which noted that the District of Columbia made substantive gains in 2017.

Researchers said the rising number for states was due to a variety of factors, though they said GOP-led states refusing to expand Medicaid played a major role, as well as Republican efforts in Congress to repeal ObamaCare and cap federal Medicaid funding.

Read more here.

GOP lawmakers air concerns with Trump drug pricing plan to health chief

Republican lawmakers who worked as doctors expressed their concerns about President Trump's controversial proposal to lower drug prices during a meeting with the president's health chief Thursday.

The lawmakers in the GOP Doctors Caucus questioned Secretary of Health and Human Services Alex Azar about a proposal Trump put forward in October to lower certain Medicare drug prices by tying them to lower prices paid in other countries.

The controversy: The proposal was a dramatic departure from the usual Republican position on drug prices, and drew some mild praise from Democrats.

But now GOP lawmakers are airing concerns.

"I would say that the Doc Caucus has concerns but we're happy that they came and explained the program in more detail and what their proposal is," said Rep. Larry Bucshon (R-Ind.), a member of the group of about a dozen GOP lawmakers who are doctors.

Bucshon said he still had concerns after the meeting. He previously called the proposal is too close to "price controls."

We have more on the meeting here.

They weren't the only ones speaking out today about the Trump proposal...

Coalition of patient, industry groups opposes latest Trump drug pricing move

A study released Thursday from Avalere Health and commissioned by the Partnership for Part D Access attempted to push back on the latest drug-pricing move by the Trump administration.

The partnership is composed of companies like Allergan and Takeda, as well as patient advocacy groups like the National Council for Behavioral Health, the National Alliance on Mental Illness and the National Kidney Foundation.

Flashback: Under a proposed rule issued earlier this week, health plans would be allowed to exclude protected drugs with price increases that are greater than inflation, as well as certain new drug formulations that are not a "significant innovation" over the original product.

Currently, private Medicare health plans are required to cover all or "substantially all" drug in six "protected" classes, such as HIV treatments, antidepressants and cancer drugs, regardless of cost.

Findings: The study argues that private Medicare plans already have enough tools to encourage the use of lower-cost drugs in the protected classes. The hope is to convince the administration the current system doesn't need any fixing.

Dem single-payer fight shifting to battle over Medicare 'buy-in'

Momentum is building among House Democrats for a more moderate alternative to single-payer health-care legislation.

The legislation, which would allow people aged 50 to 65 to buy Medicare, is being championed by Rep. Brian Higgins (D-N.Y.), who supported House Minority Nancy Pelosi (D-Calif.) for Speaker in exchange for a commitment to work on his bill when Democrats take control of the House early next year.

This sounds familiar: There are other similar bills in the House and Senate. Hillary Clinton offered a similar proposal when she ran for president in 2016. Former President Bill Clinton also proposed expanding Medicare in 1998 by allowing certain workers between the ages of 55 and 65 to buy Medicare.

But what about single payer? Higgins said a Medicare buy-in can be a bridge to "Medicare for all." It's also cheaper and quicker to implement. But some progressive single-payer advocates don't think it goes far enough.

Rep. Pramila Jayapal (D-Wash.), who is co-chair of the Medicare for All Caucus in the House, told The Hill said she has spoken with Higgins and expressed her concerns about his bill.

"We have to be careful not to perpetuate the system we have," Jayapal said. "I would prefer to have a reduction of the age of Medicare so that more people could qualify but not a buy-in, because that continues the problems that we have right now."

https://thehill.com/policy/healthcare/overnights/419009-overnight-health-care-trump-administration-allows-states-to-loosen